HomeMy WebLinkAboutInsurance Certificate: Help Now Advocacy Center
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2009 11 43 AM
WESTERN STATES INS
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6775
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~CORD. CE:RTIFICA TE OF LIABILITY ,INSURANCE OP 10 K9 -- -. - (MM/DDNYYY)
HELPN-l 04/03/09
.. UCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
..~tern States Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
- Medford HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
739 Medford Center ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-1321 Fax:541-779-9187 INSURERS AFFORDING COVERAGE NAIC#
1--.
INSURED INSURER A: Mul:ual of Em.ll:nalav J:n~urahoe 14761
INSUR~R B:
Help Now Advocacy Center INSURER C:
Lar~ Kahn
33 Central Ave #211 INSURER D:
Medford OR 97501
INSURER E;
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE: INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMElIlrWlTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL n~E TERMS, EXCLUSIONS AND CON DITIONS OF' SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'N~R ~~~ TYPE OF INSURANCE POLICY NUMBER PI)~,;!~1~~6&~E POLlC_Y(ijXJ'IRATI.gN LIMITS
LTR DATE MMIODIYY
GENERAL LIABILITY EACH OCCURRENCE ; 500000
I--- ~=;S~s 7E:e~~~;nce)
A ~ COMMERCIAL GENERAL LIABILITY NC51029 03/13/09 03/13/10 $ 300000
I--- o CLAIMS MADE [!] OCCUR ME:D E:)(p (Anyone person) $ 5000
PERSONAL & ADV INJURY $ Excclude~~
I---
GENERALAGGRE:GATE $1000000
I---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ Excluded
n n PRO- nLOC
POLICY JEeT
AUTOMOBILE: LIABILITY COMBINED SINGLE LIMIT'
I--- 5
ANY AUTO (Ea =cidenl)
-
ALL OWNED AuTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUT'OS eODILY INJURY
- $
NON-OWN~D AUTOS (Per accident)
-
- PROPERlY DAMAGE $
(Per accldenl)
GARAGE UABILllY AUTO ONLY - F.=A ACCIDENT $
~ ^"" AU>O OTHER THAN EA ACC $
AU'TO ONLY: AGG S
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGRE:GAn: $
$
~ OEOUC>!"LE $
,'^
RETENTION $ ;
WORKERS COMPENSATION AND [T~~yo(I~\fs I IU~~-
EMPLOYERS' LIABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE E.L. E:ACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L.. DISEASE ~ EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION Or OPERATIONS' LOCATIONS' VEHICLES I EXCLUSIONS ADDED BY r:NDORSEMENT I SPECIAL PROVISIONS
Advocacy office
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
Attn: Bryn Morrison
Fax: 552-5259
SHOULD ANY OF THE ABOVE DESCRIBED POUCII:S BE CANCELLED BEFORE THE EXPIFIA nON
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NonCE TO THE CERTIACATE 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
Ashland OR 97520
ACORD 25 (2001/08)
@ACORD CORPORATION 1988