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Insurance Certificate: Moss Adams LLP
I „.----,,,o ® �`�o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/30/2020 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 have ADDITIONAL INSURED provisions or be endorsed.If :1_-' 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). c PRODUCER CONTACT 0 • Aon Risk services Central, Inc. NAME; Chicago IL Office (A/CNNo.Ext): (312) 381-1000 (AC.No.): (312) 381-7007 13 200 East Randolph E-MAIL Chicago IL 60601 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: National Fire Ins. Co. of Hartford 20478 Moss Adams LLP INSURER B: Valley Forge Irsurance Co 20508 999 Third Avenue • suite 2800 INSURER C: American Casualty Co. of Reading PA 20427 seattle WA 98104 USA IINSURERD: The Continental Insurance Company 35289 INSURER E: INSURER F: . COVERAGES CERTIFICATE NUMBER:570084761876 - 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. Limits shown are as requested • INSR ADDL SUBR - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYY (MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY 5088714197 10/31/202 10/31/2021 EACH OCCURRENCE $1,000,000 General Liability DAMAGE TO RENTED CLAIMS-MADE OX OCCUR PREMISES(Ea occurrence) — $1,000,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 n GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 coPOLICY �PRO- POLICY E LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: o to B AUTOMOBILE LIABILITY 5088714166 10/31/2020 10/31/2021 COMBINED SINGLE LIMIT $1,000,000 Auto (Ea accident) • . BODILY INJURY(Per person) - o -ANY AUTO 6 Z _ OWNED —SCHEDULED BODILY INJURY(Per accident) a) AUTOS ONLY AUTOS X HIRED AUTOS x NON-OWNED PROPERTY DAMAGE Co 0(Per accident) -ONLY -AUTOS ONLY :” 0 D X UMBRELLA LIAB X OCCUR 6045509936 10/31/2020 10/31/2021 EACH OCCURRENCE $2,000,000 L) Umbrella AGGREGATE $2,000,000 EXCESS LIAB CLAIMS-MADE DED RETENTION C WORKERS COMPENSATIONON4t 5088714183 10/31/2020 10/31/2) x PER STATUTE OTH- EMPLOYERS'LIABILITY - Y/N Workers Compensation ER C OFFICER/MEMBER ANY PROPRIETOR/EXCLUDED?TNER/EXECUTIVE N/A' 5088714216 10/31/2020 10/31/2021 E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 _.. _._ILyes,.describe under.. —----- --_- _ _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— ... a DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland, Oregon and its elected officials,,Officers, and employees are added as Additional Insured as respects the El General Liability and Automobile Liability as required per written contract. umbrella is a follow form. 30 day notice of cancellation except 10 days for non-payment. Policies evidenced herein are primary and non-contributory to other insurance available to the certificate holder, but only to the extent required by written.contract with the insured. A waiver of subrogation in favor of Additional Insured as respect the General Liability, Auto Liability and Workers Compensation pursuant to a written contract. - • _ CERTIFICATE HOLDER ' CANCELLATION ` • - • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ' EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE • POLICY.PROVISIONS. City of Ashland,_Oregon. AUTHORIZED REPRESENTATIVE ...Kir-- 20 rr- 20 East Main street Ashland, oR 97520 USA tSeid �� r1702444:04,0242 WE Ell ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD mrAsn CIIenl.Services $ ' 4orlook PointLinoalnohlre,IL 60069 MDG2020 00001542 01 111111111111IIIIIIii1II'IIIIII'IIIIIIIInl�IIIIIiuIuuIIIIuIIIIII . ?• City of Ashland, Oregon ,A;• 20 East Main Street Ashland, OR 97520 - . e o 5 c M C c c E