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HomeMy WebLinkAboutInsurance Certificate: Jackson County CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 6/25/2012 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: Sandy Orr I FAX AIC No :(591)772-3785 Beecher Carlson Insurance Agency IZC AICNNo Ext : (541) 772-1111 707 Murphy Rd EMAIL _AbDRESS.sandy. INSURER(S) AFFORDING COVERAGE NAIC # Medford OR 97504 INSURERA :New York Marine & Gen Ins Co INSURED INSURER B City Of Ashland INSURER C 20 E Main St INSURER D: INSURER E Ashland OR 97520 INSURER F COVERAGES CERTIFICATE NUMBER:2012-13 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 INADDIL SR SUWVD ER POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MM1DD YYYY LIMITS GENERAL LIABILITY EA,-H C,CCUPPENCE $ DP,UIAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREfv11SES ~Ea occurrence' $ CLAIMS-MADE F--lOCCUR MED EtP (Any one person) £ PEPSCiNA,L G ADV INJUP r' £ -ENEPL,L A,-,~R'EGATE GEN'L AGGREGATE LIMI- APPLIES PEP_ PPODI_JCTS - COMP/OP AGG £ POLICY JE ~ LOC $ AUTOMOBILE LIABILITY L-OMBINED SINGLE LIMIT tEa accidentl ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BGDIL'( INJURY (Per accident) $ NON-OVINED PROPERTY DAMAGE $ HIRED AUTOS AUTOS IF'eraccident) UMBRELLA LIAB HO,-C IR EAiLH C,CCURPENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION X VVr -71-f 10TH- AND EMPLOYERS' LIABILITY YIN TOPY LIMITS ER ANY PROPRIETORIPARTI`ERIEXECIJTIVE EL EACHA.CCIDEfJT { 1,000,000 (Mandatory In ry In ENH) R EXCLL DED? NIA WC2012EPP00044 7/1/2012 7/1/2013 (Manda EL DISEASE - EA EMPLO'~E $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Deductible-All Other $450,000 E L DISEASE - P!.)LIC'r LIMIT $ 1,000,000 Deductible-_ode 7535+ $650, 000 Jedu cube-POlre $750,000 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 bergniapl@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 ~~~-u-{/}• L`~'71~..• ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD