The URL can be used to link to this page

Home My WebLink AboutCity of Ashland This certificate is issued as a matter of information only and confers no rights upon the certificate holder other than those provided in the coverage document. This certificate does not amend, extend or alter the coverage afforded by the coverage documents listed herein. Named Member or Participant City of Ashland 20 East Main Street Ashland, OR 97520 Companies Affording Coverage COMPANY A - City County Insurance Services (CIS) COMPANY B - Westchester Fire Ins. Co. COMPANY C - RSUllndemnity This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is subject to all the terms, conditions and exclusions of such coverage documents. Type of Coverage Certificate # Effective Expiration Limits Date Date General Liability 05LASH 7/1/2006 7/1/2007 General Aggregate $3,000,000.00 X Commercial General Liability Each Occurrence $1,000,000.00 X Public Officials Liability X Employment Practices X Occurrence 05LASH 7/1/2006 7/1/2007 General Aggregate None Each Occurrence $1,000,000.00 Auto Physical Damage X Scheduled Autos X Hired Autos X Non-Owned Autos 05APDASH 7/1/2006 7/1/2007 A A B C C Boiler and Machinery 05PASH 05BASH 7/1/2006 711/2006 7/112007 7/1/2007 er Filed Values Property er Filed Values Excess Crime Excess Earthquake Excess Flood Workers' Compensation escription: Mount Ashland Hill Climb Run, August 5, 2006 from 7am to 7 pm ertificate Holder USDA Forest Service Attn: Steve Johnson 645 Washington Street Ashland, OR 97520 CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the issuer of this certificate. By: ~~. -4 Date: April 6, 2006 -------.---T- ---. PSA Liability Insurance Summary ~ Named Insured: Professional Skaters Association and Its Members Who Have Paid A Premium and Been Endorsed to the Policy Policy Period: April 30, 2005 to April 30, 2006* Covered Activities: / Instruction of Figure Skating, Strength and Harness Training, Conditioning, BalletIModernlJazz Dance, In-Line Skating, Plyometrics, Power Skating, Power Hockey by Member Instructors and/or Carrier: General Liability-Capitol Specialty Insurance Excess Accident- Lloyd~ofLondon Both A+ rated " Policy Form: Occun:enqeForm with Broadened Coverage Endorsement .' $ 2,000,000 General Liability Protection Progl'8ll1; General Aggregate: Each Occurrence: ....!ii., .... .... . ."; . . $. 1,000,000 (Bodily Injury and Property,Damage Combined Single Limit) '., ' . / Products. Completed Operations Aggregate: $ 1,000,000 Personal Injury and Advertising Injury: $ 1,000,000 Athletic Participants Legal Liability: $ 1,000,000 Fire Damage Limit (Anyone fire): $ 300,000 Sexual Abuse/Mo1estation $ 100,000/ $200,000 Participant Accident Protection Pro&ram Medical Expense/Aggregate $ 25,000/ $100,000 $250 Deductible per injury / *Coverage for each Member Instructor will become effective the latter of the policy effective date or the date on which the completed PSA Liability Insurance Enrollment Form and Payment in full are received by PSA. All cov- erages for Member Instructors expire on 4/30/06. - _. -..----.-~-T--.-- . " QBE INSURANCE CORPORATION Philadelphia, Pennsylvania Deans & Homer 340 Pine Street 2nd Floor San Francisco, Ca 94104 I nsurance Billing August 01, 2006 Your policy is underwritten by Deans and Homer on behalf of QBE INSURANCE CORPORATION It is our pleasure to provide you excellent service. POLICY INFORMATION BILLING INFORMA TIClN POLICY NUMBER: POLICY TERM: INSURED: City of Ashland 20 E Main St Ashland, OR 97520-1850 2671849 6/01/06 - 6/01/07 INSURANCE PROVIDED BY: aSE INSURANCE CORPORATION Due Dclte August 22, 2006 Amount Due $ 375.100 AGENT WHA Insurance Agency, Inc 2930 Chad Drive Eugene, OR 97408-7381 (541) 342-4441 You will receive no more bills until your policy renews or you make a change in coverage resulting in additional premiums. LOCATION(S) & TYPE(S): LOC 1: Arnie Krigel Memorial Sculpture Gar Miscellaneous Property Floater Mortgagee: LOC2: LOC3: See billing detail on rev.~rse. If you have questions or wish to make changes to your policy, please contact your agent. Please detach and return with payment. Please send onlv payments to this address. Send no correspondence. See billing detail for policy contact informatiion. Please make sure the payment address appears in the return window. Due Date Amount Due Amount Enclosed 8/22/06 $ 375.00 j Statement Date: August 01, 2006 Deans & Homer PO Box 45688 San Francisco, CA 94145-0688 11111..1111"111.1'111111.11'111111111.1.1..1.1..1.1..1.1.1'11 OR 16410 Policy: 2671849