HomeMy WebLinkAboutInsurance Certificate: Community Health Ctr CERTIFICATE OF LIABILITY INSURANCE 2/2/2010YV)
PRODUCER (541) 482 -0831 FAX: (541) 488 -5851 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ashland Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
585 A Street Suite 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW._
P. O. Box 880
Ashland OR 97520 INSURERS AFFORDING COVERAGE NAIC
INSURED INSURER A: Mutual of Enumclaw 14761
Community Health,Center Inc INSURER B:
8385 .DiSision Road INSURER C:
INSURER D:
White City OR 97503 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.
INSR 'ADD'4 I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
I TR !NSW, TYPE OF INSURANCE DATE IMWDDIYYYYI DATF IMMIDDIYYYYI
GENERAL LIABILITY EACH OCCURRENCE 1,000 000
DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)_ 300,000
A CLAIMS MADE `X OCCUR NC18143 3/14/2010 3/14/2011 MED EXP (Any one person) 10,000
PERSONAL BADV INJURY 1,000,000
GENERAL AGGREGATE 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG 2,000,000
R 1 POLICY PRO
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO (Ea accident)
ALL OVMED AUTOS
BODILY INJURY
SCHEDULED AUTOS (Per person)
AUTOS
HIRED
BODILY INJURY
NON OVMED AUTOS accld
Pe enq
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTOONLY -EA ACCIDENT
ANY AUTO OTHERTHAN EA ACC
AUTO ONLY: AGG
EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE I$
OCCUR CLAIMS MADE AGGREGATE
DEDUCTIBLE
RETENTION
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY TORY L
LIMITS
ANY PROPRIETOR/PARTNER /EXECUTIVE Y i E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L. DISEASE- EA EMPLOYE
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ADDITIONAL INSURED
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Its Officers, Employees Agents NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Bryn Morrison
20 E Main St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ashland, OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESEN E V a a l l
ACORD 25 (2009/01) 19 09 ACORD CORPORATION. All rights reserved.
INS025 (X0901) The ACORD name and loge are registered mark f ACORD