HomeMy WebLinkAboutInsurance Certificate: EarthScope Consortium, Inc.Ac"RH CERTIFICATE OF LIABILITY INSURANCE
DATE( 123 02 YYY)
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
Arthur J. Gallagher Risk Management Services, LLC
6200 S. Syracuse Way Ste 220
Greenwood Village CO 80111
C NTACi
NAME: Tracy PettBrsen
PHONE - FAz _ —
1rc aO No ;
ADDRESS: Traoy_Pettersen@ajg.com
INSURERS AFFORDING COVERAGE
NAIC tl
INSURER A: National Fire Insurance Cc of Hartford
20478
INSURED EARTCON-W
larthScope Consortium, Inc.
1200 New York Avenue, NW Ste 400
INSURER B: Continental Casualty Company_-
20443
INSURER C : Continental insurance Company
35289
INSURER D: Federal Insurance Company
20281
Washington, DC 20005
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NI1MRER-A9.AA7R947 nizvminKi IJIIMRFR,
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
ADDL
SUBR
mm_.
POLICYNUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MM/OD/YYY
W L€NITS
A
X
COMM£RCIALGENERALLIABILITY
7036523688
1/1/2025
1/112026
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE � OCCUR
DA GET RE T D
PREh41St�Ea occurrence
$ 1, 0 000
00,
MED EXP (Any one person)
$ 15,000
PERSONAL & ADV_ INJURY
$ 1,000,000
AGGREGATE UWT APPLIES PER:
GENERAL AGGREGATE
$ 2,000.000
GEN'L
X
PRO -
POLICY JECTPRO- ❑ LOC
PRODUCTS - COMPIOPAGG
$2,000,000
�..
$
OTHER:
B
AUTOMOBILE
LIABILITY
7036523691
111/2025
1/112026
R MBINED SINGLE LIMIT
EaaWdanl
$ 1 000 000
BODILY INJURY {Per person)
S
X
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INAMY(Peraccldenl)
$
X
HIRED NLY X NON-OWAUTOS ONLY
P OPER Y DPJAGfAVTOSO
$�
S
C
X
UMBRELLA LIAR
4
OCCUR
7036523707
11112026
111/2026
EACH OCCURRENCE
$10,000,000
AGGREGATE
$ 10,0()0,0()0
EXCESS L1AB _
CLAIMS -MADE
DED I X I RETENTION $
$
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
ANYPROPR3ETORIPARTNEWEXECUT€VE
OFFICERWEMBEREXCLUDED?
NIA
I PER OTH-
STALL! ER
E.L. EACH ACCIDENT
$
E.L- DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
1€ yyeun s, dean be der
DESCRIPTION OF OPERATIONS below
--
E.L. DISEASE - POUCY LIMIT
$
D
Crime
82638381
1/112025
111/2026
rsnt
S1,000,000
$10.000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Addldma€ Remarks Schedule, maybe atisched It more space Is required)
Policy: Directors and Officers
Policy Term: 1/1/2026 to 1/1/2026
Policy Number: 82638381
Carrier Name: Federal Insurance Company
Aggregate: $3,000,000
Policy: Employment Practices Liability
Policy Term: 1/1/2025 to 1/1/2026
See Attached,..
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland, Oregon an Oregon Municipal Corp. ACCORDANCE WITH THE POLICY PROVISIONS.
20 E. Main Street
Ashland OR97520 AUTHORIZED REPRESENTATIVE
USA
m 1988-2015 ACORD CORPORATION, All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Arthur J. Gallagher Risk Management Services, I..i..0
6200 S. Syracuse Way Ste 220
Greenwood Village CO 80111
MDG2025 00015952 01
��I�III'ill"'I-III;I'I111iIII'II'I'I"IIIIII"II'lll'I[IdII-II
,e City of Ashland, Oregon an Oregon Municipal Corp.
20 E. Main Street
Ashland, OR 97520
mt
We are providing you with a Certificate of Insurance confirming our client's coverage.
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digital copies of certificates via e-mail in the future. Or, do you no longer require a
certificate of insurance for our client? Please contact us at
COI.UpdateMyEmail@AJG.com and provide the following information for processing:
1. Confirmation that a certificate of insurance is no longer required; or
2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery
3. Insured Code: EARTCON-06
4. This Certificate Number: 525678947
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• �v
AGENCY CUSTOMER ID. EARTCON-06
LOC N:
ADDITIONAL REMARKS SCHEDULE
AGENCY NAMED iNSURED
Arthur J. Gallagher Risk Management Services, LLC EarthScope Consortium, Inc.
1200 New York Avenue, NW Ste 400
Poi€CY NUMBER Washington, DC 20005
CARRIER
NAIC CODE
EFFECTIVE DATE:
AUUI I IUNAL. PItMAHK5
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
Policy Number: M38381
Carrier Name: Federal Insurance Company
Aggregate: $2,000,000
Retention: $25,000
Policy: Fiduciary Liability
Policy Term: 111/2025 to 1/1/2028
Policy Number: 82638381
Carrier Name: Federal Insurance Company
Aggregate: $1,000,000
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d 2008 ACORD CORPORATION. All drihis raxprvad
The ACORD name and logo are registered marks of ACORD