HomeMy WebLinkAboutInsurance Certificate: OSPIRG Foundation ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDM YY)
A CORO
1`/ 05/102011
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 endarsement(s).
PRODUCER NAME:
Hull&Company,Inc. AIC No EM: IC No
6443 SW Beaverton-Hillsdale Hwy ADDRESS:
Suite 350 INSURER(S)AFFORDING COVERAGE NAIC 0
Portland OR 97221 INSURERA: Maxum Indemnity Company 26743
INSURED INSURERS:
OSPIRG Foundation,Inc. INSURERC:
1536 SE 11 th INSURER D
INSURER E
Portland OR 97214 INSURERF:
COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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.
LTR
INSR TYPE OF INSURANCE POLICY NUMBER MMA)OA'YVV M/DOM'YPY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000
X COMMERCIAL GENERAL L ABILITY PREMISES Ee o nenn $ 100,000
CLAIMS� E9 OCCUR MEDEXP As, ono arson 5.000
A BDG0024292-05 051142011 05/142012 PERSONAL&AOV INJURY $ 1,000,000
GENERAL AGGREGATE It 2,000,000
GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGG EXCLUDED
X POLICY PRO LOC $
R OMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident
ANY AUTO
BODILY INJURY(Perpemon) $
A.) OV,TJED SCHEDULED BODILY INJJRY(Peraceiderrt) $
AUTOS NON-CMED PROPERTY DAMAGE $acacenT HIRED AUTOS AUTOS
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED I I RETENTION$
WORKERS COMPENSATION np STATU- OTH-
ANDEMPLOVERS'LUBILITY YIN
MY
OFICERIMEMSER EXCLUDED �TIVE N/A E.L.EACH ACCIDENT
(Mandatory In NF) E L DISEASE EA EMPLOYE
ItyYees desmbeunder
DESCRIPTION OF OPERATIONS be E.L.DISEASE POLICY LIMB
DESCRIPTION OF OPERATIONS ILOCATION r d a cheduls,If mom span is raquind)
D
LJAN1012
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Ashland THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
20 East Main St. ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Ashland OR 97520 ('�.
V �
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