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HomeMy WebLinkAboutInsurance Certificate: Central Oregon & Pacific Railroad Inc (2) LIABILITY INSURANCE DATE (MMIDD/YYYY) A~,°!~° ~ CERTIFICATE OF 5/20/2014 F 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 NAME- CONTACT Sandy Orr Beecher Carlson Insurance Agency ILC PHONE (541)772-1111 AIC N0; (541)772-3785 3256 Hillcrest Park Drive =SS: sandy. orr@beechercarlson. com INSURER(S) AFFORDING COVERAGE NAIC # Medford OR 97504 INSURER AMidwest Employers Casualty 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:2013-14 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMID IMWDDfYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENT1715- COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 7 OCCUR MED EXP (Any one person) S PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S POLICY F-IJECT 171 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ TH- A WORKERS COMPENSATION X RY U IT- I T O R AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.LL EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH} EWC008757 /1/2013 /1/2014 E .L. DISEASE - EA EMPLOYE $ 1,000,000 If as, describe under Retention - All Other $500 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 Retention - Codes 7539, $750,000 7720 & 7710 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Permit #CORP140502. Blanket Waiver of Subrogation per endorsement I0-30 (1/93) attached applies when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Central Oregon & Pacific Railroad, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. c/o Genesee & Wyoming Railroad Services, AUTHORIZED REPRESENTATIVE 13901 Sutton Park Dr South, Ste 160 Jacksonville, FL 32224 ` c~ Sandy Orr/SANDOR ja./~GVZU_Q? . 041S__ ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (2o1005).o1 The ACORD name and logo are registered marks of ACORD Midwest Employers Casuafty Company Endorsement Schedule insured: City of Ashland Policy Terri: 07/01/2013 to 07/01/2014 Policy No.: EWC008757 Endorsement Effective Expiration Date Description Code Date Date Created SO-6(3) 07/01/2013 07/03/2013 SO-10 0710112013 07/03/2013 10-31 07/01/2013 07/03/2013 10-34 07/01/2013 07/03/2013 0-39E 07/01/2013 07/0312013 % SO-43 07/01/2013 07/0312013 SO-44 07101/2013 07/03/2013 10-85 07/01/2013 07/03/2013 10-86 07/01/2013 07/03/2013 10-OR (0-05) 07/01/2013 07/03/2013 10-30(l) 12/05/2013 12/06/2013 ?age 1 of 1 Print Date: 12/0612013