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HomeMy WebLinkAboutInsurance Certificate: OSF AC~ ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/21/2010 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 CONTACT NAME: Paula Ortiz PHONE A/C. No Ext (541) 772-1111 AC No : (541) 772-3785 Beecher Carlson Insurance Agency LLC ( 707 Murphy Rd ADDRRESS:paula.ortiz@beechercarlson.com P CUSTOMER ID RODUCER 00006488 Medford OR 97504 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A :Great American / American INSURER B : Oregon Shakespeare Festival INSURER C : PO BOX 158 INSURER D : INSURER E : Ashland OR 97520 INSURER F COVERAGES CERTIFICATE NUMBER:11-12 Gl, BA, Umb 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SR D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE U OCCUR X AC8049553 1/1/2011 1/1/2012 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY 7,1 PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED AUTOS X AP8049554 1/1/2011 1/1/2012 BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS PIP-Basic $ 15,000, Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE ! $ 5,000,000 EXCESS LIAB CLAIMS-MADE I AGGREGATE $ 5 , 000 , 000 DEDUCTIBLE $ A X RETENTION $ 10,000 PlIB8049555 i1/1/2011 1/1/2012 $ 1 WORKERS COMPENSATION , WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN !TORY LIMIT : ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder included as additional insured as respects general liability on a primary & noncontributory basis where required by written contract. This form is subject to policy terms conditions & exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Its agents, directors, officers, AUTHORIZED REPRESENTATIVE employees and volunteers 20 E Main Ashland, OR 97520..4"al!> X/Y Mike Mastroni/PAUORT , ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD