HomeMy WebLinkAboutInsurance Certificate: Marylill Elbe
CERTIFICATE OF INSURANCE 06/09/2008
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.
Roanoke, Indiana 46783
3URED INSURERS AFFORDING COVERAGE
essional Skaters Association INS. A: Philadelphia Indemnity Insurance Company
3006 Allegro Park SW INS. B:
Rochester, MN 55902 INS. C:
MARYLILL ELBE
60 FAIR OAKS DRIVE
MEDFORD, OR 97504
CERT NUMBER: 1000637420
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 5,000,000
GL PHPK318041 07/01/2008 07/01/2009 Prod ucts-Com leted Operations Aggregate 1,000,000
A Personal and Advertising in'u 1,000,000
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 None
Abuse-Molestation-Per Occurence (sublimit) 1,000,000
Abuse-Molestation-Annual Aggregate (sublimit) 2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
EXCLUSION-DESIGNATED ACTIVITY, SERVICE OR WORK: Services provided by registered coaches of Professional Skating Association whose primary residence (as per the
enrollment form completed) is not located in the United States of America (including its territories and possessions), Puerto Rico and Canada while performing those services outside
of
the United States of America (including its territories and possessions), Puerto Rico and Canada.
The Certificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form PI-AM-002- Additional Insured - Certificateholders
effective July 01, 2008.
CERTIFICATE HOLDER CANCELLATION
ASHLAND PARKS & RECREATION SHOULD ANY OF THE ABOVE DESCRIBED
340 S PIONEER STREET POLICIES BE CANCELED BEFORE THE
ASHLAND, OR 97520 EXPIRATION DATE THEREOF, THE ISSUING
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
j AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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