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HomeMy WebLinkAboutInsurance Certificate: Children's Advocacy Center of Jackson County (2) A~~ ® F DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 012 9/2 0 1 4 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). CONTACT PRODUCER Brown & Brown Northwest N AME: Sand L. Orr 3256 Hillcrest Park Drive PHONE FAX Medford, OR 97504 Arc No Ex~_ 541-494-2687 _ A/c No): 541-494.2787 E-MAIL- ADDRESS: sorr(O7bbnW.com INSURERS AFFORDING COVERAGE NAIC # www.bbnw.com INSURER A : Great American Assurance Co INSURED INSURER B : Jackson County Child Abuse Task Force Children's Advocacy Center of Jackson County INSURER C: 816 W 10th Street INSURER D : Medford OR 97501 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 22154547 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 TYPE OF INSURANCE INSD W VD POLICY NUMBER MM/ IDY/YYYY MM LTR / DNYYY LIMITS A COMMERCIAL GENERAL LIABILITY ✓ PAC0629478 11/1/2014 11/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE El/ OCCUR PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 ✓ POLICY a JECOT D LOC PRODUCTS - COMP/OPAGG $ 3,000,000 1 OTHER: $ (Ea COMBINED SINGLE LIMIT $ 1,0_00,0_00 A AUTOMOBILE LIABILITY ICAP0629479 11/1/2014 11/1/2015 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ✓ AUTOS NON-OWNED PROPERTY DAMAGE $ ✓ HIRED AUTOS ✓ AUTOS Per accident $ UMBRELLA LIAB ( OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION ( PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑i ( E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE l $ If yes, describe under I DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ A Professional Liability PAC0629478 11/1/2014 11/1/2015 $1,000,000/$3,000,000 A Abuse & Molestation Liability PAC0629478 11/1/2014 11/1/2015 $1,000,000/$3,000,000 i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder included as respects General Liability when required by written agreement per endorsement attached. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN its officers & employees ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE Sandy L. Orr ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD