HomeMy WebLinkAboutInsurance Certificate: Jackson Cty School 5
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A CORD~ CERTIFICA TE OF LIABILITY INSURANCE I DATE (NMIDOIVYYY)
6/23(2009
PRODUCER (541) 772-1111 FAX: (541) 772 37B5 THIS CERllFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Beecher Car1050n Insurance Aqency LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
707 Murphy Rd AL TER THE COVERAGE AFFOROED BY THE POLICIES BELOW.
,
Medford OR 97504 INSURERS AFFORDING COVERAGE N"'C U
INSURED INSl!RER ^ Special Districts As.oc
Jackson county School District No 5 IN~ur;cl{l:t
BB5 Siskiyou Bl.vd INSUJ;',EfI C
INSI.RFR[)'
AshJ.and OR 97520 INSURER E.
CO RAG
THE POLICIES OF INSURANCE LISTED BelOW HAVE BEEN ISSUED TO THE INSURED NANED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTA/'IlDlNG />NY
REQUIREMENT, TERM OR CONDI1ION OF !>NY CONTRACT OR OTI-lER DOCUMENT WITH RESPECT TO W;ICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANCE AFFORDED'?~':"'~~r-: ~~~IC1ES DESCRIBED HE~~~_~IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
I~;: ~~~F TYPE OF INSURANCE POLICY NUMBER P~i+~~~~j6&WE P~!fJ,~Jb~~N , LIMITS
~NERAL UA.B'L1TI . EACH aC:::URREN:::E I 10,000,000
X COMM~:HCw.. G'=-J\I::.HM..lIAl:llll Y ~~~il9~~~~r>c~' $
A I CL.<.JMS MADE 0 ~CCUR 24P60056599 7/1./2009 7/1./201.0 MEDEXP'Arr o.....~r~C""' ,
PERSml/,L /I. fl.DV INJ..RY $
- G<='j""'" "GGf\EGAT<= , 20,000,000
@~ AGG~r..~!rlM\T nE~ PER: 0.-- , I,
X FOLlCY PR!?I- LOC
~OMOBIU;; LIABILITY COMelNEO SIN(.LE LIMIT ,
(=fBccidflflti
f- ;wynno
- '" O'M'>JFOIJJTC:S BOO'. Y INJJRY
pcrpor::on) $
I- SCHEDULED AlJTOS
I- HIRED AUTOS BODL Y INJJRY
(?naccidanl) ,
I- NO~I OW1ED /lUTOS
f- - PR:>PEfHY DNlAGE $
(:>FrAr.lirlAnl)
~RA'" LIA.IUTY AUTO ON:'" Y - ~ACCIDE\Jl ,
>>JYAUTo) OT -lErl TH.AN "AA~
. AJTO ON'-Y: AGO ,
SESSJUMBRB...LA LIABILITY - - ,
OCCUR D CLAIMS MK>E ,t,C;(iR~';AT= $
=1 DEDUCTIBLE
RETENT ON ., ,
INORI-<ERS COMPENSAllON ANO 1~'-)C;;TA:l,!." IO)!~
EMPLOYERS'lIABllITY
IWY .oI?OP~lETOR;PAAT."'ER!E."'.ECt/TIVE E.l. EACI-c ACCIDE.'JT
OFFIc:=RIMFMAFR F>cr.11 jf)Fn? E.L. DI::EASE.. EA ::MPlO-tEE $
lfY'll>. rIll.~rrllf; Ilnrt~r
SPFCIIJ :>pOVISII)NStlFln...- =.LOISEASE-POl~YUMlT ,
OTHER
DESCRIPTION OF OPERAllONSA..OCATIONSNEHICLESIEXCLUSIONS ADOEO BY ENDORSEMENTISPEClAL. PROVISIONS
The City of A~h~and, Orggon, it~ offi~er~ and emp1.oyee~ i~ an additional in~urgd .. respgct~ Genera1. Liabi1.ity when
required by writtQn aqreQrnant.. Thh fOrm is subject to policy terms, conditions: and exclusions:.
CERTIFICATE HOLDER
CANCELLATION
(541)499-5311 SHOULD ANY OF TH&f ABOVE DESCRIBED POLICIES BE CANCELLED BEFORIi nlEi
Ci ty of Ash1and EXPIRA TlON DATE THEREOF, THE ISSUING INSURER \NILl ENOEAVOR TO MAL
. 20 East Main street 10 DAYS WRHTEN NOTICE TO THE CERTIFICATE HOWER NAMED TO THE LEFT, BUT
A.sh~and , OR 97520 -
FAILURE TO DO SO SHAll IMPOSE NO OBI..lGAilON OR LIABILITY OF Am KIND UPON mE
INSURER- ITS AGENTS DR REPRESENTATlVES.
AUTHORIZED Rl:PRl:SENTAllVE; .,/Ja.f)dJu....J<. ~
Sandy Or::i SANDO:p.
ACORD 25 (2001/0(1)
INS025 [0100)_0001
@ACORDCORPORATION19(10
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