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HomeMy WebLinkAboutInsurance Certificate: New Tribe ACORO® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/21/2010 PRODUCER (801) 763-1375 FAX: (801) 763-1374 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stratus Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 260 South 2500 West, Suite 303 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pleasant Grove UT 84062 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A Certain UW at Lloyds New Tribe, Inc. INSURER B _ PO Box 638 INSURER C. I INSURER D Grants ass OR 97528 I 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I LIMITS LTR NSRDI TYPE OF INSURANCE DATE MM/DD/YYYY DATE MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1 19 00 000 DAMAGE TO RENTED X COMMERCIAL. GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A X CLAIMS MADE EX OCCUR ~kBLN005468 3/12/2010 3/12/2011 I MED EXP (Any one person) $ 11,000 PERSONAL & ADV INJURY I $ 1~ 000 000 GENERAL AGGREGATE $ 2,000,000 i-J GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000 000 X POLICY PRO LOC - JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY ~1 SCHEDULED AUTOS j (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS j (Per accident) ' PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ! AUTO ONLY - EA ACCIDENT~$ I ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE 1 $ j OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE _ $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N !TORY LIMITSERR ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F-1 (Mandatory in NH) E1. DISEASE - EA EMPLOYE $ yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below ~ OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS It is understood and agreed that the Certificate Holder is named as Additional Insured, but only with respects to its liability arising out of the activities of the Named Insured, subject to all policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION North Mountain Park Nature Center DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Ashland Parks and Recreation Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Linda Chesney, Stewardship Coordinator IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 620 N MT Ave. Ashland, OR 97520 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE B Christopherson/TAYL ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered marks of ACORD