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HomeMy WebLinkAboutInsurance Certificate: Garda CL NW ACORDN CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDfYYYY) 06/16/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chicago Risk-Management CITY RECORDER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HUB International Midwest limited ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 55 East Jackson Boulevard Chicago, IL 60604 , INSURERS AFFORDING COVERAGE NAIC# INSUREO INSURER A: Lexington Insurance Company , . 19437 Garda CL Northwest, Inc> INSURER B: New Hampshire Insurance Co. '." .. 23841 301 North Lake; Suite 600 '.. - INSURER c: National Union Fire:lns: Co. 19445 '/ Pasadena,-CA 91101 INSURER 0: Iron shore Specialty Insurance C 25445 .\ ',. 0" , . , 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. I~i: r-N~~! TYPE OF INSURANCE POLICY NUMBER PJlk~~~J~~68~IE POl.ICY EXPIRATION LIMITS , DATE MMIDDIYY A ~NERAl. LIABILITY 084196666 06/15/09 . 06/15/10 EACH OCCURRENCE $3 000 000 \ DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY $100 000 X I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ X Errors & Omissions PERSONAL 8. ADV INJURY $3 000 000 X SIR:$1,000,OOO GENERAL AGGREGATE $3 000 000 ~~ AGG~EnEILlMIT APPlSIPER: PRODUCTS - COMP/OP AGG $3 000 000 X POLICY ~~RT LOC C ~TOMOBILE LIABILITY CA0912345 06/15/09 12/15/09 COMBINED SINGLE LIMIT C ~ ANY AUTO CA0912346 06/15/09 12/15/09 (Eaaccident) $5,000,000 0 - ALL OWNED AUTOS 01DW80906001 06/15/09 06/15/10 BODILY INJURY $ SCHEDULED AUTOS (Per person) - .1L HIRED AUTOS BODILY INJURY $ .1L NON-QWNED AUTOS - 0" (Peraccidenl) , . - ., - " PROPERTY DAMAGE . - (Peraccidenl) - '. $ .. -. w ,. , .-..... ~":,GE L1ABILl1:Y '. ,. AUTOONLY.EAACCIDENT' $ . ANY AUTO OTHER THAN' EA ACC $ AUTO ONLY: AGG $ A ~~SS/UMBRELLA LIABILITY 015437836 06/15/09 06/15/10 EACH OCCURRENCE $10000000 X OCCUR W CLAIMS MADE AGGREGATE $10 000 000 $ ~ ~EDUCTIBLE $ X RETENTION $ 25 000 $ B WORKERS COMPENSATION AND WC004375253 06/15/09 12/15/09 X I. WC STATU.. I IOJ~- EMPLOYERS' LIABILITY WC004375254 $1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT OFFICERJM!;:MBER EXCLUDED? WCOO4375255 , t:.L. UISEA~E . EA EMPLOYEE ,1 000,000 lfyes, describe under WC004375256 ,1,000000 SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Ashland, Oregon, and its elected officials, officers and employees are listed as additional insured under general liability and auto liability where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOUl.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELl.ED BEFORE THE EXPIRATION City of Ashland DATE THEREOF, THE ISSUING INSURER Wll.LENDEAVOR TO MAIL .....30.... DAYS WRITTEN 90 N. Mountain Ave. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Ashland, OR 97520 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ~D REPRESENTATIVE .. _...~ -./ F a.u.J- ACORD 25 (2001108) 1 of 2 #S209715/M209682 NXB @ ACORD CORPORATION 19B1l