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HomeMy WebLinkAboutInsurance Certificate: Help Now Advocacy Center HELPNOW-01 APITTMAN ACORET DATE(MM/DDIYYYY) �� • CERTIFICATE OF LIABILITY INSURANCE 3/23/2020 • THIS CERTIFICATE IS'ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERSNO RIGHTS,UPON:THE CERTIFICATE-HOLDER-THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE,POLICIES_ . ' BELOW._':THIS'CERTIFICATE_OF_INSURANCEDOES NOT.CONSTITUTE A CONTRACT'BETWEEN_THE•ISSUING.INSURER(S),AUTHORIZED ' REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 1 • IMPORTANT:` If'the=certificate'holder'is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED iprovisions'or be endorsed. If SUBROGATION IS WAIVED subject to'the terms and conditions of the policy,certain policies may'require=an>endorsement. A sfatement,onPr, this certificate-does not confer rights to the'certificate holder In lieu of such endorsement(s). • CONTACT ' PRODUCER _. . - -- - NAME:• i -. - - - --- -•-- - Medford OfficePHONE PayneWestInsurance,Inc. ' (A/C,No,Ext):*1)779-1321 • -t.;•. •II(Nc,No):041)779-9187,' 38 North Central Ave. ADDRESS: - Medford,OR 97501 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Mutual of Enumclaw Insurance Company 14761 INSURED INSURER B: I Help Now Advocacy Center INSURER C Larry Kahn 33 N Central Ave#211 INSURER D: Medford,OR 97501 - INSURER E: INSURER F: - 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDDIYYYY) (MM(DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 500,000 CLAIMS-MADE X OCCUR CPP0003496 3/13/2020 3/13/2021 DMGEOEocTcDen.ce), $ 300,000 • - '- -- '- MED EXP(Anti one Persoh)' --$- _. - _ 10(000 .-,,ag...< :#-„ >7•;:-• - _ - -.. . _ ._. .—-_. - PERSONALE ADV INJURY.. .$.._.__ _.-__.-_._. . - Zi.p 114 ,•. 1•,000,000 'b 'L AGGREGATE LIMIT-tAPPLIESPER. ,. ":GENERALAGGREGATE `- $ +:••" R u t':'''POLICY` JEC+w ' LOC"f V.': t , . • ;, i` ',.i PRODUCTS COMP/OP r$d'r S . AGG' ...•- OTHER:i..- _ , '?<,af.: ." , . ' ,-_. $ ..••AUTOMOBILE'LIABILITY', ''`"- ;' 1(.•'• ' - • ' ' - , _ ' ) •".. , 'COMBINED SINGLE LIMITS^ '- '`.'i,;1, r. (Ea accident) $ ANY AUTO .r•_. a, ,I, -, ,i, - • • BODILY INJURY(Per person) $- • OWNED . SCHEDULED _ - AUTOS ONLY _ AUTNOSSWN - I BODILY INJURY(Per-accident) $ _ AUTOS ONLY _ AUOTOS ONLDY (Per accident)AMAGE $ UMBRELLA LIAB _ OCCUR 1EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y!N STATUTE ER ANYIPRWMEIEBOR/PAR NERE ECUTIVE N!A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Bryn Morrison 20 E Main St Ashland,OR 97520 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD