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HomeMy WebLinkAboutInsurance Certificate: Cascadia Consulting Group (2) OP ID: SR 2/14/2016Y) ATE CERTIFICATE OF LIABILITY INSURANCE D 1 12/14/2016 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 CONTACT NAME: Sprague Israel Giles P HONE FAX 1501 Fourth Avenue, Suite 730 A/C No Ext): Seattle, WA 98101-3225 E-MAIL Robert Karl ADDRESS: CA License #0192858 PRODUCER CUSTOMER ID CASCA-1 _ INSURER(S) AFFORDING COVERAGE NAIC # INSURED Cascadia Consulting Group, Inc INSURER A : Darwin Select Insurance Co. 24319 1109 1st Ave., Ste. 400 NON ADMITTED CARRIER INSU Seattle, WA 98101 INSURER B INSURER C INSUrER D : INSURER_E 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 UBR POLICY EFF POLICY EXP TYPE OF INSURANCE INSR MD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ - COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY r PJECT RO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS r--~ BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) NON-OWNED AUTOS $ $ 1 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ J'! EXCESS LIAB CLAIMS-MADE' ' GGREGA,TE - DEDUCTIBLE $ i F-1 RETENTION $ - $ WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS' LIABILITY / N TORY ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab 0304-2934 12/17/2016! 12/17/2017 !EA.CLAIM 1,000,000 $25,000 Deductible RETRO-DATE: 12/17/08 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ***EVIDENCE ONLY*** CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE 4. ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD