HomeMy WebLinkAboutInsurance Certificate: Help Now Advocacy Center
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.....ACORD~
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~ ~ DUCER
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· .estern States Ins.
739 Medford Canter
Medford OR 97504
Phone: 541-779-1321
2008J 1: 32AM_WERTERN STATES INS
CERTIFICATE OF LIABILITY INSURANCE
- Medford
P. 1
OP 10 K9 I DATE (MMIODIYYYY)
HELPN-1 OS/28/08
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 POL.ICIES BEL.OW.
No. 3797
Fax:541-779-91B7
INSURERS AFFORDING COVERAGE
Mutu..J. or i:ht>>'llCl$.w In8Uk'~nCe
NAIC#
---" .'-
14761
INSURED
He1p Now Advocacy Center
L~rrv Kahn
33 ~Central Ave #211
Medford OR 97501
COVERAGES
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E
...--.----
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSuED TO THE INSURf:D NAMeD ABOVe F'OR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIRf:MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATe MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE. AF'FORDED BY THE POLICIES DESCRIBED HE:REIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICieS. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDuCED BY PAID CLAIMS.
.... POLl~11 EFFECTI~t:. ll:1ll~AIINr -__.___I.."...",~~ ..... -."..
LTR NSIl.[ TY!"E OF INSURANCE POLICY NUMBER DATI; MWODfYV DATEIMM/DOIYVi LIMITS
GENERAL LIABILITY EACH OCCURRENCE: $ 500000
- PREM~ES (Ea OC"f"..ur~n~)
A X COMMERCIAL GENERAL LIABILITY NC51029 03/13/08 03/13/09 $ 300000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5000
...._'..'...
PERSONAL & ADV INJURY $ Exccl uded
.-.... - --
GENERAL AGGREGATE $1000000
-.....-..- .-
GEN'L AGGA.EGArE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Excluded
I POLICY n j~& nLOC
AUTOMOBILE LIABILITY COMBINED SINGLe LIMIT
-- $
ANY AuTO (E~ ~=dM()
- ...-..,-. -,.,.~"
ALL OWNED AuTOS BODILY INJURY
- $
SCHEDULED AUTOS (P~r person)
--
HIRED AUTOS eOOIL Y INJURY
- (Per eccident) $
NON-OWNED AUTOS
- -..
~ -.---.. PROPERTY DAMAGE $
(Per accidenl)
GARAGE LIABILITY AuTO ONLY - EA ACCIDENT $
=1 ANY AUTO -...... ---
OTHER THAN EAACC $
AUTO oNLY: AGG $
EXCI;SSlUMBRELLA LIABILITY EACH OCCuRRENCE $
~ OCCUR o CLAIMS MADE .-.
AGGREGATE $
-'-"--
$
-----.---------
R DeDUCTIBLE $
.......-.
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1MmS I lu~r
ER
EMPLOYERS' LIABILITY -.-------
E,L, EACH ACCIDENT $
ANY PROPRIE;TOR/PARTNERlEXECUTIVE r--' -----..
OFFICERlMf:M6ER EXCLUDeD? E.L. DISEASE - EA EMpLOYEf: $
~~~~I~ta~~~v~~~~s below f---.-. .......... ..,.""..., . --.. --
e.L. DISEASE - POLICY LIMIT $
OTHER
A Property NC51029 03/13/08 03/13/09 Contents $15,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Policy premium has been paid in full.
CERTIFICATE HOLDER
CANCELLATION
City of Ash1and
Bryn Morrision
Fax: 488-5311
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES GE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR
Ash1and OR 97520
@ACORD CORPORATION 1988
ACORD 25 (2001/08)