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HomeMy WebLinkAboutInsurance Certificate: Center for Non-Profit Legal Services A` ® DATE (MM/DD YVYV) CERTIFICATE OF LIABILITY INSURANCE 6/17/2015 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 Liberty Mutual Insurance NAME: PO Box 188065 PHONE Fairfield, OH 45018 A L Eat ual.com EADDRESS; CLServ?ceCenter(a~LibertyMut/cam 800-845-3666 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : American Fire and. Casualty CompianL_4066._. INSURED INSURER B : _ Center For Non-Profit Legal Service, Inc. PO Box 1586 INSURER C : - - Medford OR 97501 INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 25136233 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. _ INSRA,DDL SU B FIPOLICY EFF POLICY EXPT LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/VYYY MM/DD/YYYV COMMERCIAL GENERAL LIABILITY ✓ BZA56486295 5/15/2015 5/15/2016 EACH OCCURRENCE $ 1,000,000 ✓ DAMAGE TO RENTED 1,000,000 CLAIMS-MADE OCCUR PREMISES (Ea occurrenceL,$_ _ ✓ Business-owners MED EXP (Any one person) $ 15,606 PERSONAL & ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- D LOC 'PRODUCTS -COMP/OP AGG $ 2,000,000 ✓ ! - - - JECT D OTHER: $ COMBINED SINGLE LIMIT A 1,000,000 oMOBIE LIABILITY BZA56486295 5/15/2015 5/15/2016 - Ea accident) $ AUT L - - BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED 'PROPERTY DAMAGE $ HIRED AUTOS ✓ AUTOS l'r(Per accident) $ 7EXCE ELLA LIAB R EACH OCCURRENCE OCCU - - ! SS LIAB C LAIMS-MADE AGGREGATE! RETENTION $ PER OTH- I WORKERS COMPENSATION STATUTE ER AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE rEL: EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑i N / A~ (Mandatory in NH) DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below DISEASE- POLICY LIMIT $ i DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Ashland is listed as Additional Insured Designated Person or Organization perform BP0448. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Christy Blackman ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE Pte, ~~~`.~rGL` Katherine Campbell ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 25136233 56486295 115-16 Master Certificate Katherine Campbell 6/17/2015 1:11:10 PM (PDT) Page 1 of 1