HomeMy WebLinkAboutInsurance Certificate: Catherine Handsford/Hansford Economic r-
DATE (.NM!DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 10/1/2016
THIS CERTIFICATEIS 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).
PRODUCER CONTACT
NAME:
TRUCKEE TAHOE INSURANCE SR`VCS/PHS (~°No,Ext); (AI .No): (888) 443-5112
E-MAIL
DDR
130124 P: F: (888) 443-6112 A
ADDRESS:
PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC~
SAN ANTONIO TX 78265 INSURERA: Se_nt171e1 Iris G LTD
INSURED INSURER B
CATHERINE HANSFORD HANSFORD ECONOMIC INSURER C:
CONSULTING INSURER D
PO BOX 1 0 3 8 4 INSURER E-
TRUCKEE CA 96162 INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
INSR ADDL SUBR POLICY'EFF POLIGI EXP
7I'PE OFIN3 URANCE POLI(.~'NUMBER LItl17TS
L7R A-56 Ty MM/DD,1-1Y 7
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000
CLAIMS-MADE OCCUR DAMAGE TO RENTED $1 000,000
PREMISES (Ea occurrence) 1
A X General Liab x X 57 SBA RE1303 1''`2 ; 2016 10/25/2017 MED EXP (Any one person) $10 0 0 0
,
-1 PERSONAL & ADV INJURY $1,000, 000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2, 000, 000
POLICY[-] PRO JECT LOC PRODUCTS - COMP/OP AGG s2, 000, 000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 0 0 0 0 0 0
(Ea accident) ~ , ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS 7 SBA BH13 0 3 1 0 ~ 25 j 2 016 n/25/2017 BODILY INJURY (Per accident)
A 5
X HIRED X NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE
DE RETENTION $
WORKERS CO-M ENS4770N PER OTH-
1.!'D EVPL0 ERS' L4BL 77y STATUTE ER
ANY PROPRIETORIPARTNERIEXECUTIVEYIN E.L. EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? N/A
(Mandatory in NH ) ❑ E.L. DISEASE- EA EMPLOYEE $
If yes, describe under $
DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICOMRD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insureds Operations. Certificate Holder is an Additional
Insured per the Business Liability Coverage Form SS0008 attached to this
policy. Waiver of Subrogation applies in favor of the Certificate holder per
the Business Liability Coverage Form SS0008 attached to this policy. Coverage
is primary & non-contributory per the Business Liability Coverage Form
CERTIFICATE HOLDER CANCELLATION
City of Ashland, Oregon, and its SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Elected Officials, Officers and BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
employees AUTHORIZED REPRESENTATIVE ti
20 E MAIN STS
ASHLAND, OR 97520
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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