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Home My WebLink AboutInsurance Certificate: Ashland Gun Club DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/20/2011 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 ACr Lockton Risk Services HONE ~Ax P.O. Box 410679 A/C No.Ext): 877-487-5407 A/C, No): Kansas City, MO 64141-0679 -MAIL ODRESS: INSURER(S) AFFORDING COVERAGE NAIC NSURER-A: Certain Underwriters at Lloyd's, London INSURED NSURER-B: Ashland Gun Club NSURER-C: P. O. Box 953, NSURER-D: Ashland, OR 97520 NSURER-E: NSURER-F: COVERAGES CERTIFICATE NUMBER: 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. IN ADDL SUB OLICY EFF POLICY EXP SR INSR MM/DD/YYYY) MM/DD/YYYY) LT D R TYPE OF INSURANCE POLICY NUMBER LIMITS A GENERAL LIABILITY X LM201144982 09/0512011 09/05/2012 EACH OCCURRENCE $1000000 DAMAGE TO RENTED X -COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $300000 CLAIMS MADE X OCCUR MED EXP An one person) $5000 PERSONAL & ADV INJURY $1000000 GENERAL AGGREGATE $2000000 _N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 PRO- P OLICY 1-1 JECT LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident) $ ANY AUTO BODILY INJURY (Per Person $ ALL OWNED SCHEDULED BODILY INJURY (Per AUTOS AUTOS accident $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUl OS Per accident $ MBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ ED RETENTION $ WORKERS COMPENSATION C STATU- T'- ND EMPLOYERS' LIABILITY DRY LIMITS R NY PROPRIETOR/PARTNERJEXECUTIVE Y/N FFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ MANDATORY IN NH) E.L. DISEASE - EA f es, describe under EMPLOYEE $ E.L. DISEASE - POLICY ESCRIPTION OF OPERATIONS below LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS 20 E. Main St., Ashland,OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 110312 Additional Insured Copy