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HomeMy WebLinkAboutInsurance Certificate: Community Volunteer Network (2)---1 ® CERTIFICATE OF LIABILITY INSURANCE DATE(26/DDIYYYY) �.. 12ll2019 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 Underwriting Associate Caring Communities Shared Services LTD PHONE 847-549 8225 FAx 847-549-8095 1850 W. Winchester Road (A/C, No, EXt (,C No). ADDRESS Certificates@caringcomm.org Suite 109 Libertyville IL 60048 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Pacific Retirement Services Inc. INSURER A: Caring Communities, A Reciprocal RRG 12373 INSURER B: Community Volunteer Network One West Main St. INSURER C: Suite 303 INSURER D. Medford OR 97501 INSURER E COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADVL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR X CCRRRG-0015-20 01/01/2020 01/01/2021 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000.00 MED EXP (Anyone person) $ PERSONAL BADVINJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000.00 PRODUCTS - COMP/OP AGG $ Incl X POLICY PRO- ❑ LOC JECT $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIREDAUTOS NON -OWNED AUTOS EACH OCCURRENCE $ UMBRELLA LIAR OCCUR-GL AGGREGATE $ $ EXCESS LIAR CLAIMS MADE-PL $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND PER OTH- EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? N / A STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 12/26/2019 16:02:39 The Certificate Holder is included as an Additional INSURED under Coverage B, Commercial General Liability of this POLICY but only with respect to liability arising out of the Retired Senior Volunteer Program (RSVP) as described within the Financial Assistance Award Contract entered into with the Named INSURED. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE g ACORD 25 (2014/01) CO 19BB-2014 ACORD GURPURATIUN. All ngnts reserved. The ACORD name and logo are registered marks of ACORD