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Home My WebLink AboutInsurance Certificate: Multicultural Assoc of SO .i , CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DONYYY) A CORD_ OPID SAW I MULTI-1 06/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Protectors Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Pilot Rock Ins Agency LLC (CA) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 4669 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97501 Phone: 541-773-5358 Fax: 541-772-1906 INSURERS- AFFORDING COVERAGE NAIC# INSURED INSURER A' Travelers IndQll\l\ity Co of Conn INSURER B: Multicultural Association of INSURER c' Southern Oregon PO Box 67 INSURER 0: I Medford OR 97501 I 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 HERE!N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR-AOO' ~~1!~TJ~rJ.f,wlE P~k!fll~J;b'b"~~N L TR INSR TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE .1 000 000 - 06/01/09 06/01/10 PREMIS'ES YEa occurence} A X ~ COMMERCIAL GENERAL LIABILITY X660746X6496 .100,000 - ~ CLAIMS MADE ~ OCCUR MED EXP (Any ona person) . 5, 000 PERSONAL & ADV INJURY $1,000 000 GENERAL AGGREGATE .2,000,000 ~.~ AGG~EnE:L1MIT APnS PER PRODUCTS - COMPIOP AGG .2,000,000 POLICY I Fjf8i LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT , 1,000,000 A ANY AUTO BA1335W096 06/01/09 06/01/10 (Eaaccident) - ALL OWNED AUTOS BODILY INJURY - , SCHEDULED AUTOS (Per person} - X HIRED AUTOS BDOIL Y INJURY , ~ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE , (Per accident) ~":GE UABIUTY AUTO ONLY - EA ACCIDENT , ANY AUTO OTHER THAN EA ACC , AUTO ONLY: AGG , ::JESS/UMBRELLA LIABILITY EACH OCCURRENCE , OCCUR D CLAIMS MADE AGGREGATE . , =1 DEDUCTIBLE , RETENTION . $ WORKERS COMPENSATION AND I TORY LIMITS I I U ~~- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ ~~~2~~S~~b6'v~~?6~s belaw E.L. DISEASE - POLICY LIMIT . 10THE. I DESCRIPTION OF OPERATIONS J lOCATIONS I VEHICLES { EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Ashl.and is an additional. insured per GN01880196 CERTIFICATE HOLDER CANCELLATION Ci ty of Ashl.and 20 E Main Str Ashland OR 97520 CITYAS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAll ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. A~ @ACORDCORPORATION 1988 ACORD 25 (2001/08) POLICY NUMBER: X-660-746X6496-TCT-09 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 05-07-09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHARITY FIRST -AMENDMENT OF COVERAGE- WHO IS AN INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization (Additional Insured): Designation Of Premises (Part Leased to You) WHO IS AN INSURED (Section II) is amended to include as an insured: A. Your members and volunteers but only with respect to their liability for your activities or ac- tivities they perform on your behalf; B. Your trustees or members of the board of gover- nors while acting within the scope of their duties as such on your behalf; and C. Person(s) or organization(s), whether or not shown in the Schedule above, but only with respect to their liability arising out of: 1. Their financial control over you; 2. Their requirements for. certain performance placed upon you, as a non-profit organiza- tion, in consideration for funding or financial contributions you receive from them; 3, The ownership, maintenance or use of that part of a premises leased to you; or 4, "Your work" for that insured by or for you. As respects Part C.3. above, this insurance does not apply to: (a) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organiza- tion(s); or (b) Any "occurrence" which takes place after you cease to be a tenant in that premises. GN 01 88 01 96 Copyright, Travelers Indemnity Company. Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement mod~ies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, ~ you spec~ically agree in a written con- tract or written agreement that the insurance pro~ vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insur~ anca is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: 8. The "bodily injury" or "property damage" for which coverage is sought occurs; and CG DO 37 04 05 b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2). of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b, Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved Page 1 of 1