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HomeMy WebLinkAboutInsurance Certificate: Center for Non-Profit Legal Service E (MM/DD/YYYY) ACO 73/28/2016 CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or 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). CONTCT PRODUCER Liberty Mutual Insurance N AMEA PO Box 188065 PHONE 800-962-7132 A/c No : 800-845-3666 Fairfield, OH 45018 E-MAIL ' Ext) L ADDRESS: Busine-s-sService@LibertyMutual.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : American Fire and Casualty Company 24066 INSURED INSURER B : Center For Non-Profit Legal Service, Inc. PO Box 1586 INSURER C Medford OR 97501 INSURER D : INSURER E. I INSURER F : COVERAGES CERTIFICATE NUMBER: 29182937 REVISION NUMBER: THIS IS 10 CERTIFY THAT fHE 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 ADDLiSUBR POLICY EFF POLICY EXP T LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY MM/DD/YYYY A COMMERCIAL GENERAL LIABILITY ✓ j BZA56486295 5/1 5/2016 5/1 5/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 1,000,000 CLAIMS-MADE '~✓JOCCUR PREMISES Ea occurrence ✓ BUSInesSOWners _ MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY E PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 ✓ 1 JECT OTHER: A AUTOMOBILE LIABILITY BZA56486295 5/15/2016 5/15/2017 Ee aBINEDtSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I it I I I DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Ashland is listed as Additional Insured Designated Person or Organization per form BP0448. 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 Attn: Christy Blackman ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE Andrea Richardson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 29182937 1 56486295 1 16-17 Master certificate I Andrea Richardson 1 3/28/2016 2:10:31 PM (EDT) Page 1 of 1