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HomeMy WebLinkAboutInsurance Certificate: Dancing People CERTIFICATE OF LIABILITY INSURANCE F -ATE MM/DD o11/25/2013 Y1 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(ies) 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). CONTCT PRODUCER Jon Snowden N AME: Jon Snowden IAVC. No, Exit. ) HONE 541 482-2451 NC Na: 541 482-4957 420 Bridge St P E-MAIL Staten m Ashland, OR 97520 ADDREss:'on 'onsnowden.com Ilk INSURERS AFFORDING COVERAGE NAIC d INSURER A: State Farm Fire and Casual Company 26143 INSURED Stiehm, Robin INSURER e: dba Dancing People Co INSURER C: 310 Oak St Ste 5 INSURER D Ashland, OR 97520 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. INSR ADDL UBR POLICY EFF POLICY UP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY UNITS J= min A GENERAL LIABILITY FYI❑ 97-BB-W571-2 0912512013 09125/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 CLAIMS-MADE OCCUR MED EXP(My we person) $ 5,000 PERSONAL B ADV INJURY $ • GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 X POLICY PRO- LOC - - ❑ ❑ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident E 'ANY AUTO BODILY INJURY (Per person). ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS $ NON 0 MEO PROPERTY DAMAGE- HIREDAUTOS AUTOS Per acct ent $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH- LIM AND EMPLOYERS' LIABILITY T ER ANY Y/❑N N/A❑ E.L. EACH ACCIDENT $ OFFICEIMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ Ityes, tle under TIClN E. L. DISEASE - POLICY LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Ramada; Schedule, If more space Is required) Business - Misc 310 Oak St. Ashland, OR 97520 CERTIFICATE HOLDER CANCELLATION - City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE - THE EXPIRATION DATE THEREOF, NOTICE: -WILL_BE DELIVERED_IN _its Officers and EmployBeS_ ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHOR ED EPR TATIVIE 20 E,Main St A(4 Ashland, OR 97520 © 9 -2010 ACORD OR RATIO All rights r rved. ACORD 25 (2010/05) The ACORD name and logo are regis ered marks of ACORD 1001486-132849.8 01-23-2013