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Home My WebLink AboutInsurance Certificate: SOU Foundation f = E I IA One Bela How, Suite 100 I IJI ICE, COMPANILS Bala Cynw d, Pennsylvania 19004 610.617.7900 fax 610.617.7940 A &UmvlkElr4)l lhe'rrik16N1a rinaGroul] r HLY.com Philadelphia Indemnity Insurance Company COMMON POLICY DECLARATIONS Policy Number: PHSD1103092. Named Insured and Mailing Address: Producer: 108020 Southern Oregon University Foundation Ashland Insurance, Inc 1250 Siskiyou Blvd 585 "A" Street Ashland, OR 97520-5001 P.O. Box 880 Ashland, OR 97520 (541)482-0831 Policy Period From: 12/10/2015 To: 12/10/2016 at 12:01 A.M. Standard Time at your mailing address shown above. Business Description: Non-Profit Organization IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial Property Coverage Part Commercial General Liability Coverage Part Commercial Crime Coverage Part Commercial Inland Marine Coverage Part Commercial Auto Coverage Part Businessowners Workers Compensation Flexi Pius Five 1,760.00 Total $ 1,760.00 FORM (S) AND ENDORSEMENT (S) MADE A PART OF THIS POLICY AT THE TIME OF ISSUE Refer To Forms Schedule 'Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations CPD- PiIC (06/14 Secretary President and CEO Philadelphia Indemnity Insurance Company Form Schedule ® Policy Policy Number: PHSD1103092 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form Edition Description Recurring Payment Flyer 1212 Recurring Payment Flyer CSNotice-1 1014 Making Things Easier BIP-190-1 1298 Commercial Lines Policy Jacket LAH-Notice 0813 Policyholder Notice (Loss Assistance Hotline) PP2015 0615 Privacy Policy Notice CPD-PIIC 0614 Common Policy Declarations Named Insured Sched 0100 Named Insured Schedule IL0985 0108 Disclosure Pursuant To Terrorism Risk Insurance Act Page 1 of 1 Philadelphia Indemnity Insurance Company Named Insured Schedule Policy Number: PHSD1103092 Souther Oregon University Alumni Association Southern Oregon University Chamber Music Concerts Friends of the Hannon Library Friends of hte Schneider Museum of Art Osher Lifelong Learning Institute Raider Club Page 1 of PI-NPD-1 (01-02) ILADELPHIA One Salo Ilozo.. Suite 100 Palo n d, Penns. lvani0 19004 INSURANCE COMPANIES 610.61 7900 Fox 610.E 7.7,040 :4 A1crt$;trs~!'El~e'Pc:ikicr Gromp PHLY.corn FLEXIPLUS FIVE NOT-FOR-PROFIT ORGANIZATION DIRECTORS & OFFICERS LIABILITY INSURANCE EMPLOYMENT PRACTICES LIABILITY INSURANCE FIDUCIARY LIABILITY INSURANCE WORKPLACE VIOLENCE INSURANCE INTERNET LIABILITY INSURANCE Philadelphia Indemnity Insurance Company Policy Number: PHSD1103092 DECLARATIONS NOTICE: EXCEPT TO SUCH EXTENT AS MAY OTHERWISE BE PROVIDED HEREIN, THIS POLICY IS WRITTEN ON A CLAIMS MADE BASIS AND COVERS ONLY THOSE CLAIMS FIRST MADE DURING THE POLICY PERIOD AND REPORTED IN WRITING TO THE INSURER PURSUANT TO THE TERMS HEREIN. THE AMOUNTS INCURRED FOR DEFENSE COST SHALL BE APPLIED AGAINST THE RETENTION. Item 1. Parent Organization and Address: Southern Oregon University Foundation 1250 Siskiyou Blvd Ashland, OR 97520-5001 Internet Address: www. giving.sou.edu Item 2. Policy Period: From: 12/10/2015 To: 12/10/2016 (12:01 A.M. local time at the address shown in Item 1.) Item 3. Limits of Liability: (A) Part 1, D&O Liability: $ 1,000,000 each Policy Period. (B) Part 2, Employment Practices: $ 1,000,000 each Policy Period. (C) Part 3, Fiduciary Liability: $ each Policy Period. (D) Part 4, Workplace Violence: $ each Policy Period. (E) Part 5, Internet Liability: $ each Policy Period. (F) Aggregate, All Parts: $ 11000,000 each Policy Period. Page I of 2 PI-NPD-1 (01-02) Item 4. Retention: (A) Part 1, D&O Liability: $ 10,000 for each Claim under Insuring Agreement B & C. (B) Part 2, Employment Practices: $ 10,000 for each Claim. (C) Part 3, Fiduciary Liability: $ for each Claim. (D) Part 4, Workplace Violence: $ for each Workplace Violence Act. (E) Part 5, Internet Liability: $ for each Claim. Item 5. Prior and Pending Date: Part 1 12/10/2009 Part 2 12/10/2009 Part 3 No Date Applies Part 4 No Date Applies Part 5 No Date Applies Item 6. Premium: Part1 $ 1,645.00 Part 2 $ 115.00 part 3 Part 4 Part 5 State Surcharge/Tax: Total Premium: $ 1, 760.00 Item 7. Endorsements: PER SCHEDULE ATTACHED In witness whereof, the Insurer issuing this Policy has caused this Policy to be signed by its authorized officers, but it shall not be valid unless also signed by the duly authorized representative of the Insurer. Authorized Representative Countersignature Countersignature Date Page 2 of 2