HomeMy WebLinkAboutAshland Gun Club
A CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE IMM/DD/YY)
07/27/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Risk Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA TE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO BOX 410679 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Kansas City, MO 64141-0679 INSURERS AFFORDING COVERAGE
INSURED Ashland Gun Club INSURER A: Legion Insurance Company
INSURER B:
P.O.Box 953 INSURER C:
INSURER D:
Ashland, OR 97520 INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Pgk!fEYI~JJ~~J~$~ LIMITS
lTR DATE IMM/DD/YYI
A GENERAL LIABILITY GLl1928129 09/18/2001 09/18/2002 EACH OCCURRENCE $ 2,000,000
-- --
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,000
I CLAIMS MADE [][] OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $ 2,000,000
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
Xl POLICY n ~~gT nlOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
f---- $
ANY AUTO lEa accident)
f----
ALL OWNED AUTOS BODILY INJURY
f-- $
SCHEDULED AUTOS (Per personl
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGA TE $
$
R DEDUCTIBLE $
RETENTION $ $
I WC STATU- I IOTH-
WORKERS COMPENSP.T!ON AND ,__ ; TORY LIMITS ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
E.l. DISEASE - EA EMPLOYEE $
E.l. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERA TlONS/LOCA TlONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
#'Iy<
CERTIFICA TE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
20 E. Main St.
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
- .-- . ..-"..",.
Ashland, OR 97520 IM:t~E~~~_OBLlGATION OR LIABILITY OF ANY KIND' UPON',."HJ: 'INSURER, ITS AGENTS OR
REP SENTATlVES. ~.
A.~~~PRESENT\t~~
'I ~ ?" ~ -.:~~
I // ./ j' \.. i>'\. .
ACORD 25-S (7/97) i ,) """- :;) ( ') @ACORD CORPORATION 1988
IMPORT ANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement{s).
OISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)