HomeMy WebLinkAboutInsurance Certificate: Camp Latgawa (2)
City County Insurance Services CERTIFICATE OF COVERAGE Rev. 717/05
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
Description: For the CERT Advanced Training Retreat, for Ashland Fire and Rescue Station 1, to be held on March 5, 2010, through March 7,
2010, at Camp Latgawa, 13250 SF Little Butte Creek Road, Eagle Point, OR 97524.
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
Camp Latgawa and such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
OR-ID Conference of the United Methodist issuer of this certificate.
Church
13250 SF Little Butte Creek Road
Eagle Point, OR 97524 By: /7,,0,.46. ~ Date: January 7, 2010