HomeMy WebLinkAboutInsurance Certificate: Youth Symphony of Southern Oregon
A ® FDATE (MMIDD{YYYY)
CERTIFICATE OF LIABILITY INSURANCE 1/1772014
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 Jessica Cleeton _
NAME _
Brown & Brown Northwest PHONE (541)772-1111 FAZ (541)772-3785
3256 Hillcrest Park Drive E-MAIL ADDREss;
INSURER(S) AFFORDING COVERAGE NAIC 0
Medford OR 97504 _ INSURER A:American States Insurance Co 19704
INSURED INSURERB:SAIF Corporation 52412
YOUTH SYMPHONY OF SOUTHERN ORE INSURER C :
PO BOX 4291 INSURER D :
INSURER E
MEDFORD OR 97501 INSURER F
COVERAGES CERTIFICATE NUMBER: 14 15 GL Auto 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 LIP.IITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE ADD( WSUBRI VD I POLICY NUMBER POLICY Y VYY ! MM/ IC
LTR IYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE £ 11000,000 DAMAG X COMMERCIAL GENERAL LIABILITY II 15M,1E1 iE2 oNCOrr nc $ 11000,000
A CLAIMS-MADE OCCUR W1CH65230480 11/29/201411/24/2015 MEDEXPiAnyanepeson; £ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 11000,000
GENT. AGGREGATE LIMIT APPLIES PFR PRODUCTS - COMP OF AGG S 11 000 , 000
PRO- a
X POLICY [7 .C 7 1
AUTOMOBILE LIABILITY I Oh181NEDy SINGLE LIMIT 1,000,000
ANY AUTO l a
A i BODILY INJURY IPe, Gersenl G
ALL OWNED SCHEDULED 101CH65230480 11/24/201911/24/2015
`
AUTOS AUTOS BODILY INJURY ,Pe, acaoenq £
NON-OWNED PROPERTY DAMAGE
X HIRED AUTOS X AUTOS '.Per i ❑r
c
UMBRELLA LIAR OCCUR EACH OCCURRENCE
EXCESS LIAB HCLAIMS-l.AADE AGGREGATE $
DED RETENTIONS $
B WORKERS COMPENSATION rPJC STATU- I 0TH-
: AND EMPLOYERS' LIABILITY Y IN:
ANY PROPRIETOWPARTNER. EXFCUTIVE I--t i ( EL EACH ACCIDENT $
OFFICER MEMBER EXCLUDED"' I kl
(Mandatory in NH) i E L DISEASE - EA EMPLOYE $
if yes desz"Ve untle!
DESCRIPTION OF OPERATIONS telo, EL . DISEASE - POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101. Additional Remarks Schedule, it more space is required)
Re: Verification of Insurance
This form is subject to policy terms, conditions, and exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland Finance Department ACCORDANCE WITH THE POLICY PROVISIONS.
20 East Main Street
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
J Cleeton/JESSCL
ACORD 25 (2010/05) C 1988-2010 ACORD CORPORATION. All rights reserved.
INS025.2)=5l o1 The ACORD name and logo are registered marks of ACORD