HomeMy WebLinkAboutInsurance Certificate: I Secure Inc
EK5-09-22 12:30 Jeff Clark Insurance 541 479 0922 541 488 5311 P 1/2
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■ ACC?R1~1~
■ ~,,,,",r~ CERTIFICATE OF LIABILITY INSURANCE 09122 Y'
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 golicy(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 endorseme s
PROOUCER. CONTACT.::.
Jeff Clark Insurance PHONE FAX
629 S.W. 6th street No ~,,:541-476-7715 T 1", Nol: 541-479-0922
Grants Pass, OR 97526 E-MAIL
RpS?RESS:_„
INSURE- S). AFFORDINGCOVERAGE NAIL iR.
.....!asuftERA:aregnrl_Auto Insurance Co I
INSURED I Secure lne. INSURER.®.i
Po Box 2541 _ -
Grants Pass, OR 97528 INSURER C
INSURER D :
- MURER E
INSURER F
COVERAGES CERTIFICATE NUMBER:, REVISION NUIMABER
THIS 18 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. _
_ W_
POUCYEF
~15R €~)Li'L` t'fcl~
LTR TYPE OF IN9UiLANCE F LIMITS
I ? POLICY NUMBER MMIroD/rYYY- MWDWrfYY -
I j EACH OCCURRENCE $ 1,000,60
A COMMERCIAL GENERAL LIABILITY
CLAUS-MADE X accuR X 10174867 0411512415 04/15/2016 PAmK~~~EN g 100,4
LIMITS AT INCEPTION MED EXP (Any om person) $ 5,0
- - - i
PERSONAL & ADV INJURY $ 1,040,04.
GEN'C AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 2,400,00
POLICY I.- JEQT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: .
COM90,10 SINGLE LIMIT $ 1,04010
iEa
Auro+eoelLE LIABILITY
A ANY AUTO 10 17486T 04/15/201 S 0411512016 B11 B( ORILY INJLiRY (Per person) $
ALL OWNED SCHEDULF33 BODILY INJURY (Per accutent? $
AUTO$ - - ~ AUTOS - : - -
NUN-OWNEO l I ; PR'- ROPSI31Y>PA~-.-
HIRED AUTOS AUTOS leer scddenl)
U1M13RELUi LIA9- DCC'LAIII-110E UR CH OCCURRENCE $ 1,400,00
A I X EXCESSLIAB 014174887 04113/20150411512416AGGREGATE$ 1,000,44
DEO- l flETENTION.$ $
WQfiKERS COMPENSATBON - - - - -
ANO:EMPLOYERS LJABN (TY STATUTE ER
X IANr PROPRIETORlPARTNERIEXECUTIVE Y(IN"I SAIF 735165 Q6ro1IZ41$ 06101I2416-; El. EACH ACC!!}EiVT
I OFFICERJM£M9ER EXCLUDED? NIA
(Maw t.7 frl NH) i EI L LA5E.ASE.- EA EPflPLOYEE S -
liyyas; deex unc9er
I DESCRIPTION OF OPERATIONS'aalow E.L. DISEASE - POLICY LIMIT $
A jEquipmentFloater CIO 174867 04M6=15 0M1572016
A Property Section CIO 174867 44/1612015 0411512016
1
DESCA11PTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORD 101, Addtttoiud Rernts*9 Schedule; may be aNaereed it mme space is required)
The City of Ashland,OR and its elected officials, officers and employees are
tided as Add'1 Insured (per Master Pak Endt#CG8579 5105) but on wittl
respects to the operations of the insured in accordance with the p icy
rms and conditions (Master Pak: Endt #CG8579 5105 applies to General
Liablity, coverages only)
CERTIFICATE HOLDER CANCELLATION
GITYASH
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCI_LLI 0 BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
The City of Ashland ACCORDANCE WITH THE POLICY PROVIgION$.
20 E. Main Street
Ashland, OR 97520 AUTIL0 REPRE TATIVE
01988-20 RD CORPORAT All rig is reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD