HomeMy WebLinkAboutInsurance Certificate: OLCC
City County' Insurance Services CERTIFICATE OF COVERAGE' Rev. 7/7/05
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 09LASH 7/1/2009 7/1/2010 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 09LASH 7/1/2009 7/1/2010 General Aggregate None
X Scheduled Autos Each Occurrence $5,000,000
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 09APDASH 7/1/2009 7/1/2010
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A X Property 09PASH 7/1/2009 7/1/2010 Per Filed Values
A X Boiler and Machinery 09BASH 7/1/2009 7/1/2010 Per Filed Values
B X Excess Crime 09CASH 7/1/2009 7/1/2010 Per Loss $250,000
C Excess Earthquake
C Excess Flood
A Workers' Compensation
ascription: Includes Liquor Liability - $5,000,000 Each Common Cause, $15,000,000 Aggregate Limit. This is for beer and wine service
y the City of Ashland, through its Parks and Recreation Department, at the Oak Knoll Golf Course, 3070 Highway 66, Ashland, Oregon.
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
OLCC such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
P.O. Box 22297 issuer of this certificate.
Portland, OR 97269
By: Date: July 17, 2009