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HomeMy WebLinkAboutInsurance Certificate: Pacific Retirement Services, Community Volunteer Network ��_...,„ ® .- DATE(MMIDDIYYYY) .. =4�oRD CERTIFICATE OF LIABILITY INSURANCE_. 12/26/2020 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,h,older ih lieu:of"such endorsement(s). . - .- • --.-..---- -_ •.... -. „-, ; ,,. :.,. I CONT: Uditing Aoiate PRODUCEfj.,r. -_ N `- CONTACT nerwrssc - :. .... -. .. Caring-Communities-Shared-Services LTD i PHONE FAX 1850 W.Winchester Road (A/C,No,Ext): 847-549 8225 :,yA/C.No): 847-549 8095. Suite.109 EMAIL Cercaes caring comm.or . . ... - ADDRESS: tifit9@ g. Libertyville ; ' IL ' 60048 •, INSURERS)AFFORDING COVERAGE NAIC# INSURED Pacific Retirement Services Inc. INSURER A: Caring Communities,A Reciprocal RRG 12373 ` Community Volunteer Network INSURER B:, j One West Main St. INSURER C: Suite 303 INSURER D: • Medford OR 97501 INSURER E: COVERAGES CERTIFICATE NUMBER: I 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 ADD'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY CCRRRG-0015-21 01/01/2021 01/01/2022 EACH OCCURRENCE $ 1,000,000.00 ' CLAIMS MADE n OCCUR XDAMAGE TO RENTED $ - PREMISES(Ea occurrence) -300,000.00 _ ''MED EXP (Any one person) $ ' ' .. _ r-1_,000,000.00 PERSONAL BADV INJURY $ " •r GEN LAGGREGATE LIMIT APPLIES PER GENERALAGGREGATE" $' " 3,000,000;00 PRO- -I� -• .•.-•- - •. ._.- PRODUCTS-COMP/OPAGG )(. POLICY. � I..LOC .;_- ..,.. - -.'- � $ incl $ ,. AUTOMOBILE LIABILITY •`. ": •"' ... -' "••. - .. .' .. SINGLE $ • • COMBINED SIN LIMIT ... .- '(Ea accident) ANY AUTO ' - ," BODILY INJURY(Per person) $ - ALL OWNED - SCHEDULED ' • - AUTOS 'AUTOS ' BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ _ AUTOS • • . . , . . (Per accident) . . . $ ' EACH OCCURRENCE ' $ UMBRELLA LIAR OCCUR-GL AGGREGATE $ " EXCESS LIAB CLAIMS MADE-PL $ $ iU DEDUCTIBLE _$ RETENTION $ $ VV - KRtKD I.UMYti1SUI IUN — PER bH 01I-1- - - - EMPLOYERS'LIABILITY ' STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y//NN OFFICER/MEMBER EXCLUDED? I I N/A E.L.EACH ACCIDENT $ (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 12/26/2020 15:37:15 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 Cityof Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Com — ACORD 25(2014/01) '©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD