HomeMy WebLinkAboutInsurance Certificate: Jackson County Fire Dist #5
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Special Districts Association of Oregon CERTIFICATE OF LIABILITY COVERAGE Certificate 5743
AGENT THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER
Wilson-Heirgood Associates THAN THOSE PROVIDED IN THE COVERAGE DOCUMENT. THIS
P.O. Box 1421 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN.
Eugene, OR 97440
COMPANIES AFFORDING COVERAGE
NAMED PARTICIPANT
COMPANY A -Special Districts Association of Oregon (Self-Insured Pool)
Jackson County Fire District #5 COMPANY B - Genesis Insurance Company
5811 South Pacific Highway
Phoenix, OR 97535 COMPANY C
COMPANY D
COVERAGES
This is to certify that coverage documents listed herein have been issued to the Named Participant herein for the Coverage period indicated. Nothwithstanding 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 Date Expiration Date Limits
LT
A General Liability 25P52271-543 1/1/2010 1/1/2011 General Aggregate None
X Commercial General Liability Each Occurrence $500,000
X Public Officials Liability
X Employment Practices
X Occurrence
A Automobile Liability 25P52271-543 1/1/2010 1/1/2011 General Aggregate None
Each Occurrence $500,000
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 25P52271-543 1/1/2010 1/1/2011
X Scheduled Autos
Hired Autos
Non-Owned Autos
Excess Liability 25P52271-543 1/1/2014 1/112011 General Aggregate None
Each Occurrence $4,500,000
X General Liability
X Automobile Liability EPL Each Occurrence $4,500,000
X Public Officials Liability
EPL Aggregate $4,500,000
X Employment Practices
X Occurrence
DESCRIPTION Certificate holder is named additional participant in respects to use of the Training Trailer, but only with respects to negligence
claims for bodily injury or property damage where the named participant is deemed to have liability.
CERTIFICATE HOLDER CANCELLATION: Should any of the coverage documents herein be cancelled before the
expiration date thereof, SDAO will endeavor to mail 30 days written notice to the
City of Ashland/ Greg Case certificate holder named herein, but failure to mail such notice shall impose no
obligation or liability of any kind upon SDAO, its agents or representatives, or the issuer
20 East Main of this certificate.
Ashland, OR 97520
By: Date: 12/11/2009
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