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HomeMy WebLinkAboutInsurance Certificate: Children's Dental Clinic 01/05/2016 12:06PM 5417895284 CHILDRENS DENTAL CLH PAGE 03/05 KI Chubb Group of Insurance Companies ForeFront Portfolios" 15 Mountain View Road Warren, New Jersey 07059 For Not-for-Profit Organizations Bugg General Termsand Conditions Section DECLARATIONS FEDERAL INSURANCE COMPANY A stock insurance company, incorporated underthe laws of Indiana, herein called the Company Capital Center, 251 North Illinois, Suite 1100 Indianapolis, IN 46204-1927 Policy Number: 8168-9247 THE DIRECTORS AND OFFICERS LIABILITY AND ENTITY LIABILITY, FIDUCIARY LIABILITY AND EMPLOYMENT PRACTICES LIABILITY COVERAGE SECTIONS (WHICHEVER ARE PURCHASED) PROVIDE CLAIMS MADE COVERAGE, WHICH APPLIES ONLY TO "CLAIMS" FIRST MADE DURING THE "POLICY PERIOD", ORDURING AN APPLICABLE EXTENDED REPORTING PERIOD. THE LIMIT OF LIABILITY TO PAY DAMAGES OR SETTLEMENTS WILL BE REDUCED AND MAY BE EXHAUSTED UNLESS OTHERWISE PROVIDED HEREIN, BY "DEFENSE COSTS," AND "DEFENSE COSTS" WILL BE APPLIED AGAINST THE RETENTION. IN NO EVENT WILL THE COMPANY BE LIABLE FOR "DEFENSE COSTS" OR THE AMOUNT OF ANY JUDGMENT OR SETTLEMENT IN EXCESS OF THE APPLICABLE LIMIT OF LIABILITY. READ THE ENTIRE POLICY CAREFULLY. Item 1. Organization: CHILDREN'S DENTAL CLINIC OF JACKSON COUNTY Principal Address: 229 Stewart Avenue MEDFORD, OR 97504 Item 2. Policy Period: (A) From: 12:01 A_M, on February 1, 2016 (B) To. 12:01 A_ M _ on February 1, 2017 Local time at the address shown in Item 1. Item 3. A Combined Maximum Aggregate Limit of Liability is applicable: 7x Yes F-] No The Combined Maximum Aggregate Limit of Liability for all Claims under all Liability Coverage Sections each Policy Year shall be: $500,000.00 Item4. Coverage is available for the following only: 7 Yes ❑ No Directors & Officers Liability and Entity Liability Coverage Section Yes ❑ No Employment Practices Liability Coverage Section ❑ Yes [S]C No Fiduciary Liability Coverage Section ❑ Yes No Crime Non-Liability Coverage Section ❑ Yes 0 No Kidnap/Ransom and Extortion Non-Liability Coverage Section 14-02-10190 (Ed. 11/2004) Page 1 of 12 01/05/2016 12:06R-9 5417295284 CHILDRENS DENTAL CLH PAGE 04/05 Chubb Group of Insurance Companies ForeFront Portfolio sM 15 Mountain View Road For Not-for-Profit Organizations Warren, New Jersey 07059 Directors & OfficersLiabilltyand Entity Liability Coverage Section DECLARATIONS FEDERAL INSURANCE COMPANY a stock insurance company, incorporated under the laws of Indiana, herein called the Company. THIS COVERAGE SECTION PROVIDES CLAIMS MADE COVERAGE, WHICH APPLIES ONLY TO "CLAIMS" FIRST MADE DURING THE "POLICY PERIOD", OR AN APPLICABLE EXTENDED REPORTING PERIOD. THE LIMIT OF LIABILITY TO PAY "LOSS" WILL BE REDUCED AND MAY BE EXHAUSTED BY "DEFENSE COSTS" UNLESS OTHERWISE SPECIFIED HEREIN, AND "DEFENSE COSTS" WILL BE.APPLIED AGAINST THE RETENTION. IN NO EVENT WILL THE COMPANY BE LIABLE FOR "DEFENSE COSTS" OR THE AMOUNT OF ANY JUDGMENT OR SETTLEMENT IN EXCESS OF THE APPLICABLE LIMIT OF LIABILITY. READ THE ENTIRE POLICY CAREFULLY. Item 1. Organization: CHILDREN'S DENTAL CLINIC OF JACKSON COUNTY 229 Stewart Avenue MEDFORD, OR 97504 Item 2. Limits of Liability: (A) Maximum Limit of Liability for this Coverage Section for all Claims each Policy Year: $500,000.00 (B) Sublimit for all Excess Benefit Transaction Excise Tax: $100,000.00 Note: The Sublimit shown in (B) above is part of, and not in addition to, the Limit of Liability in (A) above. Unless the Defense Outside the Limits of Liability Option is purchased pursuantto Item 5 below, the Limits of Liability will be reduced and may be exhausted by Defense Costs, Item 3_ Retention: (A) Insuring Clause 1: None (B) Insuring Clause 2: $5,000.00 (C) Insuring Clause 3: $5,000.00 Item 4. Pending or Prior Date: February 1, 2002 Item 5. Defense Outside the Limits of Liability Option purchased: Yes © No 14-02-10191 (Ed. 03/2006) Page 1 of 12 01/05/2016 12:06PA 5417095224 CHILDRENS DENTAL CLH PAGE 05/05 ForeFront Portfolio" For Not-for-Profit Organizations G®nersl rarmsand Conditions Section Item 5. Extended Reporting Period: (A) Additional Period: (B) Additional Premium: 1 year 150% of Annual Premium Item 6. Termination of prior policies: 8168-9247 (Feb 1, 2015 -Feb 1, 2016) In witness whereof, the. Company issuing this Policy has caused this Policy to be signed by its authorized officers, but it shall not be valid unless also signed by a duly authorized representative of the Company. FEDERAL INSURANCE COMPANY ~ka~'X~ La. rest en Secretary - 11/18/2015 Date Authorized Represents iw 14-02-10190 (Ed. 11/2004) Page 2 of 12