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HomeMy WebLinkAboutInsurance Certificate: Southern Oregon Film & Media / 1 ® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/30/2015 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 Teresa Bena NAME: JD Fulwiler & Co. Insurance, Inc. PHONE (503)293-8325 FAX (503)293-5418 5727 SW Macadam Ave ADDRESS: thena@jdfulwiler.com PO Box 69508 INSURER(S) AFFORDING COVERAGE NAIC # Portland OR 97239 INSURERA-Ohio Security 24082 INSURED INSURER B Southern Oregon Film and Media DBA: SOFaM INSURERC: PO Box 1265 INSURER D INSURER E Ashland OR 97520 INSURER F COVERAGES CERTIFICATE NUMBER:2015 GL HNOA 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 r-- ~iADDL[SUBRI, - - POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WV POLICY NUMBER MM/DD/YYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY _ EACH OCCURRENCE $ 1,000,000 DAMAGE-TO RENTED 1,000,000 PREMISES( Ea,occurrencel A P i~ CLAIMS-MADE X OCCUR XII, BKS56165730 6/7/2015 6/7/2016 MED EXP (Any one person) $ _15,000 - it - - - PERSONAL &ADV INJUR -.1,000,000 GENERAL AGGREGATE I$ 2,000,000 '~_GEN'L AGGREGATE LIMIT APPLIES PER - PRODUCTS - COMP/OP AGG y X POLICY J JE - LOC - 2,000,000 OTHER: $ AUTOMOBILE LIABILITY F (EOa aBcldeDi51NGLE LIMIT $ INCLUDED ANY AUTO BODILY INJURY (Per person) $ 6/7/2016 BODILY INJURY (Per accident) $ ~ ALL OD OWNED AUTOS X ASCHEDULED UTOS NON-OWNED BK556165730 6/7/2015 PROPERTY DAMAGE y - A H R X AUTOS ! IF Per accident ~ - - - ' EXCESS LIAB i OCCUR EACH OCCURRENCE $ UMBRELLA LIAB CLAIMS-MADE . AGGREGATE $ DED RETENTION $ $ OTH- Y/NL PER NIA STATUTE ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT_$ OFFICER/MEMBER EXCLUDED' . (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ ! DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, its officers and employees are named Additional Insured. All operations of the named insured are subject to policy provisions, conditions and exclusions. 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 Bryn Morrison Finance Dept ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Teresa Bena/PPAYNE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 rgmdnn