Loading...
HomeMy WebLinkAboutInsurance Certificate: Reel House Films DATE (MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 4/16/2015 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 NAME: Marcene Forney 1 FAX Ashland Insurance Inc PAH/ONnEo (541) 482-0831 j (A/C,No): (541)488-5851 585 A Street Suite 1 E-MAIL ADDRESS: marcenef@ashlandinsurance.com P. 0. BOX 880 INSURER(S) AFFORDING COVERAGE NAIC # Ashland OR 97520 INSURERA:Valley Forge i 20508 INSURED INSURER B : Sean Nipper dba : Reel House Films INSURER C : _ 590 LOUIS J AVE INSURER D:__ INSURER E : - TALENT OR 97540 INSURER F : - COVERAGES CERTIFICATE NUMBER:15 16 GL Master 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 EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY 2,000,000 EACH OCCURRENCE n j DAMAGE TO RENTED 300,000 A CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ X 6012100600 4/20/2015 4/20/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 i GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 4,000,000 F-1 I. X POLICY I~ JECOT- LOC i PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER: BAIL $ 1 , 000 AUTOMOBILE LIABILITY Ea aBINEDtSINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ rr 11 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ - NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION iPER STATUTE OERH _ _ _ _ AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E I r-~ EACH ACCIDFNT $ OFFICER/MEMBER EXCLUDED? N / A - (Mandatory in NH) E. L. DISEASE EA EMPLOYE $ If yes, describe under j--- DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This form is subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE Kimberly Edwards/KIM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 001400