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HomeMy WebLinkAboutInsurance Certificate: Klamath Bird Observatory From: Medford Office #1 Fax: (541) 857-9883 To: 5414885320@rcfax.con Fax' (541) 488-5320 Page 2 of 2 07i02i2018 1212 PIA DATE (MMIDDrYYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 07/02/2018 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 Julie Asher NAME: Ashland Insurance Inc PHONE (541) 482-0831 FAX (541) 488-5851 AIC, No Ext : AIC, No): 585 A Street Suite 1 Ae IL DDRESS: jasher@ashlandinsurance.com P. 0. Box 880 INSURER(S) AFFORDING COVERAGE NAIC 0 Ashland OR 97520 INSURER A: Alliance of Nonprofits Ins RRG 10023 INSURED INSURER B: SAIF Corporation Klamath Bird Observatory INSURER C : PO BOX 758 INSURER D: INSURER E : Ashland OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER: 18 19 GL WC 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 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 500000 M ED EXP (Any one person) $ 20,000 A Y 2018-25840 07/01/2018 07/01/2019 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERALAGGREGATE $ 2,000,000 X POLICY PECROT - LOC PRODUCTS - COMP/OP AGG $ 2,000,000 J OTHER Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY (COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED A $ AUTOS ONLY Per accident) AUTOS ONLY L1 1 1 $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ 4..CE SS L.B CLAIMS-MADE AGGREGATE $ ED RETENTION $ $ WORKERS COMPENSATION X E H- AND EMPLOYERS'LIABILITY STATUTE E ER YIN 500,000 B ANY PROPRIR/ XECUTIVE 0 NIA 880548 03/01/2018 03/01/2019 EL EACH ACCIDENT $ OFFICER/MEMMREBER EXCLUDED? (Mandatory In NH) E.L DISEASE - EA EMPLOYEE $ 500'000 Ifyes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101,Additlonal Remarks Schedule, may be attached lfmore space is required) The City of Ashland, its officers, employees, and agents are listed as additional insureds 30 Day notice of cancellation applies except in the case of non payment which is 10 days. 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 E Main St AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD rhedford Office: 1 Fax: (541) 857-9883 To: 5414885320@rcfax cor Fax: (541) 488-5320 Page 1 of 2 07;02'2018 12:12 PM FAX Date: 07/02/2018 I Pages including cover sheet: 2 To: 5414885320@rcfax.com From: Medford Office #1 Ashland Insurance Inc 801 O'Hare Parkway, Ste 10 Medford OR 97504 Phone Phone (541) 207-1544 - 103 Fax Number (541) 488-5320 Fax Number (541) 857-9883 • Emailina: City of Ashland Certificate