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HomeMy WebLinkAboutInsurance Certificate: Dancing People Co CERTIFICATE OF LIABILITY INSURANCE D10/01/2014 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 Jon Snowden CONTACT NAME: Jon Snowden 420 Bridge St PHONE 541 482-2461 a/c No : 541 482-4957 RE EDSS: ion@jonsnowden.com StateFarm Ashland, OR 97520 ADDDRE INSURERS AFFORDING COVERAGE NAIC # INSURER A : State Farm Fire and Casualty Company 25143 INSURED Stiehm, Robin INSURER B: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDYIYYEFF YY MMLDDY EXP LIMITS LTR GENERAL LIABILITY A ❑Y 97-BB-W571-2 09125/2014 09/25/2015 DAMAGETORRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 X POLICY PRD LOC $ AUTOMOBILE LIABILITY El El COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED F AUTOS SCHEDULED BODILY INJURY (Per accident) $ DAMAGE $ AUTOS L NON-OWNED PeOacciden I) HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N TORY LIMITS E ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA ❑ E.L. EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ :i tE~ I DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required( Business - Misc 310 Oak St. Ashland, OR 97520 CERTIFICATE HOLDER CANCELLATION ANY OF AE DESCRIBED BE City of Ashland Its Officers and Employees THE SHOULD EXPI RATION H DATE VTHER OF, NOTICE POLICIES WILL CBE CDELIVERED BEFOREIN 20 E Main St ACCORDANCE -T IITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIV ©1988 2010 ACORD CO PORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks o ACO0 1001486 132849.8 01-23-2013