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HomeMy WebLinkAboutInsurance Certificate: Rogue Valley Symphony (2) )m:Terry Friend FaxID:541-772-1906 Page 1 of 5 Date:6122/2015 03:55 PM Page:1 of 5 ROGUE27 OP ID: TF F DATE 22/2015 ) CERTIFICATE OF LIABILITY INSURANCE 06/2212015 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). 'RODUCER CONTACT -NAME Terry Friend 'rotectors Insurance, LLC PHONE Mot Rock Ins Agency LLC (CA) ACC No ,,g, 541-773-5358 we No): 541-772-1906 'O Box 4669 aaoRESS: Aedford, OR 97501 terryf rotectorsins.com ferry ry Friend INSURER(S)AFFORDING COVERAGE NAIC INSURERA:American States Ins Company 19704 INSURED Rogue Valley Symphony Assoc INSURER B: SOU Music Bldg INSURER C: 1250 Siskiyou Blvd - - - Ashland, OR 97520 INSURERD: 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. LIMITS ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM1DDNYYY) (MMIODNYM A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 1,000,00 CLAIMS-MADE occuR X 01 C1252849 09/01/2014 09/01/2015 WAGE RENTED PREMIaES (Ea occurrence) $ MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 1,000,00 PRO- PRODUCTS - COMP/OP AGG $ 1,000,00 X POLICY JECT LOC $ OTHER AUTOMOBILE LIABILITY CO e NE DISINGLE LIMIT _(Ea cid ANY AUTO BODILY INJURY (Fer person) $ ALL OWNED SCHEDULED EODILY INJURY (Per accident) $ AUTOS AUTOS - NON-OWNED PROPERTY DAMAGE $ (Per accident) HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS-MADE DED RETENTION $ $ PER WORKERS COMPENSATION - STATUTE EORTH- AND EMPLOYERS' LIABILITY .~TA YIN ANY FROPRIETOR/FARTNER/EXECUTIVE E1 . EACH ACCIDENT $ OFFICERAAEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEASE - EA, EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS belurv E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, its officers and employees are listed as additional insured per attached endorsement CG7635 0207. CERTIFICATE HOLDER CANCELLATION CITYAS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD >m:Terry Friend Fax]D:541-772-1906 Page 2 of 5 Date:6222015 03:55 PM Page:2 of 5 ~ i~ # r I-1Ce COMMERCIAL GENERAL LIABILITY CG 76 35 02 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ADDITIONAL INSURED - BY WRITTEN lease or occupy, subject to the following CONTRACT, AGREEMENT OR PERMIT, OR additional provisions: SCHEDULE (a) This insurance does not apply to The following paragraph is added to WHO IS AN any p_.e P" Which takps. Harp INSURED (Section II): after you cease to be a tenant in any premises leased to or rented to 4. Any person or organization shown in the Sched- you; ule or for wham you are required by written con- n.+ Thin .1, , r + r„ 11110 ii ~~uraiivc ~ VQO iivt upply Lv tract, agreement or permit to provide insurance any structural alterations, new con- is an insured, subject to the following additional struction or demolition operations provisions: performed by or on behalf of the a. The contract, agreement or permit must be person or organization added as an in effect during the policy period shown in insured; the Declarations, and must have been exe- (2) Your ongoing operations for that in- cuted prior to the "bodily injury", "property sured, whether the work is performed damage", or "personal and advertising by you or for you; injury". (3) The maintenance, operation or use by b. The person or organization added as an in- you of equipment leased to you by such sured by this endorsement is an insured only person or organization, subject to the to the extent you are held liable due to: following additional provisions: (1) The ownership, maintenance or use of (a) This insurance does not apply to that part of premises you own, rent, any -occurrence" which takes place after the equipment lease expires; Includes Copyrighted Material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services, 2001 Safeco and the Safeco bgo are registered trademarKs of Safeco Garporation CG 76 35 02 07 Page 1 of 4 EP )rrn:Terry Friend FaxlD:541-772-1906 Page 3 of 5 Date:622/2015 03:55 PM Page .3 of 5 (b) This insurance does not apply to This exclusion applies even if the claims "bodily injury" or "property dam- against any insured allege negligence or age" arising out of the sole negli- other wrongdoing in the supervision, hiring, gence of such person or employment, training or monitoring of others organization; by that insured, if the "occurrence" which caused the "bodily injury" or "property (4) Permits issued by any state or political damage" involved the ownership, mainte- subdivision with respect to operations nance, use or entrustment to others of any performed by you or on your behalf: aircraft, "auto" or watercraft that is owned subject to the following additional pro- or operated by or rented or loaned to any in- vision: sured. This insurance