HomeMy WebLinkAboutInsurance Certificate: RVCOG
A CORDN CERTIFICA TE OF LIABILITY INSURANCE DATE (MMIODfYYYY)
12/22/2009
PRODUCER (541) 687-1117 FAX: (541)342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Ward Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P 0 Box 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Euaene OR 97440 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Special Districts Assn.
Rogue Valley Council of Governments INSURER B
PO Box 3275 INSURER C
INSURER D:
Central Point OR 97502 - 0011 INSURER E
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDfNG 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 AFF?~~:.D BY THE POLICIES DESCRI~~~ HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
: LIMITS SH Y "AVE BEEN R"n"~EO BY "In ~LAIM<
I~~: I~~~~ TYPE OF INSURANCE POLICY NUMBER P~k+~~&~~6g;WlE P2~'fll~1t~~N LIMITS
A ~NERAL LIABILITY 22P44372-397 1/1/2010 1/1/2011 EA('H 1i(,(,1 H'~REN('E . 500,000
X COMMERCIAL GENERAL LIABILITY ~~~~&~J9E~~~J~~ncel $
I CLAIMS MADE W OCCUR MED EXP 'An one person) .
PFRSONAL & ADV INJL RY .
r- NONE
GENERAL AGGREGATE .
r-
rl'L AGG~nE LIMIT AAES PER: pRnnll('p:: _ ('liMP/liP Ar.:r.: .
POLICY I ~f,9T LOC
A AUTOMOBILE LIABILITY 22P44372-397 1/1/2010 1/1/2011 COMBINED SINGLE LIMIT 500,000
- (Ea accident~ .
...!. ANY AUTO..
- ALL OVvNED AUTOS BODILY INJURY
(P9fperson) .
- SCHEDULED AUTOS
...!. HIRED AUTOS BODILY INJURY .
...!. NON-OVlrNED AUTOS (Per accident)
/ PROPERTY DAMAGE .
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT .
R-ANYAUTO OTHER THAN FAACC .
AUTO ONLY AGG .
A EXCESS/UMBRELLA LIABILITY 22P44372-397 1/1/2010 1/1/2011 I,^c" . 5,000,000
~ OCCUR o CLAIMS MADE AGGREGATE . NONE
PUBLIC OFFICIAL . 5,000,000
R DEDUCTIBLE EOL OCCURRENCE . 5,000,000
RETENTION $ EPL AGGREGATE 5,000,000
-. WORKERS COMPENSATION AND I we STATU__ I IOl~-
.EMPLOveRS.UABILlTY-....,,-, -- ,. - _.~..._-"~..- .-.--- - .. .-....- _H. - --- ..-.
ANY PROPRIETOR/PARTNER/EXECUTlVE E.L. EACH ACCIDENT $
OFFICERfMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $
Ifyes.desc:ribeunder
SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT .
OTHER
DESCRIPTION OF OPERATlONSfLOCA TlONSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECTS TO WORK PERFORMED
BY THE ROGUE VALLEY COG, SUBJECT TO TERMS << CONDITIONS.
( . .,
..\ , h ~ ... ~--~I
'. ~ - " '-
--
vii' U SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF ASHLAND, r~ I DEe 2 8 2009 EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL' ENDEAVOR TO MAIL
KATHY GRIFFIN ! I ! ! ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT
CITY HALL . i I:
ASHLAND, OR 97520 ~ FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE
L 'J INSURER, rTS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
~ ~~
Paul Jensen/OANAK ? - ,.- =
-
CERTIFICATE HOLDER
I I" -.,.,
ACORD 25 (2001/08)
INS025 (010B),OBa
'.VI k:,:, In\1
CANCELLATION
@ACORD CORPORATION 1988
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