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HomeMy WebLinkAboutInsurance Certificate: Jackson County FD #3 / 1 AcoR°® CERTIFICATE OF LIABILITY INSU DATE (MM/DDrYYYY) RANCE 12/7/2oi6 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 NAMEACT Dona Holmes WHA Insurance AIONN Ext. (800) 852-6140 A~c No: (541)342-3786 2930 Chad Drive a~DRlESS:dholmes@whainsurance.com _ INSURER(S) AFFORDING COVERAGE NAIC # Eugene OR 97408 INSURERA:S ecial Districts Assoc of OR 1119 INSURED INSURER B :GerieslS IA_SUrariCe Com an Jackson County FD #3 INSURER C 8333 Agate Road INSURER D INSURER E White City OR 97503 INSURER F COVERAGES CERTIFICATE NUMBER:2017GL/AU 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 POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM1DDlYYYY MMlDDlYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 10, 000, 000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ X Professional X 32P52299 1/1/2017 1/1/2018 MED EXP (Any one person) $ B PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ None PRO- X POLICY JECT ~ LOC PRODUCTS - COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY Ea aBcideDtSINGLE LIMIT $ 10, 000, 000 A ANY AUTO BODILY INJURY (Per person) $ AUTOS~ED X AUTOSULED X 32P52299 1/1/2017 1/1/2018 BODILY INJURY (Per accident) $ B X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ Non-owned/hired limit $ 10, 000, 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS' LIABILITY Y ! N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A _ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS belotiv _ I E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS !LOCATIONS !VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is an additional participant and loss payee in respects to participant's use of Mobile Fire Training Unit, but only with respects to negligence claims for Bodily Injury, Property Damage or Personal Injury where the Named Participant is deemed to have liability. In no event shall coverage extend to any party for any Claim, Suit or Action, however or whenever asserted, arising out of such party's sole negligence or for any Claim, Suit or Action which occurs prior to the execution of the contract or agreement. 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 Ashland Fire & Rescue ACCORDANCE WITH THE POLICY PROVISIONS. 455 Siskiyou Boulevard Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Jeffrey Griffin/DMH ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (2otaa~) COMMENTS/REMARKS $100,000 sublimit for vehicles borrowed for two weeks or less. $100 Comprehensive & $500 Collision deductibles apply. OFREMARK COPYRIGHT 2000, AMS SERVICES INC.