HomeMy WebLinkAboutInsurance Certificate: BLM
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
Type of Coverage Letter Number Date Date Coverage Limit
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 Auto:3
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: The U.S. Government, Medford District, Bureau of Land Management. is listed as additional insured under the City of Ashland's
insurance in connection with the Special Recreation Permit obtained by the City of Ashland, through its Parks and Recreation Department, for the
purpose of conducting a hike on BLM land, namely, Grizzly Peak, on July 14, 2012.
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
Medford District such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or
Bureau of Land Management the issuer of this certificate.
3040 Biddle Road
Medford, OR 97504
Date: June 22, 2012