HomeMy WebLinkAboutInsurance Certificate: Housing Authority Jackson Cty
CERTIFICA TE OF COVERAGE I ISSUE DATE (MMlDDIYY)
06/01110
PRODUCER THIS CERTIFICATE IS ISSUED AS A MA TIER OF rNFORMA TION ONt Y AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
HOUSING AUTHORITIES RISK RETENTION POOL POLICIES BELOW.
7111 NE 179TH STREET
VANCOUVER, WASHINGTON 98686 COMPANIES AFFORDING COVERAGE
(360) 574-9035
(360) 574-9401 FAX
COMPANY HARRP
COVERED ENTITY Housing Authorities Risk Retention Pool
HOLJSING ALJTHORITY OF JACKSON COLJNTY LETTER A
2251 TABLE ROCK ROAD
MEDFORD, OR 97501 COMPANY
LEITER 8
COVERAGES
THIS IS TO CERTIFY TIlAT THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO TIlE COVERED ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDrNG ANY
REQU[RE~1ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTS WITH RESPECT TO WHICH THIS CERTIFleA TE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY
THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TIlE TERMS, EXCLUSIONS AND CONDITIONS Of SUCH POLICIES; LIlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS
LT" DATE (MWDD~-'~ .... .DATE(MM/DDfYY)
A GENERAL LIABILITY
GENERAL AGGREGATE 52000000
....x....- COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 52,000000
CLAIMS MADE ...K... OCCURRENCE 046-PLEAF 07/0JlIO 07/0Jlll FIRE DAMAGE (any ODe fire) 52,000,000
-
- OWNERS'S & CONRACTOR'S PROTo
MEDICAL EXPENSES
EXCLUDED
AUTOMOBILE LIABILITY COMBINED
SINGLE LIMIT $
- ALL OWNED AUTOS
BODILY INJUR Y
....L SCHEDULED AUTOS (pER PERSON) $
PROPERTY
- HIRED AUTOS DAMAGE $
- NON-OWNED AUTOS
ANNUAL
AGGREGATE $
A OTHER
Declared Value Loss Limit I
PROPERTY 046-PLEAF 07/0JlIO 07/0 JIll Per Occurrence I Replacement
SPECIAL CALJSES OF LOSS Cost 1 $1,000 Deductible
DESCRIPTION OF OPERA TlONS/LOCATIONSIVEH1CLES/RESTRICTlONS/SPECIAL ITEMS
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT, Per the interest of the CERTIFICATE HOLDER As
shown below:
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPtRATlON DATE THEREOF,
THE ISSUING COMPANY WILL ENDEAVOR TO MAIL J..Q DAYS WRITTEN NOTICE TO THE CERTIFICATE IIOLDER
NAMED TO THE LEFT, BIIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OF LIABILITY OF
ANY KIND UPON THE COMPANY, ITS AGEWTS OR REPRESEWTATlVES.
See attached list of Certificate Holders AUTHORtZED REPRESENTATIVE
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Z:\Certificates & Endorsements\201O-201IVackson CountyVack-008.doc
COVERED ENTITY: HOUSING AUTHORITY OF JACKSON COUNTY
MEMBER NO.: 046-PLEAF
COVERAGE PERIOD: 07/01/10 - 07/01/11
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT
CERTIFICATE HOLDERS:
CITY OF ASHLAND
Its Officers, Employees & Agents
ATTN: BOB NELSON
20 E. MAIN STREET
ASHLAND, OR 97520
JOSEPHINE COUNTY
HOME REPAIR PROGRAM
ATTN: MARK SORENSEN, CDBG PROJECT MANGER
500 N.W. SIXTH STREET
GRANTS PASS, OR 97526
GOLD HILL REHABILITATION
ATTN: CITY RECORDER/TREASURER
P. O. BOX 308
GOLD HILL, OR 97525
MEDFORD EMERGENCY REPAIR
ATTN: HUD GRANT ADMINISTRATOR
200 S. IVY STREET
MEDFORD, OR 97501
HARRP
Housing Authorities Risk Retention Pool
Z:\Certificates & Endorsements\201O-2011\Jackson CountyVack-008.doc