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HomeMy WebLinkAboutInsurance Certificate: Ashland School District 5 CERTIFICATE OF COVERAGE DATE 12/18/2015 AGENT THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Northwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3256 Hillcrest Park Drive HOLDER OTHER THAN THOSE PROVIDED IN THE COVERAGE Medford, OR 97504 DOCUMENT. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN. www.bbnw.com COMPANIES AFFORDING COVERAGE NAMED PARTICIPANT COMPANY A: Propegy Casualty Coverage for Education Ashland School District #5 - 885 Siski ou Blvd COMPANY B. Ge-nesis Insurance CompanY_ Ashland OR 97520 - COMPANY C: j COMPANY D: COMPANY E: COVERAGES THIS IS TO CERTIFY THAT COVERAGE DOCUMENTS LISTED HEREIN HAVE BEEN ISSUED TO THE NAMED PARTICIPANT HEREIN FOR THE COVERAGE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH COVERAGE DOCUMENTS. AGGREGATE LIMITS WHICH ARE SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, SUITS OR ACTIONS. THE TITLES REFERENCED UNDER TYPE OF COVERAGE ARE INSERTED SOLELY FOR CONVENIENCE OF REFERENCE AND SHALL NOT BE DEEMED IN ANY WAY TO LIMIT OR EFFECT THE PROVISIONS TO WHICH THEY RELATE. _ COF " EFFECTIVE DATE J EXPIRATION DATE LIMITS LTR TYPE OF INSURANCE COVERAGE DOCUMENT NUMBER MM DNYY MWDD(YYYY GENERAL LIABILITY GENERAL AGGREGATE $ 20,000,000 LEACH OCCURRENCE I $ 500,000 A COMMERCIAL GENERAL LIABILITY 30P60056-106 7/1/2015 7/1/2016 PUBLIC OFFICIALS LIABILITY EMPLOYMENT PRACTICES I i OCCURRENCE AUTOMOBILE LIABILITY GENERAL AGGREGATE $ 20,005,000 1 A $ I ✓ SCHEDULED AUTOS 30P60056-106 71112015 71112016 EACH OCCURRENCE 10,000,000 HIRED AUTOS NON-OWNED AUTOS AUTO PHYSICAL DAMAGE SCHEDULED AUTOS PER SCHEDULE A SCHEDULED AUTOS 30P60056-106 7/112015 7/1/2016 HIRED ANDNON- OWNEDAUTOS $ 100 Comp/500 Coll ✓ 'HIRED AUTOS ✓ NON-OWNED AUTOS EXCESS LIABILITY ! GENERAL AGGREGATE i1[ $ 20,000,000 A ✓OMMERCIAL GENERAL LIABILITY 30P60056-106 7/1/2015 7/1/2016 EACH OCCURRENCE _I; $ 9,500,000 B ✓ PUBLIC OFFICIALS_ LIABILITY ✓ EMPLOYMENT PRACTICES ✓ AUTO LIABILITY PROPERTY it 71 i I ~ I I DESCRIPTION Outdoor Education classes January - May, 2016. CERTIFICATE TYPE EVIDENCE OF INSURANCE CERTIFICATE © ADDITIONAL PARTICIPANT CERTIFICATE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE COVERAGE DOCUMENTS HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, PACE WILL ENDEAVOR TO MAIL City of Ashland, WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE its elected officials, officers & employees TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY Ashland Parks & Recreation Commission 20 E Main Street KIND UPON REPRESENTATIVES.. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Sandy L. Orr 2'1732893 1 15-16 GL/AUTO/UMB Sandy L. Orr 12/18/2015 3:07:00 PM (PST) I Page 1 of 2 a Applicable Coverage Document Definitions: The following definitions are provided solely for convenience of reference and shall not be deemed in ,any way to limit or affect the provisions to which they relate, for complete details on the terms, 'conditions and exclusions of applicable Coverage Documents please refer to the SDAO Liability I Coverage Document. E Participant means: E ~ IThe Named Participant and each of the following while acting within the course and scope of their duties as such: 1. The directors, officers, Employees and agents (pursuant to ORS 30.285) of the Named Participant, including volunteers authorized to act on behalf of the Named Participant, while acting within the scope of their employment or duties, whether arising out of a governmental or proprietary function; and 2. Any board, commission, governmental agency, subdivision, department, municipal body, not-for j profit corporation, association or other unit operated by the Named Participant, or under the Named Participant's jurisdiction, will qualify as a Participant if there is no other similar insurance in place for that organization. k 3. Any person, entity or any organization the Named Participant is required by an Insured Contract to include as a Participant. This coverage will be limited to the extent of coverage ' and Limits of Liability required by the Insured Contract and will not increase the limits s stated in SECTION V. - LIMITS OF LIABILITY or alter any of the terms of coverage stated in this Coverage Document. The Insured Contract must be effective and executed prior to a covered Occurrence or Wrongful Act. In no event shall coverage under this Coverage Document extend to any party for any Claim, Suit or Action, however or whenever asserted, arising out of such party's sole negligence. a. The term "Additional Insured" if used in an Insured Contract shall be understood to mean the same as Additional Participant. Insured Contract means: 1. A lease of premises as it relates to Tort liabilities assumed by the Named Participant arising out of the lease, such assumption occurring in writing prior to the date of Occurrence; 2. A sidetrack agreement; 3. Any easement or license agreement; 4. An obligation, as required by ordinance, to indemnify a Public Body; 5. An elevator maintenance agreement; 6. That part of any other contract or agreement pertaining to the Named Participant's operations i (including an indemnification of a Public Body in connection with work performed by or for a Public Body) under which the Named Participant assumes the Tort liability of another person or entity for Bodily Injury or Property Damage to a third person or organization, provided the Bodily Injury or Property Damage occurs subsequent to the execution of the contract or agreement; and 7. Contracts for services with Public Bodies. Notwithstanding the foregoing, an Insured Contract does not include that part of any contract or ;agreement: 1. That indemnifies an architect, engineer or surveyor acting as an independent contractor for ' injury or Damages arising out of professional errors or omissions; 2. That indemnifies any person or organization for Damages by fire, to premises rented or loaned to the Participant, for an amount greater than $1 million; and 3. That involve the purchase or sale of real property or personal property. 27732893 115.16 GL/AUTO/UMB I Sandy L. Orr 112/18/2015 3:07:00 PM (PST) Page 2 of 2