HomeMy WebLinkAboutOregon Stage Works
NON PROFIT PROFESSIONAL LIABILITY POLICY
THIS IS A CLAIMS MADE POLICY. PLEASE READ THIS POLICY CAREFULLY.
NEW
Renewal of Number
.
UNITED STATES LIABILITY
INSURANCE COMPANY
WAYNE, PENNSYLVANIA
040051
CUSTOMER COPY
No. NDOI056498
POLICY DECLARATIONS
ITEM I. PARENT ORGANIZATION AND PRINCIPAL ADDRESS
8lr~u Stage Works
191 A Street
Ashland, OR 97520
9~
ITEM II. POLICY PERIOD: (MM/DDIYYYY)
FROM 317/2006 TO 317/2007
12:01 AM STANDARD TIME AT YOUR
MAILING ADDRESS SHOWN ABOVE
IN RETURN FOR THE PA Yf.1ENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY,
f THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH LIMITS OF LIABILITY ARE INDICATED.
t
I Coverage Part A. Non Profit Directors and Officers Liability
f ITEM III. LIMITS OF LIABILITY: $1,000,000 EACH CLAIM
I Not Covered FIDUCIARY LIABILITY LIMIT
~ $1,000,000 IN THE AGGREGATE
ITEM IV. RETENTION: $0 EACH CLAIM
ITEM V. PREMIUM: $744
Coverage Part B. Employment Practices Liability
ITEM III. LIMITS OF LIABILITY: $1,000,000 EACH CLAIM
$1,000,000 IN THE AGGREGATE
ITEM IV. RETENTION: $0 EACH CLAIM
ITEM V. PREMIUM: $156
NOTICE: DEFENSE COSTS SHALL BE APPLIED AGAINST THE RETENTION.
ITEM VI. Coverage Form(s)/Part(s) and Endorsement(s) made a part of this policy at time of issue:
USL-DQJ (04-00) Policy Jacket 00-273 (04-02) FLSA, Exclusion
NPPLA (09-05) Application 00-279 (05-05) Broad Form Protection and Cov. Amend. Endt.
DNOTIC (12-02) DiscI. Notice of Terrorism Insurance Coverage OO-OR (02.Q1) Oregon State Amendatory Endt
00-100 (04-00) Coverage Part A
00-101 (04-00) Coverage Part B
Date Issued: 31912006
::D(11:DEMNITYEX~:US;~::>:~:1 ~~~
8
ZURICH
MARYLAND CASUAL TV COMPANY
PRECISION PORTFOLIO POLICY - COMMON DECtARA TIONS
PRECISION PREMIER
INSTITUTIONAL PROGRAM
1'f\i$J)oticyconsists of the declarations as well as the coverage forms and endorsements
Jist~do'l. the Forms and Endorsements Applicable List
SURED AM) MAILING ADDRESS .1.:!lt:...::::::6~:~~:s:~::::=~:::::6~::::~~~~i~i~~::::~,~:~~~::::::::::]l'!:!l:!
I NStRANCE CENTER
PO BOX 6
JACKSONVillE m 97530-0006
(541) 899-9535
I'fNAMEAND SERVICING ADDRESS
:~~:I:r:':':':::':':':":'::"""':':"':":'::':':..;~~;~;.;~~.;.~~....:.:..:....:..:.......:..:...:."'..:.:.:.:.:....:::1~:::1:~
:~~tt;:::~:::::::::::::::::::::::::;:::::::::::::::::::.:::::::::::::;::::::7:::':::::;::~;:::::::::::::;:::::;:;:::;:::::::::::::::;::;:::;:;:::;:::;:;:::;:;:::;:;::~:::~::::::::::::::::::;::::::;:::::::::::::::}~~~~~~~
ZtlUCH tmlf - SEAmE
P.O. BOX 10197
JACkSONVIllE, FL 32247-6197
(800) 800-3901
FROM
02/15/2006
12:01 am
TO
U\ITIL CANCB..lED1
NON-RENEWED
f BUSINESS ENTITY: CORPOOATION
POlICY PREMUMS
loret\Jrn fl)r the payment of the premium, and subject to all the terms of this policy,
Weiilgr~~.With you to provide the insurance as stated in this policy.
