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HomeMy WebLinkAboutInsurance Certificate: ScienceWorks Hands-On Museum From: Ashland Office #1 Fax: To: 5414885320@rcfax.con Fax: +15414885320 Page 2 of 2 03109/2016 10:32 AM DD/ ACC)Rf3 CERTIFICATE OF LIABILITY INSURANCE 3 FDA/9/2016 3/9/ 16 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 CONTACT NAME: Julie Asher FAX, Ashland Insurance Inc A/CONE Ext : (541) 482-0831 A/C No : (541)488-5851 585 A Street Suite 1 ADDRESS: Dasher@ashlandinsurance. coat P. O. BOX 880 INSURER(S) AFFORDING COVERAGE NAIC # Ashland OR 97520 INSURER A:Non rofit Ins Alliance of CA INSURED INSURER B : ScienceWorks Hands-On Museum INSURER C : 1500 E Main St INSURER D : INSURER E : Ashland OR 97520 INSURER F : COVERAGES CERTIFICATE NUMBER:CL162305993 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. R INSR TYPE OF INSURANCE A D POLICY EFF POLICY EXP INSD VWD POLICY NUMBER MM/DD/YYYY MM/DDNYYY LIMITS $ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR PREMISES TOEao RENTED rence $ 500,000 ccur 2016-24747 2/18/2016 2/18/2017 MEDEXP(Arry one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 Z POLICY PJE -1 RO -CT PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a accident ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DIED % RETENTION$ 10 000 2016-24747-UMB 2/18/2016 2/18/2017 $ VVORKERS COMPENSATION PER OTFI AND EMPLOYERS' LIABILITY Y/ N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Julie Asher/JAA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD I NS025 (201401)