HomeMy WebLinkAboutInsurace Certificate: Ashland School District 5
CERTIFICATE OF COVERAGE DATE
6/28/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
AGENT
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
Property Casualty Coverage for Education
COMPANY A:
Ashland School District #5
885 Siskiyou BlvdGenesis Insurance Company
COMPANY B:
Ashland OR 97520
COMPANY C:
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 CONTRACT OR 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 AL L 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.
CO
EFFECTIVE DATEEXPIRATION DATE
LIMITS
COVERAGE DOCUMENT NUMBER
LTRTYPE OF INSURANCE
(MM/DD/YYYY)(MM/DD/YYYY)
GENERAL LIABILITY 20,000,000
GENERAL AGGREGATE
$
31P60056-106
A7/1/20167/1/2017
3
500,000
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
3
PUBLIC OFFICIALS LIABILITY
3
EMPLOYMENT PRACTICES
3
OCCURRENCE
AUTOMOBILE LIABILITY
20,000,000
GENERAL AGGREGATE$
A31P60056-1067/1/20167/1/2017
3
10,000,000
SCHEDULED AUTOS
EACH OCCURRENCE
$
3
HIRED AUTOS
3
NON-OWNED AUTOS
AUTO PHYSICAL DAMAGE
SCHEDULED AUTOSPER SCHEDULE
A31P60056-1067/1/20167/1/2017
HIRED AND NON-
3 SCHEDULED AUTOS
100 Comp/500 Coll
OWNED AUTOS$
3
HIRED AUTOS
3
NON-OWNED AUTOS
20,000,000
EXCESS LIABILITY
$
GENERAL AGGREGATE
A31P60056-1067/1/20167/1/2017
3
9,500,000
COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE
$
3
PUBLIC OFFICIALS LIABILITY
B
3
EMPLOYMENT PRACTICES
3
AUTO LIABILITY
PROPERTY
DESCRIPTION
All operations of the insured that use City of Ashland premises.
3
CERTIFICATE TYPE
EVIDENCE OF INSURANCE CERTIFICATE
ADDITIONAL PARTICIPANT CERTIFICATE
CERTIFICATE HOLDERCANCELLATION
SHOULD ANY OF THE COVERAGE DOCUMENTS HEREIN BE cCANCELLED
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
Ashland Parks & Recreation Commission TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
20 E Main Street
KIND UPON REPRESENTATIVES.
Ashland OR 97520
AUTHORIZED REPRESENTATIVE
Sandy L. Orr
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ApplicableCoverageDocumentDefinitions:
Thefollowingdefinitionsareprovidedsolelyforconvenienceofreferenceandshallnotbedeemedin
anywaytolimitoraffecttheprovisionstowhichtheyrelate,forcompletedetailsontheterms,
conditionsandexclusionsofapplicableCoverageDocumentspleaserefertotheSDAOLiability
CoverageDocument.
Participantmeans:
TheNamedParticipantandeachofthefollowingwhileactingwithinthecourseandscopeoftheir
dutiesassuch:
1.Thedirectors,officers,Employees andagents(pursuanttoORS30.285)ofthe Named
Participant,includingvolunteersauthorizedtoactonbehalfofthe NamedParticipant,while
actingwithinthescopeoftheiremploymentorduties,whetherarisingoutofagovernmentalor
proprietaryfunction;and
2.Anyboard,commission,governmentalagency,subdivision,department,municipalbody,not-for
profitcorporation,associationorotherunitoperatedbythe NamedParticipant,orunderthe
NamedParticipant’s jurisdiction,willqualifyasa Participant ifthereisnoothersimilar
insuranceinplaceforthatorganization.
3.Anyperson,entityoranyorganizationthe NamedParticipant isrequiredbyan Insured
Contract toincludeasa Participant.Thiscoveragewillbelimitedtotheextentofcoverage
and LimitsofLiability requiredbythe InsuredContract andwillnotincreasethelimits
statedinSECTIONV.–LIMITSOFLIABILITYoralteranyofthetermsofcoveragestatedinthis
CoverageDocument.The InsuredContract mustbeeffectiveandexecutedpriortoacovered
Occurrence or WrongfulAct.InnoeventshallcoverageunderthisCoverageDocument
extendtoanypartyforany Claim,SuitorAction,howeverorwheneverasserted,arisingout
ofsuchparty’ssolenegligence.
a.Theterm“AdditionalInsured”ifusedinanInsuredContractshallbeunderstoodtomean
thesameasAdditionalParticipant.
InsuredContractmeans:
1.Aleaseofpremisesasitrelatesto Tort liabilitiesassumedbythe NamedParticipant arising
outofthelease,suchassumptionoccurringinwritingpriortothedateof Occurrence;
2.Asidetrackagreement;
3.Anyeasementorlicenseagreement;
4.Anobligation,asrequiredbyordinance,toindemnifya PublicBody;
5.Anelevatormaintenanceagreement;
6.Thatpartofanyothercontractoragreementpertainingtothe NamedParticipant’s operations
(includinganindemnificationofa PublicBody inconnectionwithworkperformedbyorfora
PublicBody)underwhichthe NamedParticipant assumesthe Tort liabilityofanotherperson
orentityfor BodilyInjury or PropertyDamage toathirdpersonororganization,provided
the BodilyInjury or PropertyDamage occurssubsequenttotheexecutionofthecontractor
agreement;and
7.Contractsforserviceswith PublicBodies.
Notwithstandingtheforegoing,an InsuredContract doesnotincludethatpartofanycontractor
agreement:
1.Thatindemnifiesanarchitect,engineerorsurveyoractingasanindependentcontractorfor
injuryor Damages arisingoutofprofessionalerrorsoromissions;
2.Thatindemnifiesanypersonororganizationfor Damages byfire,topremisesrentedorloaned
tothe Participant,foranamountgreaterthan$1million;and
3.Thatinvolvethepurchaseorsaleofrealpropertyorpersonalproperty.
30643461 | 16-17 GL/AUTO/UMB | Sandy L. Orr | 6/28/2016 11:53:07 AM (PDT) | Page 2 of 2