ThisJ)c>licy consists of the following coverage parts. This premium may be subject to
iildj\Jsttnetlt
CtIIfRCfAL.WSlTY COVERAGE PART
COIlPCIAl.GEtIRAl. LIABILITY COVERAGE PART
PREMIUM
S 870.00
S 3,432.00
PREIIltIISIZE .,T S 88.00-
FEDERAL TERlftIUSltPREIIl1l S 86.00
TOTAl AI\N.IAl.f'REMIlN S 4,300.00
YOII PRECISION POlICY RENElAl. PREUllIllIltrei A lQSS-fREE CREDIT.
Countersigned by
Authorized Representative
Date
CONI\<<)N
9S5007 Ed. 09-02
includes copyrighted material of Insur..ce Services Office. IRC., with its p.rmissioIL
Copyright. InsurHce Services Offic., Ine.. 1984.
Copyright. Morylond Cosuolty Compony, 1992.
INSlIED'S afY
1.1.1
01/10/2006
--------...----_. .-...-
i'__@ f@Imm@fi, U~i~18:~~W It:i\i9;::m~tI: i'it:mfi:iii\igjjft!@~~i@:::ttII :m:i:@~::m:ti@~II::m:~t:tl~~i:i::I:::@m::::::.
OPPS .'867541 17048778 M013280302-001-00001 AtftJAL
'~.kV ~RICH GROUP - ANtIIVERSARY EFF 02/15/2006
.aJU
9S5007
COMVION
9S5OO8 Ed. 3-00
.....-..--- --._--,-- .--
PRECISION PORTFOLIO POLICY
SUPPLEMENTAL DECLARATIONS
PRECISION PREMIER
INSTITUTIONAL PROGRAM
o
ZURICH
.:.::::::::iii~i:!:n~i~j~.j:f~I!::"fj:jji:ij:f:f::.ii~.~iilll.iijl__~.:1_lIiil..ii.'i".'iili:i:..:i.":i':lj.:.lilii":.1
aJII)N POll CY DECI..ARA TIOMS
0902
Retained UinilUl PreliUl - $100
ImED'S copy
1. 2. 1
01/10/2006
" ;
NON PROFIT PROFESSIONAL LIABILITY POLICY
THIS IS A CLAIMS MADE POLICY. PLEASE READ TIllS POLICY CAREFULLY.
NEW
Renewal of Number
UNITED STATES LIABILITY
INSURANCE COMPANY
WAYNE, PENNSYL VANIA
t ,
040051
CUSTOMER COPY
No. NDOIOS6498
POLICY DECLARATIONS
ITEM I. PARENT ORGANIZATION AND PRINCIPAL ADDRESS
Oregon Stage Works
191 A Street
Ashland, OR 97520
9~
ITEM It POLICY PERIOD: (MM/DDIYYYY)
FROM 3/7/2006 TO 3/7/2007
12:01 AM STANDARD TIME AT YOUR
MAILING ADDRESS SHOWN ABOVE
IN RETURN FOR THE PA Ytl1ENT OF THE PREMIUM. AND SUBJECT TO ALL THE TERMS OF THIS POLICY. WE AGREE
\NITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF TIlE FOLLOWING COVERAGE PARTS FOR WHICH LIMITS OF LIABILITY ARE INDICATED.
Coverage Part A. Non Profit Directors and Officers Liability
ITEM III. LIMITS OF LIABILITY: $1,000,000 EACH CLAI~
Not Covered FIDUCIARY LIABILITY LIMIT
$1,000,000 IN THE AGGREGATE
ITEM IV. RETENTION: $0 EACH CLAIM
ITEM V. PREMIUM: $744
Coverage Part B. Employment Practices Liability
ITEM III. LIMITS OF LIABILITY: $1,000,000 EACH CLAIM
$1,000,000 IN THE AGGREGATE
ITEM IV. RETENTION: $0 EACH CLAIM
ITEMV. PREMIUM: $156
NOTICE: DEFENSE COSTS SHALL BE APPLIED AGAINST THE RETENTION.
ITEM VI. Coverage Form(s)/Part(s) and Endorsement(s) made a part of this policy at time of issue:
USL-OOJ (04-00) Policy Jacket 00-273 (04-02) FLSA. Exclusion
NPPLA (09-05) Application 00-279 (05-05) Broad Form Protection and Cov. Amend. Endt.
. DNOTlC (12-02) DiscI. Notice of Terrorism Insurance Coverage DO-OR (02-01) Oregon State Amendatory Endt
00-100 (04-00) Coverage Part A
00-101 (04-00) Coverage Part B
Date Issued:
31912006
INDEMNITY EXCESS & SURPLUS AGENCY, INC. (:~23] ~ A~
.~~ ' "41 I. () Authorized Representaf
USL-DOD (11/97) O""~~ .J:.:.o ~~,....~ .;:
Agent:
...T....--.
".ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP 10 1~ OAt!; (1I/l1',1lOorrrm
OREGO-l 07/14/06
~ROOUCEJt THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
rhe InsuranC& Center, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
~40 West "C" Street HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXiENP OR
?OBox6 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Jacksonville OR 97530
Phone: 541-899-9535 Fax: 541-899-9532 INSURERS AFFORDING COVERAGE NAle.
NSURED INSURER A: Zurich Insurance Company
INSURER B:
Oregon Stage Works,Inc. INSURER c:
191 A Street INsUReR D:
Ashland OR 97520
INSURER E:
IHE INSURANCE CENTER Fax; 541-899-9532
Jul 14 2006 03;21pm P001/001
::OVERAGES
THE PO~'C'E$ OF INSURANCE LISTED BELOW HAVE BEEN ISSUEo TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEO, NOTwiTHSTANDING
!f,NIY REQUIREMet>IT, TERM OR CONDITION OF ANY CONTRACT OR OTHeR DOCUMENT WITH REQPECT TO WHICH THIS C!;RTlFICATE MAY BE ISSUED OR
MAY PE~TAIN, THE; 1N8URA"ICE AI=FORDED BY THE POliCIes DESCRIBED H!;RI;I~ IS 6UilJECT TO ALL THE TERMS, EXCLUSIONS AND CONOITIONS OF :;;UCI-l
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE IlE1EN REDUCED BY PAID CLAIMS.
_Tit )l~t(Q TYPE OF INSURANC!! POL.ICY NUMBER 'DA'ii(MMiriifiWr DATsrM~ LIMITS
! GENERAL LIA8IUTY EACH OCCUR~eNcE $1000000
A X ~."o., G""",ce"""" PPS041867541 02/15/06 02/15/07 PR~M~'fS (E~ OOClI~nce) $ 1000000
CLAIMS MADE ~ OCCiJ~ MED EXP (Anyon" per3on) $10000
PERSONAL & ADV INJURY $1000000
GENERAL AGGREGATE $2000000
-
n'L AGGREGATE LIMIT APPLIES PER. PRODUCT5-COMnOPAGG S 2000000
.n.PRO- .n-
POuCY JEeT LOC
AiJTOIIIIOBILE LIABILllY COMElINED SINGLE I.,IMIT
'-- $
ANY AUTO (Ea ~a:idQnl)
r-
"" ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per perean)
I--
r- HIRED AUTOS BOOI~ Y INJURY
S
NON-OWNED AUTOS (P8r ~<X:laenl)
r--
I-- PROPERTY DAMAGE $
(Per ~ccid"nt)
GAAA.e;~ llAall-lTY AUTO ONLY - EA ACCIOENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ON~ V: AGG $
CXCESSl\JMBftELLA llABILITY EACH OCCURRENCE $
I:J OCCUR C CLAIMS. MADE AGGREGATE $
S
R OEDUCTIBLE $
ir,f. RETENTION $ $
WORKERliI COMPiNSAllON AND ITo'~yOLtM;Ts I IOJ~-
I!MPLOYERS' I.IASILllY
ANY PROPRIETORlPARTNE;RJEXECUTIVe: E.L. EACH ACCIDENT $
OPFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~E~~~5~~J:a?~~s below E.L. DISEASE - POLICY liMIT $
OTHE~
l.ESCRlPllON 01' O~~IV<TloNe' LOCATIONS' V~HleL~t/ (I;)(CL.UeIONS ADDiD BY ENDOltSE&lEN1', SPECIAL PROVISIONS
~amed Additional Insured: City of Ashland, It's Office:rs, Employ-Gas and
~nts
fit
;ERTIFfCATE HOlDt:;R
.
CANCELLATION
CITYASH liIHOULD ANYOFTH~ AElO~ DI;!SCRISED POLICIES BE CANCELLED a~FORe THE EXPIRATION
DA.TE THER!!OI', THE ISt/UINe INSURER WILL ENDI!AVOIt TO NIAlL ~ DA.YS WRnTEN
NOllC! TO TH~ OERTlFIOATE HOLDER NAM!!D TO THE; LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILflY OF ANY KIND UF>ON THE INSURER, ITS AGENTS OR
RiPRESENTATIVE$.
AUTHORIZED ~EPIt~$eNTATIVi
Geor e Wheeler
Ci.ty of Ashland
20 East Main St.
Ashland OR 97520
\CORD 26 (2001/08)