does not apply to "bodily This exclusion does not apply to: injury", "property damage", or (1) A watercraft while ashore on premises `personal and advertising injury" arising you own or rent; out of operations performed for the state or municipality. (2) A watercraft you do not own that is: c. The insurance with respect to any architect, (a) Less than 52 feet long; and engineer, or surveyor added as an insured (b) Not being used to carry persons or by this endorsement does not apply to property for a charge; `bodily injury", "property damage", or "per- sonal and advertising injury" arising out of (3) Parking an "auto" on, or on the ways the rendering of or the failure to render any next to, premises you own or rent, pro- professionfal services by or for you, includ- vided the auto" is not owned by or ing: rented or loaned to you or the insured; (1) The preparing, approving, or failing to (4) Liability assumed under any "insured prepare or approve maps, drawings, contract" for the ownership, mainte- opinions, reports, surveys, change or- nance or use of aircraft or watercraft; or ders, designs or specifications; and (5) "Bodily injury" or "property damage" arising out of: (2) Supervisory, inspection or engineering services. (a) the operation of machinery or equipment that is attached to, or d. This insurance does not apply to "bodily part of, a land vehicle that wnidri injury" or "property damage" included within qualify under the definition of the "products-completed operations haz- `mobile equipment" if it were not and". subject to a compulsory or financial responsibility law or other motor ve- A person's or organization's status as an insured un- hicle insurance law in the state der this endorsement ends when your operations for where it is licensed or principally that insured are completed. garaged; or (b) the operation of any of the machin- No coverage will be provided if, in the absence of this t listed in Paragraph endorsement, no liability would be imposed by law on ery ery or or f.(3) equipment the definition of you. Coverage shall be limited to the extent of your "mobile equipment". negligence or fault according to the applicable princi- ples of comparative fault. (6) An aircraft you do not own provided it is not operated by any insured. NON-OWNED WATERCRAFT AND NON-OWNED AIRCRAFT LIABILITY TENANTS' PROPERTY DAMAGE LIABILITY Exclusion g. of COVERAGE A (Section 1) is replaced When a Damage To Premises Rented To You Limit is by the following: shown in the Declarations, Exclusion j. of Coverage A, Section I is replaced by the following: g. "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or j• Damage To Property entrustment to others of any aircraft, "auto" Property damage" to: or watercraft owned or operated by or rented , or loaned to any insured. Use includes oper- (1) Property you own, rent, or occupy, including ation and "loading or unloading". any costs or expenses incurred by you, or Page 2 of 4 )nm.Terry Friend FaxID:541-772-1906 Paoe 4 of 5 Date:622=15 03:55 PM PageA of 5 any other person, organization or entity, for WHO IS AN INSURED - MANAGERS repair, replacement, enhancement, restora- tion or maintenance of such property for any The following is added to Paragraph 2.a. of WHO IS reason, including prevention of injury to a AN INSURED (Section II): person or damage to another's property; (2) Premises you sell, give away or abandon, if Paragraph (1) does not apply to executive officers, or the "property damage" arises out of any part to managers at the supervisory level or above. of those premises; SUPPLEMENTARY PAYMENTS -COVERAGES A (3) Property loaned to you; AND B - BAIL BONDS - TIME OFF FROM (4) Personal property in the care, custody or WORK control of the insured; Paragraph 1.b. of SUPPLEMENTARY PAYMENTS - (5) That particular part of real property on which COVERAGES A AND B is replaced by the following: you or any contractors or subcontractors working directly or indirectly on your behalf b. Up to $3,000 for cost of bail bonds required are performing operations, if the "property because of accidents or traffic law violations damage" arises out of those operations, or arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. (6) That particular part of any property that must We do not have to fumish these bonds. be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph 1.d. of SUPPLEMENTARY PAYMENTS - Paragraphs (1), (3) and (4) of this exclusion do COVERAGES A AND B is replaced by the following: not apply to "property damage" (other than d. All reasonable expenses incurred by the in- damage by fire) to premises, including the con- sured at our request to assist us in the in- tents of such premises, rented to you. A separate vestigation or defense of the claim or "suit", limit of insurance applies to Damage To Prem- including actual loss of earnings up to $500 ises Rented To You as described in Section III a day because of time off from work. - Limits Of Insurance. Paragraph (2) of this exclusion does not apply if EMPLOYEES AS INSUREDS - HEALTH CARE the premises are "your work" and were never SERVICES occupied, rented or held for rental by you. Provision 2.a.