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HomeMy WebLinkAboutInsurance Certificate: RVCOG ~ ACORd~ CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlOOIYVYY) ~ 12/16/2010 PRODUCER (541) 687 1117 FAX: (541)342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ward Insurance Agency ONLY AND CONFERS NO RIG HTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 Box 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, , E.,,:~e~e OR 97440 INSURERS AFFORDING COVERAGE NAIC# ,- - .. - .. - , .. n -- -- - - .-- -, __.h__n____ -."- - -----" -.-- --- u_ - - ._-~ -~- .- .- .~ INSURED INSURER A Special Districts Assn. of Council _. ___.___ ____~n____________ "'---'--- Rogue Valley of Governments INSURER B .. -- ----- -.__._______._._n__~____._.._ ____ .. ._-~--_. ---- PO Box 3275 . INSURE~ ~ _ ----------______.__ ____u___ .----. - .. " INSURER 0: - -.- -----. -_.~--_._._._~-_.- .- n. _____u_ Central Point OR 97502-0011 INSURER E- COVERAGES THE POLICIES OF INSURJ\NCE 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 Vv1TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUCED BY PAlO CLAIMS. IN~:~~~~~- --- TYPE O-~~N~U~NCE ~ ------ - -- ~~~IC~ ~M;~R-~ - ----. '~:~TLlt~~r6g~~~~, r~~W:7M~~:;b~~!S'y~ --- .-- ~ ~-- ~;Mt;;-- - -~ - - n. ~- A GENERAL LIABILITY 26P44372-397 1/1/2011 1/1/2012 EACH OCCURRENCE _ 1$ 500,000 --- ~ DAMAGE TO RENTED _. -;~.- -- - - - ---- . ~_ COMMERCIAL GENE~~ LIABILITY ~PBEMISES.(Ea~~currenc~) _ :.!_ _.__ _. _ _ ___ __._ CLAIMS MADE X OCCUR : _,M...i9..E.!P(A~y~rl_(!J?~rson)_ '$ _._ .._ ! ~~~~_L_~_~D~~1;l.:'..l!RY~_. $ A GEN'L AGGREGATE LIMIT APPLIES PER -- POLICY - j~-i LOC AUTOMOBILE LIABILITY X ANY AUTO : 9E~ERA~~~~EG~T5-_ s ! PRODUCTS - COMP/OP AGG $ - -~- ------ . - - .-- - NQNE 26P44372-397 1/1/2011 , 1/1/2012 I , COMBINED SINGLE LIMIT $ 500,000 I (Eaaccident) ALL DINNED AUTOS SCHEDULED AUTOS - X HIRED AUTOS X NON-DINNED AUTOS BODILY INJURY (Per person) $ I BOOlL Y INJURY (Per aCCident) '$ : PROPERTY DAMAGE : (Per-accident) GARAGE LIABILITY ANY AUTO ; ~UTO_ ON_L '!. ~~A_ ~.CC..!9~N} _ $ EA ACC S , OTHER THAN , AUTO ONLY: A _~~~ESS f UMBREL~ L~ABILlTY X OCCUR CLAIMS MADE 26P44372-397 1/1/2011 ,1/1/2012 AGG $ ! EACH OCCURRENCE _$__~ ,-q,QO.,~OQO ~~GGR_~G~:~~-=--~~~--=-~.~-.: .~, __ .__ ___ .~.O~ i PUBLIC OFFICIAL ..~__ _.5.I.OJ)~O, 0_0.0 j-- --~--- -- '- - :_EPL_~C~E __ .. $_ _ __5,1 QP.O, \)00 I EPL AGGREGATE: S 5 000 000 ; 'I we STATU. OTH- :~_~_TORY_L1MITS~._ER. ____________ !.5g~~~ A~:!Q.~___:j______ ____ [ E~~~~ASE . EA~_~OYEE..J_____.~~ _.__ , E.L, DISEASE - POLICY LIMIT I $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N r ANY PROPRIETORfPARTNERfEXECUTlVE 0 ' OFFICERIMEM8ER EXCLUDED? (Mandatory in NHJ' 'I!yes.descnbeunder I SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECTS TO WORK PERFORMED BY THE ROGUE VALLEY COG, SUBJECT TO TERMS & CONDITIONS. CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR;'O MAIL ~ DAYS WRITIEN CITY OF ASHLAND NOTlCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL KATHY GRIFFIN IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CITY HALL REPRESENTATlVES. ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE ~~ ~~ Paul Jensen/OANAK -> ~ ~ - - ACORD 25 (2009/01) INS02S (200901)01 @1988'2009ACORDCORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD