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HomeMy WebLinkAboutInsurance Certificate: SO Repertory Singers A~~ ® DATE (MMIDDIYYYY) ~ CERTIFICATE OF LIABILITY INSURANCE 5/912017 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 have ADDITIONAL INSURED provisions or 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 Liberty Mutual Insurance NAME: PO Box 188065 PHONE FAX Alc No Ext : 800-962-7132 Alc No : 800-845-3666 Fairfield, OH 45018 E-MAIL ADDRESS: BusinessService Libert Mutual.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA : West American Insurance Com an 44393 INSURED INSURER B Southern Oregon Repertory Singers PO Box 1091 INSURER C Ashland OR 97520 INSURER D : INSURER E INSURER F ; COVERAGES CERTIFICATE NUMBER: 35552523 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 ADDL SUBR POLICY NUMBER MMIDDIYYYY MMLDDIYYYY LIMITS LTR A ~ COMMERCIALGENERALLIABILITY BKW57800816 611/2017 6/112018 EACH OCCURRENCE $ 1,~~~,~~17 CLAIMS-MADE ~ OCCUR PREM SESOEa oNccur ence $ 1 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1 GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ 2~00~~~~~ ✓ POLICY ~ PRO- ~ LOC PRODUCTS-COMPIOPAGG $ 2~~~~~000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ERH ANYPROPRIETOR/PARTNERIEXECUTIVE ❑ N 1 A E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Clt of Ashland, It's officers and em to ees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y p Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main St. ACCORDANCEWITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Kim Mainous ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 35552523 ~ 7000037978 ~ 17-18 Master Certificate ~ Kim Mainous ~ 5/9/2017 1:50:46 PM (EDT) ~ Page 1 of 1 Liberty Mutual Insurance PO Box 188065 Fairfield, OH 45018 ~I~PIC City of Ashland, it's officers and employees sender: Kim Mainous 20 E Main St. Phone: 800-962-7132 Ashland OR 97520 Subject: Cert No. 35552523 -Southern Oreggon Reppertory Singers -Certificate of Liability - BI(W57800816 Date: 51912017 No. of: Pages: 2 t1RL: Hello: Please find the attached Certificate of Liability issued by Liberty Mutual on behalf of Pa newest Insurance, Inc for our insured Southern Oregon Repertory Singers. A copy of the Certifycate has been sent to the holder and insured. Please note that any changes to the proof of insurance, other than basic changes to the Certificate Holder name andlor address, must be requested by the Named Insured or Agent of Record directly. If you have any uestions or need any amendments, please contact us via email: businessservice~a libertymutual.com or call: 800-962-7132. Thanks and have a nice day, Kim Mainous, Insurance Assistant Commercial Lines Service Center Liberty Mutual Insurance Toll Free: (800)-962-7132 Fax: (800)-845-3666 This information and any attachments are intended only for the use of the addressee(s) named herein and may contain legally privileged andlor confidential information. If you are not the intended recipient of this information, you are hereby notified that any dissemination, distribution or copying of this , information, and,any attachments thereto, Is strictly prohibited. If you have received this information in error, please notify me via return a-mail and via telephone at 800-962-7132, and please permanently delete the original and any copy of any information and any printout thereof. (07654208) THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonlineT"" Insurance Visions, Inc. All rights reserved.