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Home My WebLink AboutSouthern Oregon Adolescent ACORDN CERTIFICATE OF LIABILITY INSURANCE CSR ME DATE (MMlDDIYYYY) 9S0AST1 06 21 06 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Hart Insurance P. O. Box 1240 Grants Pass OR 97528 Phone: 541-479-5521 INSURED Fax:541-474-1890 INSURERS AFFORDING COVERAGE INSURER A FIRST NATIONAL INS INSURER B: FIRST NATIONAL INS INSURER C: GENERAL INS CO INSURER D: SAIF CORP INSURER E: NAIC# Southern Oregon Adolescent Study & Treatment Center, Inc. 715 Ramsey Avenue Grants Pass OR 97527 CO CO 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. IN:iK ~~~[ POLICY NUMBER 'D~~~~MMlDDIY'iI I I~ LIMITS LTR TYPE OF INSURANCE DATE (MMlDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - A X X COMMERCIAL GENERAL LIABILITY 25CC04022540 07/01/06 07/01/07 PREMISES (Ea occurence) $ 200,000 X I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 !xl POLICY n ~f8i n LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 - B X ANY AUTO 25CC01376430 07/01/06 07/01/07 (Ee accident) - ALL OWNED AUTOS BODILY INJURY c-- $ SCHEDULED AUTOS (Per person) I--- ~ HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS f- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $ tJ OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTiON $ $ WORKERS COMPENSATION AND X I TORY LIMITS I IU~~- D EMPLOYERS' LIABILITY 953977 07/01/06 07/01/07 E.L. EACH ACCIDENT $ 500,000 ANY PROPRiETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER C PROFESSIONAL LIAB. HCM7770292D 07/01/06 07/01/07 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CITY OF ASHLAND, ITS OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED ACCORDING TO TERMS AND CONDITIONS OF CONTRACT FOR GRANT MONIES. CERTIFICATE HOLDER CITYASH CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAlLURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF Y KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV CITY OF ASHLAND 20 E. MAIN ST ASHLAND OR 97520 / Mark O'Hara ACORD 25 (2001/08) - --- ------..-