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HomeMy WebLinkAboutInsurance Certificate: Kokopelli Kayak & Whitewater ACORD- CERTIFICATE OF LIABILITY INSURANCE 9OP ID KD KO K DATE(MM/DDlKOKOKA 05/01/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hart Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3389 Crater Lake Hwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 Phone: 541-779-4232 Fax:541-772-3963 INSURERS AFFORDING COVERAGE NAIC # - INSURED INSUPERA First Mercury - - _ - INSURER B rJSUP= c IIF~ Kokopelli Ka ak & Whitewater 1655 Parker treet INSUPEP D - - - Ashland OR 97520 NSUPEP 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. h S 'L - - POLICY EFFECTIVE POLICY EXPIRATION I NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X C(DI%JMERCIPL GENERAL LIABILITY FMGP000648 04/25/09 04/25/10 PREMISES (E3 occurence( $ 50 , 000 CLAIiMQ MADE FX OCCUR MED EXP (Any one person) s excluded PERSONAL & ADV INJUPr 1,000,000 GENERAL AGGPEGATE x 2,000,000 GENT. AGGREGATE _IMITAPPLIES PER PPODUCTS COrnProP AGG , 2 , 000 , 000 - - -POLICY PRO JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LItv11? ANY AUTG (Ea accident) A~„L OWNED P,JTCS _ BODILY IIJJIJPY $ SC- HEDULE1 AUTOS (Per person) HIRED AUiO--~ BODILY INJURt $ AOTc,,S (Per accident) ~ hJ~iN-0`U/NECK - - PROPER7'r DAMAGE (Per accident] GARAGE LIABILITY AUTO ONLY - EA ACCIDENT - - i ANY AUTO OTHER TH., i J EA A('C - AUTO ONLY £ - - I EXCESS/UMBRELLA LIABILITY EACH CCCURPEfJCE $ ~~CCUP r, M DE AGGPEGATE _ Z - r DE^,i 1CTBLE I I ~ RE rEI,,F10J WORKERS COMPENSATION AND - ~ EMPLOYERS' LIABILITY STORY LI PS^ITS ER ANY PF2OPRIE IAPTN R,EXE-:~U7 vE E L EACH AC (DENT OFFICEP~MEP,`EEF E E L C I EASE E,-, EMF L 1 (EE' $ It ye descrir SPECIAL PR t loo, F L DISEASE - PULICr LI%117 OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS "It is understood and agreed that the Certificate Holder is named as Additional insured, but only with respect to its liability arising out of the activities of the Named Insured." CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Ashland IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ashland Parks & Recreation 340 South Pioneer St. REPRESENTATIVES. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Hart Insurance / Medford ACORD 25 (2001/08) © ACORD CORPORATION 1988