HomeMy WebLinkAboutInsurance Certificate: Caring Communities
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Caring Communities,a reciprocal Risk Retention Group
CERTIFICA TE OF INSURANCE
THIS CERTIFlCA TE IS ISSUED AS A MA ITER OF INFORMA TION ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICA TE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES
BELOW.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW 1IA VE BEEN ISSUED TO THE POLICYHOLDER
FOR THE POUCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDrrlON OF ANY
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFICA TE MA Y BE ISSUED OR MA Y PERTAIN, THE
INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU THE TERMS, EXCLUSIONS AND
CONDITIONS OF SUCH POUCIES. UMITS SHOWN MA Y HA VB BEEN REDUCED BY PAID CLAIMS,
Date Certificate Issued: January 4, 2008
Certificate Holder: The City of Ashland
Insurer: Caring Communities, a reciprocaJ Risk Retention Group
Washington D.C.
Policyholder: Pacific Retirement Services, Inc.
Policy Numbe'r: CCRRRG 0015
Named INSURED: Rogue Valley Manor Community Services
Policy Form: Senior Services Organization Liability Policy
Policy Term: January 1, 2008 - January J, 2009 at 12:0 J AM
Primary Coverages: Senior Services Organization Professional Liability,
Commercial General Liab i I ity and
Employee Benefit Programs Liabi I ity
Primary Coverages Limit of Liabili,y: $ 1,000,000 Per CLAIM and
$ 3,000,000 Policy Period Aggregate, all coverages
Self Insured Retention: $50,000 Per CLAIM
Excess Coverages: Senior Services Organization Professional Liability,
Commercial General Liability,
Employee Benefit Programs Liability,
Automobile Liability and
Employers'l Liability
Excess Coverages are subject to the following Underlying Insurance Requirements:
Senior Services Organization Professional Liability $ J ,000,000 Per CLAIM
Commercial General Liability $ t ,000,000 Per CLAIM
Employee Benefit Programs Liability $ 1,000,000 Per CLAIM
Automobile Liability $ 1,000,000 Each Accident
Employers' Liability $ 1,000,000 Each Accident / Disease
Excess Coverages Limits of Liability:
Senior Services Organization Professional Liability $ 10,000,000 Per CLAIM
Commercial General LiabiJ ity $ 10,000,000 Per CLAIM
Advertising Liability $ 5,000,000 Per CLAIM I Policy Period Aggregate
Watercraft Liability $ 5,000,000 Per CLAIM I Policy Period Aggregate
Employee Benefit Programs Liability $ 5,000,000 Per CLAIM / Policy Period Aggregate
Automobile Liability $ 6,000,000 Each Accident
Employers'Liability $ 5,000,000 Each Accident I Disease and Policy
Period Aggregate
CCRRRG (1/08)
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Senior Services Organization Professional Liability losses originating in Texas, Florida, Arkansas and Louisiana
are limited to: $ 2)000.000 Per CLAIM and Policy Period Aggregate
Overall Aggregate Limit of Liability: $ 11,000)000 Per Any One Event
$ 13)OOOtOOO All Events for Policy Period
Additional Terms, Conditions and Exclusions: The Certificate Holder is included as an Additional INSURED under
this POLICY but only with respect to liability arising out of services rendered by the Named INSURED as outlined
within the terms and conditions of the contractual agreement for the Foster Grandparent program between the City of
Ashland and the Named INSURED.
CJ-Iu,rJL
January 4, 2008
Authorized Representative
Caring Communities, a reciprocal Risk Retention Group
Date Certificate Signed
CCRRRG () 108)
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