HomeMy WebLinkAboutInsurance Certificate: RVCOG (2)
A CORDN CERTIFICA TE OF LIABILITY INSURANCE I DA~7:(Ml'i'DIYYYYI
12 22 2009
PROOUCER (541) 687-1117 FAX: (541) 342-8280 THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION
Ward ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
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 0:
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. NOTW'lTHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VV1TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANC;'T~F:,?~~~ BY THE POLICIES DES~~~ED HERE,'~<'S SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES
A lIM IUll.Y ~A\I~ I
INSR AOO'L TYPE OF INSURANCE PJ>l-+~~~~~~g;W1E Pg~l.fl ~1f,~J.gN UMITS
POLlCY NUMBER
A ~NERAL LIABILITY 22P44372-397 1/1/2010 1/1/2011 RR"'N"'l: $ 500,000
X COMMERCIAL GENERAL LIABILITY ~~~~~J?~~~~J~~ n "el ,
I CLAIMS MADE 0 OCCUR MED EXP IAnv ona oarson S
f-- $
f-- GENERAL AGGREGATE $ NONE
n'l AGG~EnE LIMIT AnES PER: OOM"^TO _ ceMP,ep Ac'c' S
POLICY ~c-P.T lOC
A ~TOMOBILE LIABILITY 22P44372-397 1/1/2010 1/1/2011 COMBINED SINGLE liMIT
(Eaaccidoot) $ 500,000
r-!- ANY AUTO
f-- All OINNED AUTOS BODILY INJURY
$
- SCHEDULED AUTOS {Par person)
-.!. HIRED AUTOS BODilY INJURY
$
-.!. NON-OWNED AUTOS (Par accident)
- PROPERTY DAMAGE $
(Peraccidenl)
~RAGE llABlllT'! AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN "AACe $
AUTO ONLY: AOG $
A ~ESSfUMBRELLA LIABILITY 22P44372-397 1/1/2010 1/1/2011 S 5,000,000
X OCCUR 0 CLAIMS MADE AGGREGATE $ NONE
PUBILC OFFICIAL $ 5,000,000
==1 DEDUCTIBLE EPL OCCURRENCE $ 5.000.000
RETENTION 't EPL AGGREGATE 5.000.000
WORKERS COMPENSATlON AND I T~,ST~I,l,J.(, I 10,!,\'-
EMPLOYERS' UABIUTY___ - _ T --- ------. --- --- -~-,- ---- -- ---
ANY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT S
OFFICERlMEMBER EXCLUDED? , .'
I: E.L. DISEASE - EA EMPLOYEE S
If yes, describe under i' -
SPECIAL PROVISIONS below EL. DISEA'SE _ Po"UCY,UMIT $
OTHER q P
" !/
-, - -- -.~ r- '~I ')
n~r 2 9 2009 I::
, 11;
DESCRIP1l0N OF OPERA1l0NSILOCA1l0NSNEHICLES/EXCLUSrONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ;IJI;
RE: OSING PROPERTY FOR MEAL SITE. .' j j!
-' - i
ALL OPBRATIONS OF THE NAMED INSORED UNDER WRITTEN CONTRACT AGREEMENTL ~.-- .. -~-----~----._-_.._----_. i
i ""--~'~-,"-. I
-,
,
'.-- '_'_~,_.._r ---~._.--~----_._-----,,,-- ,
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF ASHLAND EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
KATHY GRIFFIN ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
CITY HALL
ASHLAND, OR 97520 FAILURE TO DO SO SHALL IMPOSE NO OBLtGATlON OR LIABILITY OF ANY KIND UPON THE
INSURER. ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
~-~
Paul Jensen/OANAK .->- - ,,-
ACORD 25 (2001/08)
INS025 (0108).08a
i&> ACORD CORPORATION 1988
PRn..' nl?