HomeMy WebLinkAboutInsurance Certificate: Casa of Jackson County
~06/2010 08:59 FAX 5417798975 RORYWOLOIHS
::::: CERTIFICATE OF INSURANCE
This certifies that lEI STATE FARM FIRE AND CASUAL 1Y COMPANY, Bloomington, Illinois
o STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
insures the following policyholder for the coverages indieated below:
Name of policyholder Casa of Jackson County
Address of policyholder
613 Market St
Medford. OR 97504
Location of operations
SAME
~ 00'/002
Description of operations
The policies listed below have been issued to the policyholder for the policy perl cds shown. The Insurance descrtbed In these policies Is
subiect to all the terms exclusions and conditions ofthose oollcies. The lim~s of liabllltv shown mav have been reduced bv anv oaid claims.
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD liMITS OF liABILITY
Effective Date EXDiration Date rat be<linnin<l of "oliov "eriocl'
Comprehensive 06/01/10 BODILY INJURY AND
97-ES-523S.,.e Business Liability 06/01/11 I PROPER1Y DAMAGE
This insurance l"",l>des: 181 Products. Completed Operations
lEI Contractual liability
o Underground Hazard Coverage Each Occurrence $1,000,000
181 Personal Injury
o Advertising Injury General Aggregate $2,000,000
o Explosion Hazard Coverage Products ". Completed
o Collapse Hazard CDverage Operations Aggregate $2,000,000
o General Aggregate limit applies to each project
0
0
EXCESS L1ABILl1Y POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE
Effective Date ExDiration nate (Gombined Single Umh)
o Umbrella Each Occurrence $
o Other Aoor""ate $
Part 1 STATUTORY
Part 2 BODilY INJURY
Workers' Compensation
and Employers Liability Each Accident $
Disease Each Employee S
Disease. Policv limit $
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
EffeetivQ Date I;:xniraUon Date lat beainnina Df DoliCY oeriodl
.
Name and Address of Certificate Holder
City of Ashland
20 E Main st
Ashland, Or 97520
558-ilS4 a 2.90 Prlnteo In U,S,A.
If any of the described policies are canceled before its
expiration dale. State Farm willlry to mail a wrihen notice to
the certificate holder 10 days before cancellation. If,
however, we fail to mail such notice, rio obligation or liability
will be Imposed on State Farm or its agents or
represeOlaUves.
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Signature of Au'horized ep'1-"talive
AJ~II
Title
Date
S'-b-ID