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HomeMy WebLinkAboutInsurance Certificate: YMCA ACURD CERTIFICATE OF LIABILITY INSURANCE 7DATE /23/2007Y) PRODUCER (541) 772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JBL&K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: New Hampshire Insurance Ashland Family YMCA INSURER B: 540 YMCA Way INSUREPC INSURER D: Ashland OR 97520 INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY TYPE OF INSURANCE POLICY NUMBER DA EMM DDIYYY) POLICY ON DATE MM DD/Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 v DAMAGE TO RFNTED $ C ' -11,4ERCiAL GENERAL LIABILITY PREMISES Ea occurrence A X CLAIMS MADE ~ OCCUR OILX64376603 7/1/2007 7/1/2008 MEDEXP An one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 1,000,000 PRO- POLICY POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO A ALL OWNED AUTOS OILX64376603 7/1/2007 7/1/2008 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OVVNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ A DEDUCTIBLE 29UD63542153 7/1/2007 7/1/2008 $ X RETENTION $ 10,000 $ WORKERS COMPENSATION AND TORY WC STATU- LIMITS I JER OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The certificate holder shall be an additional insured in accordance with all the terms, conditions, and limitations of the policy and then only with respect to liability caused by the negligent acts or omissions of the Named Insured and then only with respect to the Triathlon CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Uartha Bennett - 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT `20 East Main Street FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Ashland, OR 97520 INSURER, ITS AGENTS OR REPRESENTATIVES. i;. AUTHORIZED REPRESENTATIVE K Edwards/PAUORT~.ti/ ACORD 25 (2001/08) © ACORD CORPORATION 1988 INS025 (0108).08a Page 1 of 2