HomeMy WebLinkAboutInsurance Certificate: Rogue River National Forest (3)
City County Insurance Services CERTIFICATE OF COVERAGE Rev. 7/7105
Agent This certificate is issued as a matter of information only and confers no rights upon the
DIRECT certificate holder other than those provided in the coverage document. This certificate
does not amend, extend or alter the coverage afforded by the coverage documents listed
herein.
Companies Affording Coverage
Named Member or Participant COMPANY A - City County Insurance Services (CIS)
City of Ashland COMPANY B - National Union Fire Insurance Company of Pitts, PA
20 East Main Street COMPANY C - RSUI Indemnity
Ashland, OR 97520
COVERAGES
This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term
or
condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is
subject
to all the terms, conditions and exclusions of such coverage documents.
CO Type of Coverage Certificate # Effective Expiration Limits
LT Date Date
A General Liability 08LASH 7/1/2008 7/1/2009 General Aggregate $15,000,000
X Commercial General Liability Each Occurrence $5,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
A Auto Liability 08LASH 7/1/2008 7/1/2009 General Aggregate None
X Scheduled Autos Each Occurrence $5,000,000
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 08APDASH 7/1/2008 7/1/2009
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A X Property 08PASH 7/1/2008 7/1/2009 Per Filed Values
A X Boiler and Machinery 08BASH 7/1/2008 7/1/2009 Per Filed Values
B X Excess Crime 08CASH 7/1/2008 7/1/2009 Per Loss $250,000
C Excess Earthquake
C Excess Flood
A P Workers' Compensation
(escription: Use of the National Forest system lands, roads, and trails for the Annual Mt. Ashland Run/Walk to be
d on Saturday, August 1, 2009, from 7 a.m. until 7 p.m.
LEASE NOTE: THIS INSURANCE EXPIRES ON 7/1/09. AS SOON AS RENEWALS FOR THE NEXT FISCAL YEAR
RE COMPLETE, A NEW CERTIFICATE WILL BE ISSUED COVERING THE DATE OF THE MT. ASHLAND RUNIWALK.
Certificate Holder CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date
thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail
Linda Duffy such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
issuer of this certificate.
c/o Steve Johnson
Rogue River National Forest
645 Washington Street By: ~i Date: March 23, 2009
Ashland, OR 97520