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HomeMy WebLinkAboutInsurance Certificate: Pathway Enterprises 1 ~ DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 0613012017 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 NAMEACT Jodi Montoya Ashland Insurance Inc PHONE (541)857-0679 A1C, No : (541)857-9883 AIC No Ext 801 O'Hare Parkway, Ste 101 A~~RESS: jmontoya@ashlandinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # Medford OR 97504 INSURERA : Berkshire Hathaway Specialty Ins. Co INSURED INSURER B : SAIF Corporation Pathway Enterprises Inc, DBA: See various DBA's in notes INSURER c 1600 Skypark Drive, Suite #101 INSURER D INSURER E Medford OR 97504 INSURER F ; COVERAGES CERTIFICATE NUMBER: 17118 Master 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 INDICATEC. NOTVVITHSTANDINGRNY REQUIREMENT, T tRM OR CONDiTiON OF ANY i;Oi~TRACT OR OTHER DOCUiv1ENT WITH RESPECT TO WHICH PHIS 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 POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA E TO RENTED 1,000,000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ 20,000 A 47SPK25497302 0710112017 07!01!2018 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 x POLICY ❑ PRO ~ LOC PRODUCTS - COMPIOP AGG $ 3,000,000 JECT Abuse and Molestation $ 3,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident x ANY AUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED 47SPK25497302 0710112017 0710112018 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 1,000,000 AUTOS ONLY AUTOS ONLY Per accident UNINSURED $ 1,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE 47SUM25497502 0710112017 07101!2018 AGGREGATE $ 3,000,000 DED RETENTION $ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS' LIABILITY STATUTE ER YIN 500,000 B ANY PROPRIETORlPARTNERIEXECUTIVE ~ NIA 524679 0410112017 0410112018 E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 500, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT ~ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This form is subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St AUTHORIZED REPRESENTATIVE Ashland OR 97520 ~~~.;;~~d'~j~,p,.__, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD