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HomeMy WebLinkAboutInsurance Certificate: Hansford Economic DATE (MMIDDIYYYY) ACC~RD~ CERTIFICATE OF LIABILITY INSURANCE 11/14/2016 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 coNracT Lauren Schmidt NAME: Sierra Insurance Associates , Inc . AIC,NN , Ext►: (530) 550-0123 (AIC, No): (530) 550-0102__. Truckee Tahoe Insurance Svcs. E-MAIL Lauren@sierrainsurance.com ADDRESS: _ 12242 Business Park Drive #1 INSURER(S) AFFORDING COVERAGE _ I! NAIC # - Truckee CA 96161 INSURERA:Sentinel Insurance 22403 INSURED INSURERB:S2CUrlt National Insurance Co 19879 Catherine Hansford INSURERC:Markel American Insurance Co. ~ 28932 - DBA: Hansford Economic INSURER D PO Box 10384 INSURER E Truckee CA 96162 INSURER F CO.~ERAGES CERTIFICATE NUI'v96ER:15 C1~KG TnTC Eft) MASTER 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 TYPE OF INSURANCE ADDL SUBR POLICY UMBER 'MMIDDIYYYY MMIDDIYYYY LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 DAMAGE TO RENTED 1, 000 , 000 A CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $ _ 57SBABH1303 10/25/2016 10/25/2017 MED EX~P (Any one person) $ 10 , 000 ~ PE' RSONAL & ADV INJURY $ _ 1, 000 , 00.0 GEN'L AGGREGATE LIMIT APPLIES PER: I , I~ j GENERAL AGGREGATE ~I $ _ 2 , 000 , 000 PRO- ~ ~ I X i JECT ~ I f f RODUCTS -COMP/Of AGG $ 2 , 000 , 000 POLICY ~ LOC I ~ 'i Non-owned ' $ OTHER: AUTOMOBILE LIABILITY ' , COMQINED SINGLE LIMIT I $ 1 , 000, 000 ' ~ Ea accident I _ _ ANY AUTO ~ ~ BODILY INJURY (Per person) A ALL OWNED SCHEDULED ~ i ( ) ! $ 57SBABH1303 10/25/2016 10/25/2017 E30DILY INJURY Per accident AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident - _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE ~ i AGGREGATE ~ $ _ _ DED RETENTION $ I $ WORKERS COMPENSATION ~ x ~I PER , j OTf{_ AND EMPLOYERS' LIABILITY STATUTE ER ANY PROPRIETOR/PARTNERlEXECUTIVE Y~ E.L. EACH ACCIDENT $ _ _1, 000, 000_ OFFICER/MEMQER EXCLUDED? y ~ N I A B (Mandatory in N!i) ~ j QWC1034304 11/3/2016 it 11/3/2017 E.l_ DISEASE FA FMPLOYFE:~ $ 1, 000 , 000 If yes, describe under I i { ~ DESCRIPTION OF OPERATIONS below , E.L. DISEASE -POLICY LIMIT $ 1 000 000 C Professional Liability i MG846153 7/7/2016 7/7/2017 $2,000,OOOPerOccurrence $2,500 Ded $2,000,000 Aggregate DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ashland, Oregon, and its elected officials, officers and employees are included as an Additional Insured as per form SS00080405. 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 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Lauren Schmidt/LS ©1988.2014 ACORDCORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. -Limits Of operations performed by or for that person or Insurance. organization. How this insurance applies when other insurance 9. Additional Insured -Owners, Lessees Or is available to an additional insured is described in Contractors - Scheduled Person Or the Other Insurance Condition in Section E. - Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is Conditions. amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONS shown in the Declarations as an Additional Insured -Owner, Lessees Or Contractors, 1 • "Advertisement" means the widespread public but only with respect to liability for "bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through: in part, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television; behalf: (3) Billboard; (1) In the performance of your ongoing (4) Magazine; operations for the additional (5) Newspaper; insured(s); or (2) In connection with "your work" b. The Internet, but only that part of a web performed for that additional insured site that is about goods, products or and included within the "products- services for the purposes of inducing the completed operations hazard", but sale of goods, products or services; or only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include: "products-completed operations a. The design, printed material, information hazard . or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to "bodily injury", "property b. An interactive conversation between or damage or personal an advertising injury arising out of the rendering of, or among persons through a computer network. the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying "advertisement". services, including: 3. "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form. field orders, change orders, designs or 4. "Auto" means a land motor vehicle, trailer or drawings and specifications; or semi-trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery or or engineering activities. equipment. But "auto" does not include 10. Additional Insured - Co-Owner Of Insured "mobile equipment". Premises 5. "Bodily injury" means physical: WHO IS AN INSURED under Section C. is a. Injury; amended to include as an additional insured b. Sickness; or the person(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured - Co- Owner Of Insured Premises, but only with sustained by a person and, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time. premises shown in the Declarations. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05