HomeMy WebLinkAboutInsurance Certificate: HOPE Equestrian Center
CERTIFICATE OF LIABILITY INSURANCE I DATE IMM/DD/YYYYI
ACORD TM April 17, 2013
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.
IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy0es) 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 CONTACT
NAME:
00007 / Debi DeTurk Peloso PHONE FAX
7765 West Highway 90 (A/C No, Ext): A/C No):
Greenville, FL 32331 E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A: MARKEL INSURANCE COMPANY 38920
H.O.P.E. Equestrian Center INSURER B:
After: Angie Ballard INSURER C:
PO Box 396 INSURER D:
Eagle Point, OR 97524
INSURER E:
INSURER F:
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 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.
NSR ADDL SUER POUCY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR MD POLICY NUMBER MM/DD/YYYY (MM/DD/YYYYI LIMITS
A GENERAL LIABILITY EACH OCCURRENCE rI 11000,000
® COMMERCIAL GENERAL LIABILITY ❑ ❑
DAMAGE TO RENTED a 100,000
F-1 ❑ CLAIMS-MADE ®DDDOfl PREMISES (Ea occurrence)
3602AG277058-8 06-23-2013 06-23-2014 MED EXP Any one person) $ 5,000
PERSONAL & ADV INJURY g 1,000,000
GENERAL AGGREGATE a 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
F1 POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG a 1,000,000
JECT
s
AUTOMOBILE LIABILITY ❑ ❑ COMBINED SINGLE LIMIT
El ANY AUTO Ea accident) a
BODILY INJURY (Per person) 4
❑ ALL OWNED ❑ SCHEDULED
AUTOS AUTOS BODILY INJURY (Per accident) 9
❑ HIRED AUTOS ❑ NON-OWNED PROPERTY DAMAGE
❑ ❑ AUTOS (Per accident) a
a
UMBRELLA LIAB ❑ OCCUR ❑ ❑ EACH OCCURRENCE 9
EXCESS UAB ❑ CLAIMS-MADE AGGREGATE a
❑ DED ❑ RETENTION If a
WORKERS COMPENSATION
AND EMPLOYERS' UABIUTY TOWC STATU-
R
R y/N ❑V LIMITS ❑ O ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A ❑
OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $
(Mandatory In NH)
If You, describe under E.L. DISEASE - EA EMPLOYEE g
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT a
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
Certificate holder only.
Confirmed event: 3/7/09 Denim & Diamond Dinner Dance and Auction
TIFICATE HOLDER CANCELLATION
H.O. P.E. Eq:Ballard n Center
Atten: Angie SHOULD ANY OF THE ABOVE DESCRIBED POLICIES CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN IN gCCORDANCE WITH THE HE POLICY
PO Box 396 PROVISIONS.
Eagle Point, 524
AUTHORIZED REPRESENTATIVE JBA
Bruce A. Kay T-C ~P AG P(10
(c) LO ORATION. ights reserved.
ACORD 25 12010/05) 1988-2010 A
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