HomeMy WebLinkAboutInsurance Certificate: Jackson Cty Child Abuse Task Force
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ACORD"' CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY)
1".......---. 10/14/2010
THIS CERllFICATE IS ISSUED AS A MATTER OF INFORMAllON ONLY AND CONFERS NO RIGHTS UPON THE CERllFICATE HOLDER. THIS
CERllFICATE DOES NOT AFFIRMAllVELY OR NEGAllVELY AMEND, EXTEND OR ALTER TIiE COVERAGE AFFORDED ay THE POLICIES
aELOW. TIiIS CERllFICATE OF INSURANCE DOES NOT CONSllTUTE A CONTRACT aElWEEN TIiE ISSUING INSURER(S), AUTHORIZEO
REPRESENTAllVE OR PRODUCER. AND TIiE CERllFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADOlnONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certal~~::OIlCles may require an endorsement. A statement on this certificate does not confer rights to the
certlflcate holder In lieu of such endorsement 5 .
PRODUCER NAME: Sandy Orr
Beecher Carlson Insurance Agency LLC r.~g~o E-, (541) 772-1111 ~NO\: (541)172-3785
7D7 Murphy Rd ~~~ss: sandy. orr@beechercarlson.com
~n~~~~~ID .POOO5994
Medford OR 97504 INSURER(S)AFFORDING COVERAGE NAle,
INSURED INSURER A :Philadelnhia Indemni tv :Ins CO 8058
INSURER B :
Jackson county Ch1~d Abuse ~ask Force INSURER C :
DBA: Children's Advocacy center INSURER 0 :
816 W 10th Street INSUR&R& :
Medford OR 97501 INSURERF:
COVERAGES
CERllFICATE NUMBER'2010-1
REVISION NUMBER'
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L1STEO BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEO ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWrrHSTANDING ANY REQUIREMENT, TERM OR CONDITIOl"i OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO V\lHICH lHlS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROED BY TIiE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH i'i LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~ TYPE OF INSURANCE N POLICY NLNBER &~Mgv~ &~r~~ LIMITS
~NI:RAL. LIABIL.1TY EACH OCCURRENCE $ l,OOO,OOO
X COMMERCIAl GENERAl LIABILITY I ~=SES YE~~~t:~ence $ 100,000
A -I CLAIM8-MADE [i] OCCUR PHPK631436 1/1/2010 1/1/2011 MED E.XP (Anyone person) $ 5,000
PERSONN.- & /CDV INJJRY , 1,000,000
GENERAl AGGREGATE $ 3,000,000
-;!l'L AGG:EnE LIMIT APMS PER PRODUCTS - COMP/OP AGG $ 3,000,000
X POLICY P.B.9; LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
- (Eaaccident)
- ,ANy AUTO BODILY INJURY (Per person) $
A ALL OVYNED AUTOS PHPK631436 1/1/2010 fLl/l/2011
- BODILY INJURY (Per accident) $
~ SCHEDULED AUTOS PROPERTY DAMAGE
~ H IRED AUTOS (Peraccidenl) $
2: NON-OV'wNED AUTOS PIP-Basic $
Unin~urcdmolori:)lcombinod .
UMBRELLA LIAS H OCCUR EACH OCCURRENCE $
e-
EXCESS LIAB CLAIMS-MADE AGGREGATE $
L.... f)Ff)1 ICTIRI F $
RETENTION $ I
WORKERS COMPENSATlON I_'/'K; STATU-~ I IOJ~-
AND EMPLOYERS' LIABILITY VIN --
ANY PROPRIETORIPARTNERIEXEOJTIVE D EL EACH ACCIDENT I
OI=l=ICERlMEJ.lBER EYCLUDED? NIA
(Mandlll:ory in NH) EL DISEASE - EA EMPLOYE $
If yes. describe under
DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $
A Professional Liability PHPK631436 1/1/2010 1/1/2011 Each Professional InCident $1,000,000
AyY'''Y'''t"U,";[ ~3,OOO/OOO
DESCRlPTlON OF OPERATlONS I LOCA TlONS I VEHICLES (Atl:II.ch ACORD 1D1, Additional Remarks Schedule, If more sp8ce Is requIred)
Certificate holder is an additional insured per form CG2026 attached.
CERllFICATE HOLDER
CANCELLAllON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRAnON DATE THEREOF, NOnCE WILL BE DELIVERED IN
city of Ash~and ACCORDANCE WITH THE POLICY PROVISIONS.
its officers & emp~oyees AUTHO~ZEDREPRESENTATIve
20 E Main Street
Ash~and, OR 97520
Sandy Orr/SANDOR ~J<.~
ACORD 25 (2009/09)
INS025 (200909)
@ 1988-2009 ACORD CORPORAllON. All right. r...rv.d.
The ACORD name and logo are registered marks of ACORD
"
POLICY NUMBER: PHPK631436
COMMERCIAL GENERAL LIABILITY
CG 20 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Personls) Or Oraanlzatlonls)
CITY OF ASHLAND, ITS OFFICERS AND
EMPLOYEES
information reouired to comolete this Schedule if not shown above will be shown in the Declarations.
Section II - Who Is An Insured is amended to in-
clude as an additional insured the person(s) or or-
ganization(s) shown in the Schedule, but only with
respect to liability for "bodily InJury", "property dam-
age" or "personal and advertising injury" caused, in
whole or in part, by your acts or omissions or the acts
or omissions of those acting on your behalf:
A. In the performance of your ongoing operations; or
B. In connection with your premises owned by or
rented to you.
CG 20 26 07 04
@ISO Properties, Inc., 2004
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