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HomeMy WebLinkAboutInsurance Certificate: Jackson Cty Child Abuse Task Force AC01°R ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD YYW) t`„- 10/10/2011 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(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). PRODUCER CNr NOME: y CT Sand Orr A Beecher Carlson Insurance Agency LLC (541)772-1111 AX(AJC No: (591)772-3785 PH°rrE 707 Murphy Rd .sandy.orr @beechercarlson.com INSURERS AFFORDING COVERAGE NAIC Medford OR 97504 IMURERA:Philadel hia Indecinity Ins Co 18058 INSURED INSURERS: Jackson. County Child Abuse Task Force, DRA: INSURERC: The Children's Advocacy Center INSURERD: 816 W 10th Street INSURERS: Medford OR 97501 INSURERF: COVERAGES CERTIFICATE NUMBER:2011-12 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE POLICY NUMBER MMIW EFF MMIICYEXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LABILITY PREMISES(Eaocarronsel $ 100,000 A CLAIMS-MADE OCCUR PHPK778738 1/1/2011 1/1/2012 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 3,000,000 X POLICY PRO- ,ECT LOC $ AUTOMOBILE LIABILITY MBN D SINGLE LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OVMED SCHEDULED PHPK778738 1/1/2011 1/112012 AUTOS X AUTOS BODILY INJURY(Per accident) $ NON-OYMED PROPERTY DAMAGE X HIREDAUTOS x AUTOS PeracddeM $ PIP-Basic $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CIAIMS�.IADE AGGREGATE $ LIEU I I RETENTIVN $ WORHERSOOMPENSATION I TORYTMITS OTR ANDEMPLOYERS'LVIBILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERYMEMBER FXCLUDED? NIA (Mandatory,in NH) E.L.DISEASE-EA EMPLOYE $ It yes desmDe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ A Professional Liability PHPK778738 1/1/2011 1/1/2012 Each Proressional rodent $1,000,000 Aggregate Lunt $3,000,000 DESCRPTON OF OPERATIONS LOCATIONS I VEHICLES(Atdch ACORD 101,AtltlttlonN Remarks SehstlWS,Ir more space Is reAVlrotl) Certificate holder is an additional insured per form CG2026 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. its,,officers"'6 reployees 20 �sMaln'3treet '• AUTHORIZED REPRESENTATIVE Ashland, OR 97520 //�I //`` � yypp n/�, , Sandy Orr/SANDOR )C„JQ. dhA-x-O� ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK778738 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) CITY OF ASHLAND, ITS OFFICERS AND EMPLOYEES Information required to complete this Schedule if not shown above will be shown in the Declarations. Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations,or - - - -- -B. In connection with your premises owned by or rented to you. CG 20 26 07 04 ®ISO Properties, Inc., 2004 Page 1 of 1 13