HomeMy WebLinkAboutInsurance Certificate: Valley Care Transportation
ACORY
'---"' OJ. 13 n
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
P R t e certl Icate 0 er IS an 0 A RED, t e polley las must e en orse. SUB A D, SU J9Ct to
the tanns and.conditions of the policy, certain policies may require an endorsement. A statement on this certificate doe~ not confer rights to the
certificate holder In "lieu of such endorsement(s).
PRODUCER ,._~
CERTIFICATE OF LIABILITY INSURANCE
OP ID AS
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
II~f~ TYPE OF INSURANCE INSR WVO POLICY NUMBER IMMtDOivW"y) IMMlDDIVYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE .1,000,000
-
A ~ :3MMERCIAL GENERAL LIABILITY GLA95905J.B 01/12/11 01/12/12 PREMISES Ea occurrencel . J.OO,OOO
- CLAIMS-MADE [!] OCCUR MED EXP (Anyone person) .5,000
PERSONAL & ADV INJURY .1,000 000
GENERAL AGGREGATE .2,000 000
~L AGG~EnEILlMIT APnS PER: PRODUCTS - COMPIOP AGG .2,000,000
X POLICY j~8T LOC - .
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT . J., 000,000
- (Eaaccident)
A - ANY AUTO GLA95905J.8 01/J.2/11 01/12/12 BODILY INJURY (Per person) .
- ALL OWNED AUTOS BODILY INJURY (Per accident) .
.!.. SCHEDULED AUTOS PROPERTY DAMAGE
.
- HIRED AUTOS IPeraccident)
- NON-OWNED AUTOS .
.
UMBRELLA L1AB H OCCUR EACH OCCURRENCE .
-
EXCESS LIAS CLAIMS-MADE AGGREGATE .
- DEDUCTIBLE .
RETENTION . .-- -- -- .
WORKERS COMPENSATION I TORY LIMITS I J OJ~-
AND EMPLOYERS' LIABILITY VI"
ANY PROPRIETORIPARTNERIEXECUTIVn E.L EACH ACCIDENT .
OFFICERlMEMBER EXCLUDED? IA
(Mandatory In NH) E.L DISEASE - EA EMPLOYE .
~~~~~~'ito~ O~~PERATIONS below E.L. DISEASE. POLICY LIMIT .
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarka Schitdule,lfmore 'PlIcel, required)
~ ";r'
, Hart-Insurance
.3389 Crater Lake-Hwy.
Medford OR 97504
Phone: 54J.-779-4232 Fax: 54J.-772-3963
INSURED
Valley Care Transportation
servi~es6 Inc.
PO Box J. J.2
Rogue River OR 97537
COVERAGES
CERTIFICATE NUMBER:
CERTIFICATE HOLDER
NAME:
AlC No Ext:
ADDRESS:
CUSTOMER 10.:
INSURER A :
INSURER B :
INSURER C :
INSURER 0 :
INSURER E :
INSURER F :
CANCELLATION
.,
., l(AlC, No):
"
9VALCAR
INSURER(S) AFFORDING COVERAGE
Zurich American Ins Co
NAIC.
REVISION NUMBER:
-<
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITYASH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Ci ty of Ashland AUTHORIZED REPRESENTATIVE
Public Works Dept.
~ E. Main Street Tom Kaldunski
hJ.and OR 97520
ACORD 25 (2009/09)
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