HomeMy WebLinkAboutInsurance Certificate: St Clair Productions
A`40R CERTIFICATE OF LIABILITY INSURANCE 06/'27/2013
PRODUCER
East Main Street Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
East Mai Services, Inc. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
wa Maddux CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
PO Box 1298 COVERAGE AFFORDED BY THE POLICIES BELOW.
Grass Valley, CA 95945
Phone 1355-493-8366, Email into@ihe mthetper.com INSURERS AFFORDING COVERAGE NAIC R
INSURED
SL Clair Productions WSURERA Essex Insurance Company 39020
Adella St. Clair INSURER a
314 Meadow Slope Dr INSURERC:
Talent, OR 97540 INSURER D:
INSURER E
COVERAGES
THE POLICIES OF NSURANCE 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
BYTHE POLICIES DESCRIBED HEREIN LS SUBJECT TO AU -THE TERMS, EXOWSIONS AND CCNDrrIONS OF SUCH PCUCIES. AGGREGATE UMMS SHOWN MAY HAVEBBFN REDUCED
BY PAID CLAIMS
[MR ADM POLICY POLICY
LT1I 11SP0 TYPEOFINSeINJICE POKY NUMBER EFFECTIVE EXPIRATION LWITS
DATE DATE
A Y GENERAL LIABILITY 3DN4701-586301 See Below See Below EACH OCCURRENCE INCLUDES
EbAMEiICIAL (£NEML LIABILITY BODILY INJURY a PROPERTY $ 1,000,000
DAM M
❑CWMSMADE ®OCCUR TENANT LEGAL LIABIUiY $ 100,000
Host Liouor Liability MEDEXP(ArtYmalxaam) $ 5,000
NL AGGICEGATE LIMIT APPLIES PER PERSONAL& ADV INJURY $ 1,000,000
20POLJCY ❑PROIECT ❑LOC GENEAALAGGREGATE $ 2,000,000
Retail Liouor tj&MY PRODUCTS-COMP,OPA $ 1,000,000
DEDUCTIBLE $ 1,000
AUTOMOBLELMBILTfY COMBNEDSINGLEUMIT $
ANY AUTO (Each Occurerce)
AIL OWNED AUTOS BODILYINJURY $
SCHEDULEDAUTOS (Per Pason) HIRED AUTOS BDDILYNJURY $
NON-OWNED AUTOS (Per acc daU
PROPERTYDAMAGE $
(Per acid"
GARAGELIABLITY AUTO ON LY-EA ACCIDENT $
ANYAUTO
OTHER THAN EA ACC $
AUTOONLY: AGG $
EXCESS11 MBRELLA LNBRUTY EACH OCCURRENCE $
OCCUR ❑ CLAMS MADE AGGREGATE $
DEDUCTIBLE $
RET&MON $ $
W EMPLOYERS ORKEASCOM LIABILITY PEHSATION AND WC STAT. LIM.❑OTH. $
ANY PROPRIETOR/PARTNERIEXECUTNE EL EACH ACCIDENT $
OFFICERMIEMBER EXCWDED?
Nymdsc,ibev EL DISEASE - EA EMPLOYEE $
SPECIAL. PROVISIONS below EL DISEASE - POLICY UMO $
OTHER
DESCRIPTION OFa ATKINSILOCATIONSIV CLMIEXCLUSIONSADDED BY ENDORSEMENTISPECML PROVISIONS
Certificate holder listed below is named as addaional Insured per attached CG 20 26 07 04 for the following dates: 09120,2013, 10/1 W2013, 10/26/2013, 1110812013,
11/20/2013, 1ZO9/2013, 01!11/2014, 02/01/2014, 02/07/2014. 03'06/2014, 03/28/2014, 04/12'2014, 04/26/2014, 05/09/2014
CERTIFICATE HOLDER CANCELLATION
City of Ashland its officers, employees and agents SHMMAWMD EA EDESCRIBEDPOUCIESBECANCEL DBEWRETNEUPIMTIM
20 E. Main St. DATE THEREOF, THE INSURER AFror101NG COVERADE WILL El BEAYN %MML V DAYS
Ashland, OR 97520 WFU TEN NOTICE TD THE CERnRGTE HOLDER NAMED To THE LEFT, SIR MWRE W Bea9
AUTHOR® RERiESENTATIVE
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ACORD 25 (2001/08) 0 ACORD CORPORATION 1988