HomeMy WebLinkAboutInsurance Certificate: Access Inc
ACORDw CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDlYYYY)
4/17/2008
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 CERnFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
li!ledford OR 97504 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Philadel'Dhia Indemnity 18058
Access Inc; INSURER B:
Conifer Gardens Lt:d Part:nership INSURER c:
3630 Aviation Way INSURER D:
li!ledford OR 97504 INSURER E
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING ANY
REQUIREMENT, TERM OR CONDIllON 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 CONDIllONS OF SUCH POLICIES.
'..,or<- Y p41n ('141M"'.
INSR ADD'L TYPE OF INSURANCE POLICY NUMBER p~.k+~~~~~6&R.vr ~~!fJ,~:C~~N LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1,000,000
~ 3'MERCIAL GENERAL LIABILITY ~~~~~J9E~~~~nce\ $ 100,000
A X - CLAIMS MADE ~ OCCUR PHPK306508 4/17/2008 4/17/2009 MED EXP I Anv one ""rson \ $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
-il'L AGGREnE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
PRO- n 1,000,000
X POLICY JECT LOC Professional Liab,
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
..!... ANY AUTO (Ea accident)
A ALL UVVNI::U AU I U::; PHPK3015508 4/17/2008 4/17/2009 BODILY INJURY
- (Per person) $
- SCHEDULED AUTOS
..!... HIRED AUTOS BODILY INJURY $
...!.. NON-OVVNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
=i ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY "DRI=Nr.1= $ 5,000,000
~ OCCUR D CLAIMS MADE AGGREGATE $ 5,000,000
$
A ~ DEDUr.TIBLE PHUB237254 4/17/2008 4/17/2009 $
X RETENTION ~ 10 000 I~
WORKERS COMPENSATION AND IT~Nfi.Wsl IOJ6'-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
11 yes, describe under
,,6c";,A oo.-."''''.-.N'''....1nw EL. DISEASE - POLICY LIMIT $
A OTHER Auto Physical. PHPK30650S 4/17/2008 4/17/2009 Comprehenaive $500 Oed.
Damage Coverage Collision $1,000 Oed.
DESCRIPTION OF OPERA TIONS/LOCA TIONSlVEHICLESlEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate holder is an additional insured as respects General Liability as required by written contract. This form
is subject to policy terms, conditions and exclusions.
CERTIFICATE HOLDER
CANCELLA nON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Cit:y of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
its officers, employees & agents 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT
Attn: Kristen Bakke -
FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
20 E Main street
Ashland, OR 97520 INSURER. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~cJ<.~
Sandy Orr/SANDOR
ACORD 25 (2001/08)
INS025 (0108).080
@ ACORD CORPORA nON 1988
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