HomeMy WebLinkAboutInsurance Certificate: OnTrack Inc
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ACORD'" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDNYYY)
~ 4/19/2011
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), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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).
PRODUCER 2~~~~CT Debbie Light, CISR
Smith & Crakes Inc. jt1g.~JQ~_~tJ: (541) 687-2211 I FAX
(AlC No}: (541) 344-5894
58 W 11th Ave ~oMo'f:~SS: debbie@smithandcrakes . com
PRODUCER 0000 612
_CUSIOMERIOJl" 1 I
Eugene OR 97401 INSURERfSl AFFORDING COVERAGE NAtC#
INSURED INSURERA:Great American Insurance Com!, I
- INSURER B ;SAIF COfPora tion I
OnTrack Inc INSURER C ; I
221 W Main INSURER 0 ; I
INSURER E ; I
Medford OR 97501 INSURER F : I
COVERAGES
CERTIFICATE NUMBER:11/l2 GL/Prof/Au/Wc
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
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.
INSRI TYPE OF INSURANCE I~~.?~ ~~I I ,,I;OLICY EF~II ,,I;OLlCY EXP I LIMITS
LTR POLlCY NUMBER MMJDONYYY MMlDONYYY
~ERAL L1ABIUTY I [5/1/2012 ~~.9~~U~~ENCE I. 1,000,000
X I ]MMERCIAL GENERAL LIABILITY DAMAGE TO RENTED I. 100,000
PRI;MISES rEa occu!!encel
A l_ _L CLAIMS-MADE [i] OCCUR X PAC6536160 5/1/2011 MED EXP (Anyone person) I. 5,000
~ Professional Liability__1 I PERSONAL & ADV INJURY I. 1,000,000
l__~ ! GENERAL AGGREGATE I. 3,000,000
I i I 3,000,000
@'L AGG~EnEILlMIT APPLIES PER: PRODUCTS. COMPIOP AGG I $
I X POLICY ~~p-.;: n LOC I ·
hOMOBILE LIABILITY 15/1/2012 I COMBINED SINGLE LIMIT I' 1,000,000
(Eaaccident)
ANY AUTO BODILY INJURY (Per person) .
~ ALL OWNED AUTOS CAP537426740 5/1/2011
A X BODILY INJURY (Per accident) .
00 :CHEDULED AUTOS PROPERTY DAMAGE
X HIRED AUTOS (Per accident) .
X NON-OWNED AUTOS .
I I "
H UMBRELLA LIAS H OCCUR I I EACH OCCURRENCE I.
I EXCESS LIAB CLAIMS-MADE I AGGREGATE I. -- .
U DEDUCTIBLE I I'
I I RETENTION $ I "
B I :ORKERS COMPENSATION 1451050 I X I T~~~IfJI~S I IOJb"
AND EMPLOYERS' LlABILITY Y I N
I ANY PROPR'ETORlPARTNERlEXEcumE 0 N/A E.L. EACH ACCIDENT . SOO/OOO
OFFICER/MEMBER EXCLUDED? 7/1/2010 7/1/2011
(Mandatory in NH) E.L DISEASE. EA EMPLOYEE $ 500,000
If yes, descnbeunder E.L. DISEASE - POLICY LIMIT I $ 500 000
DESCRIPTION OF OPERATIONS below
I I I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
As respects all operations of the insured in accordance with policy terms and conditions. The City of Ashland, its
officers, and employees are Additional Insureds
CERTIFICATE HOLDER
CANCELLATION
(541) 652-2059 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Ci ty of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
FINANCE DEPARTMENT
20 East Main Street AUTHORIZED REPRESENTATIVE
Ashland/ OR 97520
---::> ~ + (
R Crawford, CPCU/OL G:-<:';;"::;"'r? ~~c"1 H. to"' ,- ..........--
ACORD 25 (2009/09)
INS025 (200909)
@1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD