HomeMy WebLinkAboutInsurance Certificate: Klamath Bird Observatory
ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
~ 6/15/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMA TIVEL Y OR NEGA TlVEL Y 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~I~CT Julie Asher
Ashland Insurance Inc Ir~9~~ _". (541)4B2-0B31 I r~ N, . (S41) 488-5851
585 A Street Suite 1 E-MAIL_. j asher@ashlandinsurance . com
P. O. Box 880 INSURERf51 AFFORDING COVERAGE NAle"
Ashland OR 97520 INSURER A ;ANIRRG
INSURED INSURER B;
Klamath Bird Observatory INSURER c:
PO Box 758 INSURER 0:
INSURER E :
Ashland OR 97520 INSURER F :
~
COVERAGES
CERTIFICATE NUMBER:CL1l61S03105
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. NOTlMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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.
'~f: TYPE OF INSURANCE L POLICY NUMBER ..~3M~ ,J;2~'CY EXP LIMITS
GENERAL LIABILITY
-
X COMMERCIAL GENERAl LIABILITY
A I CLAIMS-MADE [i] OCCUR X 011-25840
EACH OCCURRENCE $ 1,000,000
PREM*'ES ';'E~=~nce\ $ 500,000
/1/2011 /1/2012 MED EXP (Any one person) $ 20,000
PERSONAL & AOV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
$
CE~~~lSINGLE LIMIT .
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PP~~:~~"Z'nt~AMAGE $
$
EACH OCCURRENCE $
AGGREGATE $
$
I T~~T~I.~~ I IOJ~-
E.L EACH ACCIDENT $
E.L DISEASE - EA EMPLOYE $
- E.L. DISEASE - POLlCY LIMIT $
--
-
-
~'L AGGR~E ,LIMIT AP~S PER:
X I POLICY I I ~~9..; I I LaC
AUTOMOBILE LIABILITY
-
ANY AUTO
- ALL O'lf\A'llED
_ AUTOS
_ HIRED AUTOS
-
-
-
SCHEDULED
AUTOS
NON-OI/JNED
AUTOS
_ UMBRELLA llAB HOCCUR
EXCESS LIAB CLAIMS-MADE
OED I 1 RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y f N
ANY PROPRtETORlPARTNERlEXECUTIVE D
OFFICERlMEMBER EXCLUDED?
(MOlndatory In NH)
~~st~fpTl~ OrrOPERATIONS below
NIA
DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES (Attach ACORD 101, Additional Ranarks Schedule, If more space is required)
Certificate holder is additional insured
CERTIFICATE HOLDER
CANCELLATION
p~
.....
JUN 1 6 2011
~I
SHOULD ANY OF THE ABOVE DESCRIBED POliCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE OElIVERED IN
ACCORDANCE WITH THE POliCY PROVISIONS.
City of Ashland, its officers and employe
20 E Main St
Ashland, OR 97520
,W~/H
ACORD 25 (2010/05)
INS025 (201005),01
@1988-2010ACORDCORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD