HomeMy WebLinkAboutInsurance Certificate: Ashland Community Theatre
~
ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDlYYYY)
~ 12/18/2009
PRODUCER (503)227 0491 FAX: (503)227-0927 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Gales Creek Insurance Services Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
800 NW 6th Ave., Suite 335 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Portland, OR 97209
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Ri verport Insurance Company
Ashland Community Theatre INSURER B: StarNet Insurance Company
PO Box 3284 INSURER c.
INSURER 0:
Ashland I OR 97520 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 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~;: ~~~'~, ~oono' I POLICY NUMBER !,?.}~~Y EFFECTIVE I ~l?~lfrM~prRATION I LIMITS
-"'-NERAe LIABILITY I EACH OCCURRENCE I 1,000,000
DAMAGETO~RENTED
X COMMERCIAL GENERAl LIABILITY PREMISES lEa occurrence $ 100,,~
A I CLAIMS MADE [i] OCCUR WRD 180030-AP123813-00 12/4/2009 12/4/2010 MED EXP (Anyone person) I 5,000
PERSONAL & ADV INJURY I 1,000,000
-
Jt. incl Host Liquor GENERAL AGGREGATE S 2,000,000
~'~ AGGREnE LIMIT APPLIES PER: PRODUCTS - COMPtOP AGG $ 2,000,000
X POLICY ~~,9-T n LOC I
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Eaaccident)
- ANY AUTO
- ALL OWNED AUTOS BODILY INJURY I
(Perper5on)
~ SCHEDULED AUTOS
f--- HIRED AUTOS BODILY INJURY I
(Per accident)
f--- NON-OWNED AUTOS
f--- PROPERTY DAMAGE I
(Per accident}
RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC I
AUTO ONLY: AGG $
OESS I UMBREL.L.A LIABILITY EACH OCCURRENCE I
OCCUR D CLA1MS MADE AGGREGATE I
I
R DEDUCTIBLE I
RETENTION I $
WORKERS COMPENSATION I T"X~ZItJI~S I I OJ61-
AND EMPL.OYERS' L.IABILlTY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE 0 EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(MandalorylnNH) EL DISEASE - EA EMPLOYE I
~~E21~l5p~oVlS1oNS below EL DISEASE - POLICY LIMIT $
B IOTHERVOlunteer/ , VOO2437SSl-001 12/4/2009 12/4/2010 Medical $15,000
,PAI Payments
Participant Accident I AD'D $5,000
EXCESS COVERAGE .0
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCL.USIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Ashland, its officers, employees, and agents are included as additional insureds with respect to the
operations of the n~ed insured,
CERTIFICATE HOLDER
CANCELLATION
(541) 552-2059 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WlL.L. ENDEAVOR TO MAlL. ~ DAYS WRmEN
ATTN: Bryn Morrison NOTICE TO THE CERTIFICATE HOLDER NAMED TO TIiE LEFT, BUT FAILURE TO DO SO SHALL.
20 E Main St
Ashland, OR 97520 IMPOSE NO OBLIGATION OR L.IABIL.ITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~~
Rusty Poehner/RUSTY
ACORD 25 (2009/01)
INS025 (200901)
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