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Insurance Certificate: Southern Oregon Repertory
/-"Ii SOU6365 OP ID: BK DATE (M .ACORN CERTIFICATE OF LIABILITY INSURANCE 07/2211/1 YYY) `,.i /14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Liberty Mutual Insurance PHONE FAz PO Box 188065 (AIC. No Ext): _ _ _ (AIC, No): Fairfield, OH 45018 E-MAIL PayneWest Insurance, Inc. ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American States Insurance 19704 INSURED Southern Oregon Repertory INSURER B : Singers - - Po Box 1091 INSURER C : Ashland, OR 97520 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDL UBR JEFF 7 POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ _ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 01CH94133760 06101/14 06/01/15 DAMAGE TO ENTER PREMISESEaoccurrence $ 1,000,00 CLAIMS-MADE OCCUR MED EXP (Any one person- - 1U,UU PERSONAL&ADV INJURY $ 1,000,00 - GENERAL AGGREGATE $ 2,000,00 L GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,00 jFCT RO- LOC $ X I POLICY P AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I accident) l $ -i - ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED ,I AUTOS 1. AUTOS BODILY INJURY accident $ - 1 PROPERTY DAMAGE - $ HIREDAUTOS AUTOS OWNED :(Per accident) (Per $ UMBRELLA LIAB _ OCCUR ICI 'EACH OCCURRENCE $ EXCESS LIAB i i I AGGREGATE S CLAIMS MADE DED RETENTION $ $ WORKERS COMPENSATION li WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N TORY LIMITS - _ ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I. i I~I ICI DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) THE CITY OF ASHLAND IS AN ADDITIONAL INSURED IF REQUIRED IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT SUBJECT TO GENERAL LIABILITY ADDITIONAL INSURED PROVISION. CERTIFICATE HOLDER CANCELLATION CITASH5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN THE CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. 20 E MAIN ST ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD