HomeMy WebLinkAboutInsurance Certificate: Ashland Gun Club
DATE (MM/DD/YYYY)
ACORD. CERTIFICATE OF LIABILITY INSURANCE 7/15/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
LOckton RISK Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. Box 410679 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Kansas City, MO 64012 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED INSURER A: Certain Underwriters at Lloyd's, London
Ashland Gun Club INSURER B:
P. O. Box 953, -
Ashland, OR 97520 INSURER C:
INSURER D:
INSURER 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 CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
LTR _ DATE (MM/DD/YY)- DATELMM/DD/YY
A GENERAL LIABILITY L200917419 09/05/2009 09/05/2010 EACH OCCURRENCE $1000000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $300000
CLAIMS MADE X~ OCCUR MED EXP (Any one person) $5000
I
PERSONAL& ADV INJURY $1000000
GENERAL AGGREGATE $2000000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000
X POLICY PRO i LOC
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED ALTOS BODILY INJURY
(Per person) $
SCHEDULED ALTOS
HIRED AUTOS BODILY INJURY $
NON-OWNED AJTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
- - ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR J CLAIMS MADE AGGREGATE $
- DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND EMPLOYERS' L WC STAT ITS ~TH- $
LIABILITY TORY E. L. EACH ACCIDENT $
E. L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER LISTED AS ADDITIONAL INSURED PER SCHEDULE ON FILE WITH COMPANY.
CERTIFICATE HOLDER X 1 ADDITIONAL INSURED; INSURER LETTER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS
City of Ashland WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO
2O E. Main St. SO SHALL IMPOSE NO OBLIGATION OF LIABILITY OF ANY KIND UPON THE INSURER, ITS
St., AGENTS OR REPRESENTATIVES.
Ashland, OR 97520 AUTHQRI-ZED REPRESENTATIVE
1 ' r
ACORD 25-S (7/97) ACORD CORPORATION 1988
Insured Copy
LIABCRT DIAS
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the ccertificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions o fthe policy, certain policies may
Require an endorsement. A statement on this certificate does not confer rights to the certificate holder
in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the
issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (7/97)
LIABCRT DIAS