HomeMy WebLinkAboutInsurance Certificate: Siskiyou Velo Cycling Club
CERTIFICATE OF INSURANCE o4/07/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
American Specialty Insurance & Risk Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND, OR
142 North Main Street ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW.
-)anoke, Indiana 46783
SURED INSURERS AFFORDING COVERAGE
~aague of American Wheelmen dba League of American Bicyclists INS. A: Philadelphia Indemnity Insurance Company
1612 K Street NW, Suite 800 INS. B:
Washington, DC 20006 INS. C:
SISKIYOU VELO CYCLING CLUB, INC.
PO BOX 974
ASHLAND, OR 97520
CERT NUMBER: 1000621767
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOT WITHSTANDING 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 CONDITION OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS POLICY POLICY POLICY
LTR TYPE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
General Aggregate - Per Club/Special Event 3,000,000
GL PHPK286915 02/01/2008 02/01/2009 Prod ucts-Com feted Operations Aggregate 3,000,000
Personal and Advertising Injury 1,000,000
A 12:01 a.m. 12:01 a.m. Each Occurrence 1,000,000
Damage to Premises Rented to You An One Premises 100,000
Medical Expense Limit An One Person Excluded
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The Certificateholder is an Additional Insured in accordance with the provisions and limitations of Form PI-AM-002 - Additional Insured - Certificate holders with respect to the
MOUNTAIN LAKES CHALLENGE from June 20, 2008 through June 22, 2008.
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED
20 EAST MAIN STREET POLICIES BE CANCELED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING
ASHLAND, OR 97520 COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE
HOLDER, BUT FAILURE TO MAIL SUCH NOTICE
SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS
AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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