(1)(d) of WHO IS AN INSURED (Section Paragraphs (3), (4), (5) and (6) of this exclusion 11) is deleted, unless excluded by separate endorse- do not apply to liability assumed under a side- ment. track agreement. Paraaraph (6) of this exclusion does not apply to EXTENDED COVERAGE FOR NEWLY ACQUIRED "Property damage" included in the "products- ORGANIZATIONS completed operations hazard". Provision 3.a. of WHO IS AN INSURED (Section II) is Paragraph 6. of LIMITS OF INSURANCE (Section III) replaced by the following: is replaced by the following: a. Coverage under this provision is afforded 6. Subject to 5. above, the Damage To Premises only until the end of the policy period. Rented To You Limit is the most we will pay un- EXTENDED "PROPERTY DAMAGE" der Coverage A for damages because of "property damage" to any one premises, while Exclusion a. of COVERAGE A (Section 1) is replaced rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by by the following: you with permission of the owner. a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. The Damage To Premises Rented To You limit is the This exclusion does not apply to "bodily injury" higher of the Each Occurrence Limit shown in the or "property damage" resulting from the use of Declarations or the amount shown in the Declarations reasonable force to protect persons or property. as Damage To Premises Rented To You Limit. CG 76 35 02 07 Page 3 of 4 EP Dm -i erry Friend Fax[D:541-772-1906 Page 5 of 5 Date:61222015 03:55 Pfd Page:5 of 5 EXTENDED DEFINITION OF BODILY INJURY interrupted only by a street, roadway, waterway, or right-of-way of a railroad. Paragraph 3. of DEFINITIONS (Section V) is replaced by the following: INCREASED MEDICAL EXPENSE LIMIT 3. `Bodily injury" means bodily injury, sickness or The Medical Expense Limit is amended to $10,000. disease sustained by a person, including mental anguish or death resulting from any of these at KNOWLEDGE OF OCCURRENCE any time. The following is added to Paragraph 2. Duties In The TRANSFER OF RIGHTS OF RECOVERY Event Of Occurrence, Offense, Claim Or Suit of COMMERCIAL GENERAL LIABILITY CONDITIONS The following is added to Paragraph 8. Transfer Of (Section IV): Rights Of Recovery Against Others To Us of COM- MERCIAL GENERAL LIABILITY CONDITIONS (Sec- Knowledge of an "occurrence", claim or "suit" by tion IV): your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an We waive any rights of recovery we may have against officer of the named insured has received such notice any person or organization because of payments we from the agent, servant or employee. make for injury or damage arising out of your ongoing operations or "your work" done under a contract with UNINTENTIONAL FAILURE TO DISCLOSE ALL that person or organization and included in the HAZARDS "products-completed operations hazard". This waiver applies only to a person or organization for whom you The following is added to Paragraph 6. Representa- are required by written contract, agreement or permit tions of COMMERCIAL GENERAL LIABILITY CONDI- to waive these rights of recovery. TIONS (Section IV): AGGREGATE LIMITS OF INSURANCE - PER If you unintentionally fail to disclose any hazards ex- LOCATION isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of For all sums which the insured becomes legally obli- such failure. However, this provision does not affect gated to pay as damages caused by "occurrences" our right to collect additional premium or exercise our under COVERAGE A (Section 1), and for all medical right of cancellation or non-renewal. expenses caused by accidents under COVERAGE C (Section 1), which can be attributed only to operations LIBERALIZATION CLAUSE at a single "location": The following paragraph is added to COMMERCIAL Paragraphs 2.a. and 2.b. of Limits of insurance (Sec- GENERAL LIABILITY CONDITIONS (Section IV): tion 111) apply separately to each of your "locations" owned by or rented to you. 10. If a revision to this Coverage Part, which would provide more coverage with no additional pre- "Location" means premises involving the same or mium, becomes effective during the policy period connecting lots, or premises whose connection is in the state shown in the Declarations, your pol- icy will automatically provide this additional cov- erage on the effective date of the revision. 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