Loading...
HomeMy WebLinkAboutInsurance Certificate: MAA - Liability SK131499 A� ® CERTIFICATE OF LIABILITY INSURANCE DAT9/30/2011 ) O 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 pollcy(les) 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). CONTACT PRODUCER Commercial Lines 206-701-5900 NAME: ---.-._ — PHONE fAX Wells Fargo Special Risks, Inc.CAL#OG13561 IAIC N°'.ExW------------- - ---'-L'Nom.—"---"------"' ADDRESS: 520 Pike Street,Suite 2100 -.--,._________- ___. INSURER s AFFORDING COVERAGE _ HAIC tl _ Seattle,WA 98101 INSURER A: NOVA Casualty Company INSURED Mt.Ashland Association INSURER-B P.O.Box 220 INSURER C INSURER D_. INSURER E: Ashland,OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER: 3336801 REVISION NUMBER: See below 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. INSR TYPE OF INSURANCE ADDL LTR OM POLICY NUMBER (MM)T)D1YYYY1 iMMJDDIYVYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE ___$ 1,000,000 A WFR-GL-0010050-2 10/01111 10/01/12 DAMAM TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES_LE—urmnce $ _ CLAIMS-MADE OCCUR MED EXP(Any one person)_ _$ Not Covered PERSONAL 8 AOV INJURY $ 1,000.000 GENERAL AGGREGATE $ None GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOP AGO $ 7,000,000 POLICY n PRO- LOC -- ----- $ ----- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ - _ _ _, Ee accWanl $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accben) $ AUTOS AUTOS _ ___.. NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Were S UMBRELLA DAB OCCUR EACH OCCURRENCE $ _ EXCESS LMB CLAIMS-MADE AGGREGATE LED F RETENTION$ $ WORKERS COMPENSATION WC STATU- OETH. AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNE11EEECUTIVE❑ E .EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In KH) E.L.DISEASE-EA EMPLOYE $ N yea,describe antler --- -- -- DESCRIPTION OF OPERATIONS Wow E.L.DISEASE POLICY LIMIT $ A Excess Liability - WFR-XS-0010008-2 10/01/11 10/01/12 $5,000.000 Occur./$10,000.000 Ag9. Products CamplOp Aw:$10.000.000 Personal d Adv Injury:$5.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,II more apace Is required) City of Ashland,its Officers 8 Employees are Additional Insured when required by written contract,agreement,lease,or permit,solely as respects liability arising from operations of Named Insured Re: Interest in Owned assets acquired 07101/92. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland,Its Officers THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 8.Employees ACCORDANCE WITH THE POLICY PROVISIONS. 20 E.Main Street AUTHORIZED REPRESENTATIVE Ashland,OR 97520 9� era The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) 111111111111111111 IN 11111111111111111111111111111111111111111111111111111111111111111111