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HomeMy WebLinkAboutInsurance Certificate: Rogue Valley Council of Governments ,nco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2015 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 NCONTACT AME: Marcy Baker Ward Insurance Agency PHONE (541) 687-1117 FAX (541)342-8280 A/C., No Ext): -(A/C, No):_ PO BOX 10167 E-MAIL ADDRESS: marey@wardinsurance.net INSURER(S) AFFORDING COVERAGE NAIC # Eugene OR 97440 INSURERA:Special Districts Assn. of Ore INSURED INSURER B Rogue Valley Council of Governments INSURER C PO BOX 3275 INSURER D: INSURER E Central Point OR 97502-0011 INSURER F: COVERAGES CERTIFICATE NUMBER:16/17-2 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 LTR TYPE OF INSURANCE POLICY EFF POLICY EXP POLICY NUMBER I MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY 500,000 EACH OCCURRENCE A CLAIMS-MADE X~ OCCUR DAMAGE TO RENTED j PREMISES (Ea occurrence $ X 31P44372-429 1/1/2016 1/1/2017 MED EXP _(Anyone person) $ PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 11 $ PRO- POLICY ~ i OTHER , JECT LOC PRODUCTS COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 500 , 000 (Ea accident) _ BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED 1 31P44372-429 1/1/2016 1/1/2017 BY INJURY (Per acadent)I $ AUTOS AUTOS _ X HIRED AUTOS 1 X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident $ i -MADE EACH OCCURRENCE $ 5,000,000 UMBRE LABAB ~i-- OCCUR A X EXCESS A' GGREGATE $ 5,000,000 DED RETENTION$ 31P44372-429 1/1/2016 1/1/2017 I$ 'WORKERS COMPENSATION : PER OTH- AND EMPLOYERS' LIABILITY : STATUTE ER N I ANY PROPRIETOR/PARTNER/ Y/ EXECUTIVE I OFFICER/MEMBER EXCLUDED? N/ A li r E L EACH ACCIDENT L$ (Mandatory in NH)E.L DISEASE - EA EMPLOYEE $ If es. describe under : IS DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECTS TO WORK PERFORMED BY THE ROGUE VALLEY COG, SUBJECT TO TERMS & CONDITIONS. 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 KATHY GRIFFIN ACCORDANCE WITH THE POLICY PROVISIONS. CITY HALL ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE Paul Jensen/.EMILY © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (20140) )