HomeMy WebLinkAboutInsurance Certificate: Ashland Housing Opportunities
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AI..C~RD' LIABILITY INSURANCE I .... """'DNYVY)
CERTIFICATE OF 03/11/2011
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), AUTHORIZE!),
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: .If the cert!ficate holder. is an_~DDI~lqN~L. INSURED, the pollcy(les) must be endorsed. If SUBROG~TION IS WAIVED, subject to
. the .t!~S andcon_dltlo_n~ of. theiPollcy, certain policies may require an endorsement.- A statement on this certificate does.not confer rtgl]~ .t<<? t~e - - -..-
certificate holder In lIiu of such endorsement(s). I -,.; .
PROD~ I Phone: sro.:365-7001 F8)(: 503-365-73541 , CONTACT, SISKIYOU INSURANCE MARKETPI:ACE"(GP) I .' . "
I NAM~;
MID VALLEY GENERAL AGENCY LLC . , PHONE 1541-479-6672 :./.- '. . I'AX . f541-474-6632 . ~.'" -
I l$.lil?.-~l: j
4305 RIVER ROAD N .. , . . (t!s;~_l:
:~ J _,;~.'l I E.MAll VANETTA@SISKIYOUINS.NET' '.." ,;' ~
KEI~ER'[)R 97303 .." ! ! i ~~?Bg::;_:
~~~~~~~.ID: 2690 "', " ., .. - -
.
,
INSURER(S) AFFORDING COVERAGE - - ,
NAlC'
INSURED INSURER A . SCOTTSDALE INSURANCE COMPANY
ASHLAND HOUSING OPPORTUNmES, INC. ,
1215 SW "G" ST. INSURERB :
GRANTS PASS OR 97526 INSURER C :
INSURER 0
INSURERE :
INSURERF ;
~
COVERAGES CERTIFICATE NUMBER: 47978
REVISION NUMBER:
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
C~~:T1FICATE MAY BE ISSUED OR ~~~ ..p~~!~~, ,~.~~~NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
INSR TYPE OF INSURANCE ADD'L SUBR] I POLICYEFF POLlCYEXP
_LTR IN~B. POLICY NUMBER _(MMIOO[YIDL _IM.M.ID,D['Q'yY) LIMITS
'. ~o.
A GEHERAL UAB<ITY CPS1159952 03/31/11 03131/12 1,000,000
I- - EACH OCCURRENCE S
X CpMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 100,000
'-'.... ..- PREMISES Eaoccurencej
, - ,I C~IMS-MADE IXl OCCUR ' " .., MED. EXP (Anyone person) 5,000
"'::""2:- , ... S
"c- ? ., , "p . PERSONAL & ADV INJURY - u 1,000,000
.. "'1.<.'.0. r...... ...._.... ,.lC'i"L' - -. . . S
.:1-..... ' .. . GENERAL AGGREGATE - ,. 0
-~ '" !:,l,,':""'.l.<'.;. .,. , ,-- .....,~"" '.J" . . . - - ,. S'''t' 1,000,000
- - -, , ., -
~~ A.~G~i~~~f'~~~ ~:~:.PE~: - - . ;T''::'' '. '" .. PROOUCTS=COMP~PAGG' '1 ;000,000
.. - ., S
'.. ..' ., --
. POLICY c' lOC'. - .' '. . S
AUTOMOBILE LIABILITY - '- - .., _. . . COMBINED SINGLE LIMIT
I--- '. - . .,'-; " " S
--, (Eaaccidenl)
- ANY AUTO ,
BOOIL Y INJURY (Per pe1"SOn) S
- ALL OWNED AUTOS BODILY INJURY (Per eccident)
S
- SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Peraccidenl) S
-
- NON..()WNED AUTOS S
S
UMBRElLA UA8 f=1 ;'"CUR EACH OCCURRENCE .
-
EXCESS "AB I . CLAIMS-MADE -- AGGREGATE .
- -'---... . - -.
. , , .
- DEDUCTIBLE
RETENTION . S
WORKERS COMPENSATlON -.J...:WC-STATU- ._LL~TH .
... EMPLOYERS' LIABILITY "N _TQRY..LJ~lIS _ ER
"'" Pll:OPRlETORIPARTNERlEXECUTlVE 0 EL EACH ACCIDENT .
OFFlCERlMEMBER EXCLUDED? NIA E.l. D1SEASE-EA EMPLOYEE I $
(MandllorylnNH)
lfye8.dltlCl'ibeuncler E.l. DISEASE.POLlCY LIMIT rS
OESCRIPTION OF OPERATIONS bekM-
DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORD 101. AddlUonal Remarks Schedule, If more space Ie required)
1971 SISKIYOU BLVD, ASHLAND, OR 97520
CERTIFICATE HOLDER
CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 EAST MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND, OREGON 97520
AUTHORIZED REPRESENTATIVE
Attention: ROBERT 0 NELSON MID VALLEY GENERAL AGENCY LLC W. ,e., ~-'
4 Herman R Deiss
ACORD 25 (2009109)
@1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD