HomeMy WebLinkAboutInsurance Certificate: Michael & Jacquelyn Young Revocable Trt
CERTIFICATE OF COVERAGE
Agent This certificate is issued as a matter of information
DIRECT only and confers no rights upon the certificate holder
other than those provided in the coverage document.
This certificate does not amend, extend or alter the
coverage afforded by the coverage documents listed
herein.
citycounty insurance services
Named Member or Participant Companies Affording Coverage
City of Ashland COMPANY A - CIS
20 East Main Street COMPANY B - National Union Fire Insurance Company of Pitts, PA
Ashland, OR 97520 COMPANY C - RSUI Indemnity
LINES OF COVERAGE
This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated Not withstanding 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.
Company Certificate Effective Termination Coverage Limit
Type of Coverage Letter Number Date Date
General Liability A 12LASH 7/1/2012 7/1/2013 General Aggregate: $15,000,000
X Commercial General Liability Each Occurrence: $5,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
Auto Liability A 12LASH 7/1/2012 7/1/2013 General Aggregate: None
X Scheduled Autos Each Occurrence: $5,000,000
X Hired Autos
X Non-Owned Autos
Auto Physical Damage A 12APDASH 7/1 /2012 7/1 /2013
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
X Property A 12PASH 7/1/2012 7/1/2013 Per Filed Values
X Boiler and Machinery A 12BASH 7/1/2012 7/1/2013 Per Filed Values
X Excess Crime B 12ECASH 7/1/2012 7/1/2013 Per Loss: $250,000
Excess Earthquake
Excess Flood
Excess Cyber Liability
Workers' Compensation
Description: Per the requirements of the lease agreement for the real property located at 5 "B" Street, Ashland, Oregon, namely, a parking lot,
which the City of Ashland is leasing from Michael H. Young and Jacquelyn J. Young, Trustees of The Michael H. & Jacquelyn J. Young Revocable
Trust; and John C. Schwendener and Patty G. Schwendener, husband and wife, Lessors. City's intended use of these premises is to facilitate the
Ashland Creek Riparian Bank Restoration Project. Lessors are named as additional insureds and loss payees, as applicable.
Certificate Holder: CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date
thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail
Michael H. Young and Jacquelyn J. Young, Trustees of such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or
The Michael H. & Jacquelyn J. Young Revocable Trust; the issuer of this certificate.
and John C. Schwendener and Patty G. Schwendener,
husband and wife.
t Date: June 29, 2012