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Home My WebLink AboutCasa of Jackson County A CORDTM CERTIFICA TE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) 4/13/2006 PRODUCER (541) 772-1111 FAX (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A M.t\ TTER OF INFORMATION Security Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Murphy Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Philadelphia Insurance Access Inc INSURER B: Philadelphia Indemnity 3630 Aviation Way INSURER c. INSURER 0: Medford OR 97504 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L P~k+~~~~~g8~~ P~j'~(~~=N LIMITS LTR I NSRD TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - X COMMERCIAL GENERAL LIABILITY ~~~~~H?E~~~;7,~nce) $ 100,000 A I CLAIMS MADE [iJ OCCUR PHPK166495 4/17/2006 4/17/2007 MED EXP (Anyone person) $ 5,000 - PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 ~ .nPRO- n- X POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLI= LIMIT 1,000,000 - (Ea accident) $ X ANY AUTO - A ALL OWNED AUTOS PHPK166495 4/17/2006 4/17/2007 BODILY INJURY - (Per person) $ - SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA Jl.CCIDENT $ =1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 ~ OCCUR D CLAIMS MADE AGGREGATE $ 5,000,000 $ B ~ DEDUCTIBLE PHUB061719 4/17/2006 4/17/2007 $ X RETENTION $ 10,000 $ WORKERS COMPENSATION AND I T~~{I~Hs I 10TH- ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is an additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLA TION City of Ashland its officers, employees & agents Attn: Kristen Bakke 20 E Main Street Ashland, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~o<.~ ~- ACORD 25 (2001/08) INS025 (0108).06 AMS Sandy Orr/SANDOR VMP Mortgage Solutions, Inc. (800)327-0545 @ ACORD CORPORA nON 1988 Page 1 of2 --------r----..- CERTIFICATE OF INSURANCE RE eEl VE D JU N 2 3 2006 This certifies that 181 STATE FARM FIRE AND CASUAL TV COMPANY, Bloomington, Illinois D STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois insures the following policyholder for the coverages indicated below: Name of policyholder Casa of Jackson County Address of policyholder Location of operations 10 S. Grape St Medford, OR 97501 3501 Excel Dr Medford, OR 97504 Description of operations Court Appointed Advocate The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is sub' to all the terms exclusions, and conditions of those licies. The limits of Iiabil" shown ma have been reduced b an id claims. POLICY PERIOD LIMITS OF LIABILITY TYPE OF INSURANCE Effective Date Ex iration Date innin of lic riod BODILY INJURY AND PROPERTY DAMAGE POLICY NUMBER 97-ES-5238-8 This insurance includes: Comprehensive Business Liabili 0 6/01/0 6 181 Products - Completed Operations 181 Contractual Liability D Underground Hazard Coverage 181 Personal Injury D Advertising Injury D Explosion Hazard Coverage D Collapse Hazard Coverage D General Aggregate Limit applies to each project D Each Occurrence $1,000,000 General Aggregate Products - Completed Operations Aggregate $2,000,000 $2,000,000 EXCESS LIABILITY D Umbrella Other POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE Effective Date Ex iration Date (Combined Single Limit) Each Occurrence $ A r; ate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers' Compensation and Employers Liability Each Accident Disease Each Employee POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date Ex iration Date Name and Address of Certificate Holder CITY OF ASHLAND 20 E MAIN STREET If any of the described policies are canceled before its expiration date, State Farm will try to mail a written notice to the certificate holder 10 days before cancellation. If, however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. ~C~,~ Signature of A \C,. ~~lQ \ ASHLAND, OREGON 97520 Title Date --- -----------1---- --