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HomeMy WebLinkAboutInsurance Certificate: City of Ashland (2) jr, _ ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/Y 7/28/2010 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the 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). PRODUCER NAME: Sandy Orr Beecher Carlson Insurance Agency LLC Arch o Ext : (541) 772-1111 Arc No (541)772-3785 707 Murphy Rd E-MAIL ADDRESS: sandYorr@beechercarlson.com PRODUCER 00006545 CUSTOMER ID p: Medford OR 97504 INSURER(S) AFFORDING COVERAGE NAIC t INSURED INSURER A New York Marine & Gen Ins Co INSURER B : City Of Ashland INSURER C : 20 E Main St INSURER D INSURER E : Ashland OR 97520 INSURERF : COVERAGES CERTIFICATE NUMBER:2010-11 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD/YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES 'Ea occurrence $ CLAIMS-MADE E OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV IN.H_IPv $ ENEPAL A GPE:--TE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COM?P;C~P AGG $ POLICY PRO - L7 JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per acudent) NON-OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURPENCE $ EXCESS LIAB CLAIMS-MADE u,GGFEGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION Excess Workers WCSTA.TU- OTH- AND EMPLOYERS' LIABILITY Y I N X Ti?F'f LIMITS ER ANY PROPRIETOR/PARTI\IER/EXEi=UTINE Compensation E EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED'% NIA (Mandatory in NH) MW100287 /1/2010 /1/2011 E DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below' E L DISEASE- POLICY LIMIT $ 1,000,000 Dedu,-_Iibe - Code 7~,39 $650,000 Deductible - A.II ether $450,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Contract for re-assignment of ASA #3 to Ashland Fire and Rescue. CERTIFICATE HOLDER CANCELLATION bergmapl@jacksoncounty.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Jackson County Attn: Penny Bergman 1005 E Main Street AUTHORIZED REPRESENTATIVE Medford, OR 97504 Sandy Orr/SANDOR ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD