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Insurance Certificate: Galli Group PC
9GALLGR OP ID: MW 11123/201 YY) A`CORO CERTIFICATE OF LIABILITY INSURANCE DATE 5 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 Phone: 541-479-5521 NAME: _ Hart Insurance _ Fax: 541-474-1890 a°NN Extl Not P. O. Box 1240 Grants Pass, OR 97528 ADDRESS: Hart Insurance Agency INSURER(S) AFFORDING COVERAGE _ NAIC # " INSURER A: Ohio Security Ins Co 4.1939_ INSURED The Galll Group PC INSURER B : SAIF Corporation 612 NW 3rd Street 'INSURER c Grants Pass, OR 97526 INSURER D : 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. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 BZS56410713 01/11/2016 01/11/2017 DAMAGE TO RENTED 1,000 0O A X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ ' CLAIMS-MADE 4:1 OCCUR MED EXP (Any one person). $ 15,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY PRO LOC $ COMBINED SINGLE LIMIT 1,000,00 AUTOMOBILE LIABILITY Ea accidentZ _ $ B X ANY AUTO BAS56410713 01/11/2016 01/11/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS PROPERTY DAMAGE H AUTOS NON-OWNED Per accident $ _ UMBRELLA LIAB _ OCCUR j EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ RETENTION $ DED WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY 500,00 C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 948255 11/01/2015 11/01/2016 E.L. EACH TORY LIMITS ACCIDENT ER _ _ OFFICER/MEMBER EXCLUDED? ~ NIP' E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) 500,00 If yes, describe underPERATIONS below E.L. DISEASE - POLICY LIMIT $ 50000 DESCRIPTION OF O DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Ashland Loop reservoir project CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E. Main Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Hart Insurance Agency ©1988-2010 ACORD CORPORATIO All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD