HomeMy WebLinkAboutInsurance Certificate: Planned Parenthood
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AcQ ® CERTIFICATE OF LIABILITY INSURANCE D120016
12109/20
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
Marsh USA, Inc. NAME__
1166 Avenue of the Americas A/CNo Ext : (A/C, No):
New York, NY 10036 E-MAIL
Attn. healthcare.accountscss@marsh.com Fax: 212-948-1307 ADDRESS:_
INSURER(S) AFFORDING COVERAGE NAIC #
109210-NIP-CAS-17-18 EUG,O GL INSURER A : New Hampshire Insurance Company 23841
INSURED N/A N/A
PLANNED PARENTHOOD OF SOUTHWESTERN INSURER B
OREGON, AN AFFILIATE OF PLANNED PARENTHOOD INSURER C
FEDERATION OF AMERICA, INC. INSURER 0:
3579 FRANKLIN BLVD. - -
EUGENE, OR 97403 INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: NYC-007476578-09 REVISION NUMBER:3
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 ADDLSUBR
LTR POLICY NUMBER MM/DD YYYY MM DD YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY 082695195 0110112017 01/01/2018 EACH OCCURRENCE $ _ 1,000.000
DAMAGE TO RENTED
CLAIMS-MADE N OCCUR PREMISES Ea occurrences $ 500,000
MED EXP (Any one person) $ Included
X SIR: $100,000
PERSONAL & ADV INJURY $ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
L J LOC PRODUCTS COMP/OP AGG $ 2,000,000
POLICY F PRO JECT L J
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
Ea accident
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS TOS Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' 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 EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: PPSO'S ASHLAND HEALTH CENTER - THE GE1 YOURSELF TESTED! (GYT) PROGRAM WILL PROVIDE FREE SEXUALLY TRANSMITTED INFECTION (STI) TESTING, COUNSELING, AND TREATMENT
COORDINATION FOR YOUTH AGES 25 AND UNDER AT PPSO'S ASHLAND HEALTH CENTER. TARGET GROUPS FOR THIS PROGRAM INCLUDE YOUTH AGES 20-25, MEN, AND LGBTQ YOUTH.
CITY OF ASHLAND IS INCLUDED AS ADDITIONAL INSURED AS THEIR INTERESTS MAY APPEAR.
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: DAVE KANNER, CITY ADMINISTRATOR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 E MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND, OR 97520
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Ricki Fitzsimmons
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD