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Home My WebLink AboutChildren's Advocacy Center ACORD~ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/19/2007 PRODUCER (541)772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JBL&K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Philadelnhia Indemnity 18058 Jackson County Child Abuse Task Force INSURER B DBA: Children's Advocacy Center INSURER C 816 W 10th Street INSURER 0 Medford OR 97501 INSURER E 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 Ar..: REf.:ATE L1MITS-.c::HOWN MAY HAVE BEEN REDI Ir.ED BY PAID r.LAIMS. INSR ADD'L TYPE OF INSURANCE PJ>i+~Y ~~f6gl)~~ Pg~~Y/~~~t~~N LIMITS POLICY NUMBER ~NERAL LIABILITY EACH OCl:IlRRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~~C~~J9E~ENT~~ence\ $ 100,000 A I CLAIMS MADE D OCCUR PHPK262772 11/1/2007 11/1/2008 MED EXP An one oerson\ $ 5,000 PER."nNAL iI. ADV INJIIRY I 1,000,000 GENERAL AGGREGATE $ 3,000,000 ~'L AGG~EnE LIMIT nES PER PROD' '''''T'' - COMP/OP AGG I 3,000,000 X POLICY ~WT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) - ANY AUTO - ALL OWNED AUTOS BODILY INJURY (Per person) $ - SCHEDULED AUTOS - HIRED AUTOS SOOIL Y INJURY $ (Per accident) - NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) ==iAGE LIABILITY AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY' AGG $ =SESS/UMBRELLA LIABILITY ."000'00 $ OCCUR D CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION <I: $ WORKERS COMPENSATION AND l'r~'65mT,If~ I IO,'",\'- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E,L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ A OTHER Professional Liab. PHPK262772 11/1/2007 11/1/2008 Each Incident $1,000,000 Aggregate Limit $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is an additional insured per form CG2026 attached. CERTIFICATE HOLDER CANCELLATION City of Ashland, its officers Attn: Jill Turner City Hall Ashland, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 ~J<.~ ACORD 25 (2001/08) INS025 (0108).0803 Sandy Orr/SANDOR @ACORDCORPORATION1988 Page 1 012 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) INS025 (0108}.08a Page 2 of 2 POLICY NUMBER: PHPK262772 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(sl Or Oraanlzatlonlsl CITY OF ASHLAND, ITS OFFICERS AND EMPLOYEES Information reauired to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to in- clude as an addijional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to YOlL CG 20 26 07 04 @ ISO Properties, Inc., 2004 Page 1 of 1 o