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HomeMy WebLinkAboutInsurance Certificate: Central Oregon & Pacific Railroad Inc (3) AC~ 0 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/27/2014 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: Sand Orr Beecher Carlson Insurance Agency LLC PHONE (541) 772-1111 FAX, No : (541) 772-3785 3256 Hillcrest Park Drive E-MAIL . sandy. orr@beechercarlson. com INSURERS AFFORDING COVERAGE NAIC # Medford OR 97504 INSURER A -Midwest 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. ILTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MNW~D EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION $ $ A WORKERS COMPENSATION wC STATU- OTH- AND EMPLOYERS' LIABILITY YIN X RY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) EWC008757 /1/2013 /1/2014 E.L. DISEASE - EA EMPLOYE S 1,000,000 If yes, 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! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space I. required) Re: Permit #CORP140501. 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, Suite 160 Jacksonville, FL 32224 Sandy Orr/SANDOR WAI&-(,K. ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD Midwest Employers Casualty oan-y Endorsement Schedule Insured: City of Ashland Policy Term: 07/01/2013 to 07/01/2014 Policy No.: EWC008757 Endorsement Effective Expiration Date Description Code Date Date Created SO-613) 07/01 /2013 07/03/2013 SO-10 07/01/2013 07/03/2013 10-31 07/01/2013 07/03/2013 10-34 0710112013 07/03/2013 10-39E 07/01/2013 07/03/2013 SO-43 07/01 /2013 07/03/2013 SO-44 07/0112013 07/03/2013 10-85 07/01/2013 07/03/2013 10-86 07/01/2013 07/03/2013 10-OR (9-05) 071101/2013 07/03/2013 0--30 (1) 12/05/2013 12/06/2013 Page 1 of 1 Print Dates 12106/2013