HomeMy WebLinkAboutInsurance Certificate: Housing Authority Jackson Cty
CERTIFICATE OF COVERAGE I ISSUE DATE (MMIDD'YY)
06/01111
PRODUCER THIS CERTIFICATE IS ISSUED AS A MA ITER OF INFORMATION ONLY AND
CONFERS NO RIGJfTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
OOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
HOUSING AUTHORITIES RISK RETENTION POOL POLICIES BELOW.
7111 NE I 79TH STREET
VANCOUVER, WASHINGTON 98686 COMPANIES AFFORDING COVERAGE
(360) 574-9035
(360) 574-940 I FAX
COMPANY HARRP
COVERED ENTITY Housing Authorities Risk Retention Pool
HOUSING AUTHORITY OF JACKSON COUNTY LEITER A
2251 TABLE ROCK ROAD
MEDFORD, OR 97501 COMPANY
LEITER 8
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICA TED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTS WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY
THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS
LTR DATE (MMlDDiYY) DATE (MMIDD/YY)
A GENERAL LIABILITY
GE~ERALAGGREGATE $2.000.000
----X- COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2000000
CLAIMS MADE ....L OCCURRENCE 046-PLEAF 07/011ll 07/01112 FIRE DAMAGE (anyone fire) 52.000,000
-
- OWNERS'S & CONRACTOR'S PROT,
MEDICAl. EXPENSES
EXCLUDED
AUTOMOBILE LIABILITY COMBINED
SINGLE LIMIT S
- ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (PER PERSON) S
-
PROPERTY
- HIRED AUTOS DAMAGE S
- NON-OWNED AUTOS
ANNUAL
AGGREGATE S
A OTHER
Declared Value Loss Limit I
PROPERTY 046-PLEAF 07/011ll 07/01112 Per Occurrence I Replacement
SPECIAL CAUSES OF LOSS Cust 1 $1,000 Deductible
DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEHICLES/RESTRICTIONStSPECIAL ITEMS
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT, Per the interest of the CERTIFICATE HOLDER As
shown below:
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE ISSUING COMPANY WILL ENDEAVOR TO MAIL J..Q DAYS WRITIEN NOTICE TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OF LIABILITY OF
ANY KIND UPON THE COMPANY, ITS AGE?\'TS OR REPRESENTATIVES.
See attached list of Certificate Holders AUTHORIZED REPRESENTATIVE
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Z:\Certificates & Endorsements\20 11-20 12Vackson CountyVack-008.doc
COVERED ENTITY: HOUSING AUTHORITY OF JACKSON COUNTY
MEMBER NO.: 046-PLEAF
COVERAGE PERIOD: 07/01/11 - 07/01112
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT
CERTIFICATE HOLDERS:
CITY OF ASHLAND
Its Officers, Employees & Agents
ATTN: BOB NELSON
20 E. MAIN STREET
ASHLAND, OR 97520
JOSEPHINE COUNTY
HOME REPAIR PROGRAM
ATTN: MARK SORENSEN, CDBG PROJECT MANGER
500 N.W. SIXTH STREET
GRANTS PASS, OR 97526
GOLD HILL REHABILlT A nON
A TTN: CITY RECORDERffREASURER
P. O. BOX 308
GOLD HILL, OR 97525
MEDFORD EMERGENCY REPAIR
ATTN: HUDGRANT ADMINISTRATOR
200 S. IVY STREET
MEDFORD, OR 97501
HARRP
Housing Authorities Risk Retention Pool
Z:\Certificates & Endorsemcnts\2011-2012Vackson County\Jack-008.doc