HomeMy WebLinkAboutInsurance Certificate: Community Health Center
A CORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY)
5/28/2008
PRODUCER (541)482-0831 FAX: (541)488-5851 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ashland Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
585 A Street Suite 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 880
Ashland OR 97520 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Mu tual of Enumclaw 14761
Community Health Center Inc INSURER B:
19 Myrtle Street INSURER C:
INSURER 0:
Medford OR 97504 INSURER E:
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.
AGl REGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~;: ~~~~ TYPE OF INSURANCE POLICY NUMBER P~;+~~:~~~8,wIE Pg~!fJ/~~~~N LIMITS
GENERAL LIABILITY ~ACH O~NCE $ 1,000,000
--
X COMMERCIAL GENERAL LIABILITY ~~~~g~J?E~~~d~~nce\ $ 300,000
A I CLAIMS MADE ~ OCCUR NC18143 3/14/2009 3/14/2010 MED EXP IAnv one oerson) $ 10,000
PERSONAL & Anv IN.IIIRY $ 1,000,000
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREAE LIMIT APPLIES PER: PRODLJCT!=: - COMP/OP Ar:r: $ 2,000,000
:xl PRO- r--l
POLICY :1I='r.'= LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY , .---..-- $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION ~ $
WORKERS COMPF.NSATION MID I TVX~$T ~]}t~ I 10J~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E,L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ADDITIONAL INSURED
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
Its Officers, Employees & Agents
Bryn Morrison
20 E Main St
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 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
ACORD 25 (2001l08)
INS025 (0108),08a
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