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HomeMy WebLinkAboutAshland Gun Club (2) IDATE (MM/DD/YYYY) ACORD . CERTIFICATE OF LIABILITY INSURANCE 09/07/04 PROP'~CER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Carpenter Insurance Service, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 134 Holiday Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite #300 Annapolis, MD 21401 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Northland Insurance Co. Ashland Gun Club ,NSURERB: c/o Rick Georgeson, Treasurer INSURERC: P.O. BOX 953 ,NSURERD: Ashland, OR 97520 INSURERE: 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 ¢tDD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POMCY NUMBER DATE (MM/DD/YY) DATE {MM/DD/YY) LIMITS A GENERAL L,AB,L,TY NC 018136 09 / 05 / 04 09 / 05 / 05 EACH OCCURRENCE * 2, 000, 00 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ 10 0,0 0 I CLAIMS MADE OCCUR MED EXP (Any on,; person) $ 1 t 0 0 X Shootinq Liab. PERSONAL&ADVINJURY $ 2,000,000 SCGL GENERAL AGGREGATE $ 2, 0 0 0, 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- CONIP/OP AGG $ I nc 1 in AC × AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ I DEDUCTIBLE $ RETENTION $ $ WC STATU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Additional Insured: City of Ashland CITY RECORDER'S COPY Broad form CERTIFICATE HOLDER CANCELLATION City of Ashland 20 E. Main Street Ashland, OR 97520 ACORD 25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAV()R TO MAIL ~_0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Carpenter Insurance Service, Inc. © ACORD CORPORATION 1988