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HomeMy WebLinkAboutInsurance Certificate: Ashland Family YMCA Client#: 2065674 ASHLAFAM DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 7/31/2025 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Ryan Davidson USI Insurance Services NW CL1 PHONE 503 224-8390 FAX 610 362-8130 825 NE Multnomah, Suite 1500 MA Lo,Ext: (A/c,No): ADDRESS: ryanl.davidson@usi.com Portland, OR 97232 INSURER(S)AFFORDING COVERAGE NAIC# 503 224-8390 Philadelphia Insurance Company 32204 INSURER A: P P y INSURED INSURER B:SOuthlake Specialty Insurance Company 16999 Young Men's Christian Association SAIF Corporation 36196 INSURER C: P of Ashland dba Ashland Family YMCA Travelers Indemnity Com an 25658 INSURER D: Y P y 540 YMCA Way INSURER E: Ashland, OR 97520 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 CONTRACTOR 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. ADDLSUBR LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY PHPK2575527006 07/01/2025 07/01/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE [*OCCUR PREMI6ESOEa oNcurrDence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OPAGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY PHPK2575527006 07/01/2025 07/01/202 EeaBc,den SINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Pera ccident $ B X UMBRELLA LAB N OCCUR XAOR90018 07/01/2025 07/01/2026 EACH OCCURRENCE $1,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $1,000,000 DED RETENTION$ $ C AND EMPLOYERS'LIABILITY WORKERS COMPENSATION 280249 07/01/2025 07/01/202 X STATUTE EORH ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT s500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 s500,000 A Abuse&Molestation PHPK2575527006 07/01/2025 07/01/202 $1,000,000 A Professional Liab PHPK2575527006 07/01/2025 07/01/202 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE x. B-le-e ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S50326616/M50284880 RXDJT