HomeMy WebLinkAboutInsurance Certificate: Youth Symphony of Southern Oregon
I 0 DATE (MM1DD/YYYY)
INSURANCE
ACOR" CERTIFICATE LIABILITY
11/512015
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
Liberty Mutual Insurance NAME
PO Box 188065 PHONE 800-962-7132 FAX
(.A..1C No,_Ext~ (A/C, No: 800 845 3666
Fairfield, OH 45018 E-MAIL
ADDRESS__ BusinessServlce@LlbertyMutual com
INSURER(S) AFFORDING COVERAGE I NAIC #
INSURER A Ohio Casualty Insurance Company 24074
INSURED INSURER B : American Fire and Casualty Cam an 24066
Youth Symphony Of Southern Oregon
PO Box 4291 INSURER C
Medford OR 97501 INSURER D:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 27223056 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.
_ ADDL SUBR.._-._._.. POLICY EFF POLICY EXP
INSR
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDfYYYY MM/DD/YYYY LIMITS
A COMMERCIAL GENERAL LIABILITY BL056812029 11/24/2015 11/24/2016 EACH OCCURRENCE s 1 000,00.0
DAMAGE TO RENTED $ 1 000,000
i CLAIMS -MADE ;OCCUR PREMISES __{Ea occurrence)
MED EXP (Any one person) S 15.000
. .
1,000,000
I PERSONAL & ADV INJURY _ $ I I..
!
GENERAL AGGREGATE 5
GEN'L AGGREGATE LIMIT APPLIES PER 1,000,000
PRO- j PRODUCTS COMP/OP AGG $
✓ POLICY LOC 1,000.000
$
OTHER:
B AUTOMOBILE LIABILITY BAA56812029 11/24/2015 11/24/2016 E~ ~BlcNdeD`SINGLE LIMIT $ 1,000.000
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
✓ HIRED AUTOS _ ✓_j AUTOS ! t_(Per accident)
$
I
UMBRELLA LIAB i._.__ 'OCCUR EACH OCCURRENCE S
.
EXCESS LIAB I CLAIMS-MADE. ;AGGREGATE $
i
!
DED ! RETENTION $ $
WORKERS COMPENSATION I PER ! OTH-
Y/N _i _ST aTUTE _ ER_
AND EMPLOYERS' LIABILITY
I E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE i
j
OFFICER/MEMBER EXCLUDED? ;N/A
(Mandatory in NH) j E.L. DISEASE EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $
I
i
DESCRIPTION OF OPERATIONS I LOCATIONS 1 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
Finance Department ACCORDANCE WITH THE POLICY PROVISIONS.
20 East Main Street
Ashland OR 97520
AUTHORIZED REPRESENTATIVE
Kyle Buchanan
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
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