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Home My WebLink AboutInsurance Certificate: Theron D Logan ACORD", ..CERTIFICATEOF LIABILITY INSURANCE OP 10 D~ DATE (MM/DDIYYYY) LOGTH-1 01/23/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Marketplace, ~nc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1998 Skypark Dr Suite .100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 Phone:541-779-0177 Fax:FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Liberty Northwest Ins INSURER B: Theron D. .Logan INSURER c: 338 Cher;y Wood INSURER D: Eagle Point OR 97524 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRt TYPE OF INSURANCE POLICY NUMBER PD~~~1ti~r8~tWiE P8k!fEy(~~thRD~~N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500 ,000 - A X X COMMERCIAL GENERAL LIABILITY BHO (10) 5344 62 05 01/.12/09 01/12/10 U~Mf'\\:IC I v KeN I eU $ 100000 PREMISES (Ea occurence) I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 10000 PERSONAL & ADV INJURY $ 500,000 - GENERAL AGGREGATE $ 1 ,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (Ea accident) $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - (Per person) $ SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY - (Per accident) $ NON-OWNED AUTOS - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ =i ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ ~ OCCUR D CLAIMS MADE AGGREGATE $ $ =i DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS I IUJH- ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ ~~~~I~tS~~oJ:~~6NS below E.L. DISEASE - POLICY LIMIT $ OTHER ~c~'~~._ r =" 'r-~".. . q \\ n iT~ fm I r\l' r.? V -~ t cO r. ,II ... r f\ ~ ; ~..:.~:~ :::-:-~~...', \'>t... ~ i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 1U) j "'... . ! P additional insured as per attached blanket additional insdform CG85 f ~< I ' Ii 05/05 I U JAN 2 6 2009 'I )1: ! \ ! i }' t!:'l; L -- ? . i J City of Ashland 27 1/2 N Main Ashland OR 97520 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 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 KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Kevin Cope CERTIFICATE HOLDER ACORD 25 (2001/08) @ ACORD CORPORATION 1988 COMMERCIAL GENERAL LIABILITY CG 85 76 05 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY MASTER P AK@ (OREGON) This endorsement modifies insurance provided under the following: - - COMMERCIAL GENERAL LIABILITY COVERAGE PART - - - - INDEX PAGE SUBJECT ~ - - BLANKET ADDITIONAL INSURED (OWNERS, LESSEES, CONTRACTORS OR LESSORS) 2 - - - FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT - 3 4 - NON-OWNED WATERCRAFT - - SUPPLEMENTARY PAYMENTS (BAIL BONDS) - - 4 PERSONAL AND ADVERTISING INJURY - ELECTRONIC PUBLICATION EXTENSION 5 5 AGGREGATE LIMITS (PER LOCATION) 5 AGGREGATE LIMITS (PER PROJECT) 6 VOLUNT ARY PROPERTY DAMAGE COVERAGE OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE 6 7 NEWLY FORMED OR ACQUIRED ORGANIZATIONS DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 8 BODILY INJURY (MENTAL ANGUISH) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS 8 8 MEDICAL PAYMENTS n__~ ., ,..f Q -11f-l 1. BLANKET ADDITIONAL INSURED (Owners, Lessees, Contractors or Lessors) (lncl udes a Primary/Non-Contributory provision) Section II _ Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy in a written contract or written agreement. The written contract or written agreement must be currently in effect or becoming effective during the term of this policy and executed prior to the "bodily injury," "property damage" or "personal and advertising injury:' A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. The insurance provided the additional insured is limited as follows: A. The person or organization is only an additional insured with respect to liability caused by your negligence and: 1. Arising out of real property, as described in a written contract or written agreem'ent, that you own, rent, lease or occupy; or 2. Caused by your ongoing operations performed for the additional insured. The insurance provided the additional insured in 1.A.2. above does not apply to: a. Coverage A _ Bodily Injury and Property Damage Liability, Coverage B - Personal and Ad- vertising Injury Liability or defense coverage under the Supplementary Payments arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opin- ions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. b. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) that was performed by or on behalf of the additional insured(s) at the site where the covered operations have been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing a principal as part of the same project. B. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of Insurance as stated in the Declarations of this policy and defined in Section III _ Limits Of Insurance of this policy, whichever are less. These limits are inclusive of and not I in addition to the limits of insurance available under this policy. C. The insurance provided the additional insured does not apply to the liability resulting from the neg- ligence of the additional insured. 1__ ...:+h:+" nOl"l'Y'Iiccinn Pace 2 of 8 _ D. As respects the coverage provided to the additional insured under this endorsement, Section IV- Conditions is amended as follows: 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim, or Suit An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense, that may result in a ciaim or "suit" under this insurance to us; - - - - - - - - - - b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. 2. The following is added to Condition 3. Legal Action Against Us: We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. 3. The following is added to Paragraph a., Primary Insurance of Condition 4. Other Insurance: If the additional insured's policy has an Other Insurance provision making its policy excess, and a Named Insured has agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured1s policy for damages we cover. 4. The following is added to Paragraph b., Excess Insurance of Condition 4. Other Insurance: Except as provided in Paragraph 4.a. Primary Insurance as amended above, any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis. In the event an additional insured has other coverage available for an "occurrence" by virtue of also being an additional insured on other policies, this insurance is excess over those other policies. 2. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT If Damage To Premises Rented To You under Coverage A is not otherwise excluded from this policy, the following applies: A. The last paragraph of 2. Exclusions of Section 1- Coverage A is replaced by the following: If Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do not apply to damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or temporariiy occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III " Limits Of Insurance. _....:__ I....~ ,,,,ith it~ nprmic:c::inn. PaQe 3 of 8