Loading...
HomeMy WebLinkAboutInsurance Certificate: Ashland Springs Hotel (2) NEUM03C OP ID: TMR 2/311201 YY) ATE '`'~°ROa CERTIFICATE OF LIABILITY INSURANCE 1 1213112013 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). PRODUCER CONTACT Therese Rayburn Phone: 541-245-1111 United Risk Solutions, Inc. NAME: PO Box 936 Fax: 541-245-1112 PHONE AIC N E 541-245-1111 F'ix 541-245-1112 NC No Medford, OR 97501.0067 ADDRESS: therese.raybum@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC p INSURERA:ZUrlch North America INSURED Neuman Hotel Group, LLC INSURER B: Ashland Springs Hotel - dba: Waterstone Spa INSURER C 212 E Main Street INSURER D: Ashland, OR 97520-1829 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 E TYPE OF INSURANCE L Q I BR POLICYNUMBER MMLID YYY MML00 YYY LIMITS INRR MD TR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CP0553794300 1211712013 1010112014 PREMISES Ea (Ed 1,000,000 occurrence $ CLAIMS-MADE Fx-1OCCUR MED EXP(Any one person) $ 5,00 • Prof hislonal Uab PERSONAL a AOV INJURY $ 1,000,00 X Liquor GENERALAGGREGATE $ 3,000,00 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 3,000,00 POLICY PRO- X LOC $ AUTOMOBILE LIABILITY CEO EIIN fSINGLE LIMIT $ 1,000,000 A X ANY AUTO CP0553794300 12/1712013 1211712014 BODILY INJURY (Per person) $ ALLOWNED SCHEDULED BODILY INJURY (Par accident) $ AUTOS NOUTOS N-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS _ Peraccidenl $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS LIAR CLAIMS-MADE UMB55379"00 1211712013 1211712014 AGGREGATE $ 5,000,00 DED RETENTIONS $ WORKERS COMPENSATION WCSTATU- OTH- ANDEMPLOYERS'LIABILITY YIN TORY NITS S R ANY PROPRIETOWARTNERIEXECUTNE ❑ NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? - - - (MandatorylnNH) E.L. DISEASE - EA EMPLOYE $ I=, describe under RIPTION OF OPERATIONS beacW E.L. DISEASE - POLICY LIMIT $ A Employee Beneflfa CP0553794300 12/1712013 1211712014 EBL 1,000,000 Card 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The Imagine Project, the City of Ashland, its officers, and employees are Additional Insured per CG2026 07/04 CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland, OR 97520-2014 AUTHORIZED REPRESENTATIVE I ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 POLICY NUMBER: CP0553794300 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 Person(s) Or Organization(s) The Imagine Project, the 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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. ® ISO Properties, Inc., 2004 CG 20 26 07 04 EP