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HomeMy WebLinkAboutInsurance Certificate: Oregon Bicycle Racing Assoc ACORDTM CERTIFICATE OF LIABILITY INSURANCE DAT01/16/2008YYY) PRODUCER Phone: (800) 747-9573 Fax: (303) 422-1276 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Camp Team ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7615 W. 38Th Avenue, Unit B-109 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Wheat Ridge CO 80033 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Capitol Speciality Ins. Corp Oregon Bicycle Racing Association INSURER B: P.O. Box 16355 INSURER C: Portland, OR 97292 INSURER D: 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 ADDt TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRD DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY CS00217968-19561 05/03/2008 05/04/2008 EACH OCCURRENCE 1,000,000 X DAMAGE TO RENTED 100,000 COMMERCIAL GENERAL LIABILITY REMISES (Ea occurrence) I CLAIMS MADE X OCCUR ED. EXP (Any one person) 5,000 A X INC ATHLETIC PARTICIPANTS PERSONAL & ADV INJURY 1,000,000 ENERAL AGGREGATE 2,000,000 RODUCTS-COMP/OP AGG. 1,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS Per person) HIRED AUTOS BODILY INJURY NON-OWNED 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 CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ ORKERS COMPENSATION AND WC STATU- MPLOYERS LIABILITY NY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT FFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE f yes, describe under PECIAL PROVISIONS below .L. DISEASE-POLICY LIMIT OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTS/SPECIAL PROVISIONS Sprint Thaw Mtn Bike Festival / USA Policy Deductibles: $0.00 per each bodily injury / $500.00 per each property damage claim. Additional Insured(s): Earnest Holdings, LLC., Thomas Rollins, City of Ashland and its employees, United States Forest Service, Richard Palen. All participants, staff and facilities as scheduled with the company are added as additional insured in regards to the operations of the insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SOMBA i._ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE k TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE P.O. BOX 1196 S ' NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S AGENTS OR Talent, OR 97540 ` ;7- REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention: Amy Warner Bob Leid ACORD 25 (2001/08) © ACORD CORPORATION 1988