HomeMy WebLinkAboutInsurance Certificate: Interfaith Care Community
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYVYY)
8/1/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Hull & Company, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
6443 SW Beaverton-Hillsdale Hwy HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 350
Portland, OR 97221 INSURERS AFFORDING COVERAGE NAtC #
INSURED INSURER A Capitol Specialty Insurance Corporation
Interfaith Care Community of Ashland/CERVS INSURER B
601 N. Grape Street INSURER C
INSURER D
Medford, OR 97501 INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY COI\ITRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ~D'L . lVPI= OF POLICY NUMBER P8.k+i~~~~&'W~ Pg~!fJ r~~~~~N LIMITS
LTR iNSRI"I
A X GENERAL LIABILITY CS01255047 8/20/2008 8/20/2009 EACH OCCURRENCE $ 500,000
r--
X COMMERCIAL GENERAL LIABILITY ~~~~~~ YE~~~6~'~nceJ $ 100,000
:=:=J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJJRY $ 500,000
r-- 500,000
GENERAL AGGREGATE $
- 500,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $
I POLICY n ~8T n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
I--
ALL OWNED AUTOS BODIL Y INJURY
I-- $
SCHEDULED AUTOS (Per person)
I--
I-- HIRED AUTOS BODIL Y INJURY
$
NON-OVVNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
o OCCUR n CLAIMS MADE AGGREGATE $
$
R DEDUCTiBlE $
RETENTION $ $
WORKERS COMPENSATION AND I WC STATU- r IOTH-
TORY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If ~s, describe under IblWCEx $
S ECIAL PROVISIONS below EL DISEASE - POLICY LIMIT
A OTHER CS01255047 8/20/2008 8/20/2009 $1,033,000 TIV BLDG: 1 LOC:1-6
PROPERTY $791,000 TIV BPP: LOC 1-7
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is listed as Additional Insured per form CG2012 AI - State or Political Subdivisions - Permits.
BLDG 1 LOC #1-4,6: 90% COINS, ACV, BASIC, $500 DED
BLDG 2 LOC #4: 90% COINS, ACV, BASIC, $500 DED
BPP LOC #1-7: 90% COINS, ACV BASIC, $500 DED
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
-
20 E. Main NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH: LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF Am KIND UPON THE INSURER, ITS AGENTS OR
Ashland, OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ..........~, d
I 1"-1 Yv">-* J~...lW)CJ.....v
ACORD 25 (2001/08)
@ACORD CORPORATION 1988