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HomeMy WebLinkAbout2015-096 Concession Agrmt - Greenleaf 2015 Calle GuF -~iajuato Restaurant Concession License This RESTAURANT CONCESSIC N LICEICN (also referred to herein as "License") is made and entered into this day of I Y _ 2015, by and between the City of Ashland, a municipal corporation of the State of Oregon, by and through the Ashland Parks and creation Commission, (hereinafter collectively referred to as "City'), and ` li " (hereinafter referred to as "Concessionaire"). 1. SCOPE OF GRANT: Concessionaire has license to operate and maintain an outdoor dining concession within the described Concession Area Exhibit A. a. This license gives no estate or interest in the Concession Area, is revocable and not assignable. b. This license does not otherwise waive, modify or grant compliance with federal, state, or local laws applicable to the Concessionaire or its business. c. The City retains all rights to use and maintain the Concession Area for those purposes which it holds the property without unreasonably interfering with the license granted to concessionaire. 2. TERM / EFFECTIVENESS: The term of this License shall commence upon approval and execution by both City and Concessionaire and shall terminate on November 15, 2015, unless terminated early as provided for herein. 3. DURATION / MINIMUFA INTERVAL OF USE: The duration and scope of the revocable License and Concession granted by this License is for one season, beginning March 15, 2015 and ending November 15, 2015. a. Concessionaire is permitted to prepare, operate, and shall terminate Concession Area for outdoor dining concession operation between the period beginning March 15, 2015 at 7:00 A.M. and ending November 15, 2015 at 5:00 P.M. 4. PAYMENT OF LICENSE FEES: Concessionaire shall pay a license fee based upon the square footage of the Concession Area. The square footage awarded shall be determined each year by written order of the Parks Director and shall be set forth precisely in Exhibit A. a. The square footage flat fee shall be $7.00 per square foot for restaurants, for the 2015 concession year. b. Any payments for fees, taxes or assessments required or in arrears or disputed must be made by Concessionaire before any new license will be authorized for the Concessionaire. 5. USE OF PREMISES AND CONCESSION OPERATION LIMITS: a. Compliance with Law. Comply with all federal, state and local laws, rules, and regulations applicable to public health and safety and licensing related to food and food handling and doing business in the State and City of Ashland; b. Maintenance an(- Safety. Maintain all the grounds, improvements, facilities, assets equipment and fixtures contained within the Concession Area in good repair and in safe, sanitary, clean, and attractive condition that is approved acceptable by the City, such approval not to be unreasonably withheld. c. Improvements and Placement of Restaurant Equipment. Unless otherwise set forth herein, Concessionaire may make physical improvements or alterations to the concession Area or install structures or fixtures thereon only after express written authorization of the City Parks Director, such approval not to be unreasonably withheld. Calle Guanajuato Restaurant Outdoor Dining Concession 1 d. Concessionaire may place tables and chairs, serving tables or host podium stand or other items reasonably related to the outdoor dining concession ('restaurant equipment') in the Concession Area. e. Restaurant equipment shall be of sturdy and durable construction, movable by one person, and shall be self-supporting, and at no time attached, tied or locked to trees, hydrants, poles, fences or other items. f. Restaurant equipment, or materials otherwise associated with the restaurant owner and restaurant employees shall not block or in any way impede pedestrian or fire and emergency vehicle access to the Calle Guanajuato as required by this License. g. Restaurant equipment, supplies or materials otherwise associated with the restaurant owner and restaurant employees shall not block, impede or in any way hamper vehicular traffic on Calle Guanajuato during the following hours or as otherwise permitted under Ashland Municipal Code 10.68.400 Monday through Friday Saturday and Sunday Prior to 11:30 a.m. Prior to 8:00 a.m. & after 10:00 p.m. & after 10:00 p.m. h. Concessionaire shall promptly remove any offensive, hazardous or dangerous restaurant equipment, furniture, or solid waste within the Concession Area, at all times. 6. FIRE AND LIFE SAFETY. Concessionaire shall comply with any and all fire and life safety guidelines, recommendations and requirements issued by the City of Ashland Fire Marshal, including, but not limited to: a. Maintain all required fire and emergency access areas; b. Ensure that permitted restaurant equipment shall not encroach upon or obstruct public walkways or open space areas while maintaining a clear eight (8) foot pathway for emergency vehicles as approved by the City of Ashland Fire Marshal; c. Maintain a clear, unobstructed space around any fire hydrant as required for fire safety; d. Have available and shall maintain such fire extinguishers as determined by the Fire Marshal; e. Advise patrons and shall strictly abide by the Park prohibition on smoking. Smoking is not permitted on the Calle Guanajuato under any circumstances; and f. No use any bottled gas, electrical devices, or hazardous materials or hazardous substances without prior approval by the Ashland Parks Director. [For purposes of this License "Hazardous Substance" or "Hazardous Material" means any hazardous, toxic, infectious, or radioactive substance, waste, or material as defined or listed by any local, state or federal environmental law.] 7. VEHICULAR ACCESS. As otherwise provided herein, Concessionaire shall strictly comply with vehicular access to the Calle Guanajuato as is permitted by AMC 10.68.400. a. City, at its sole discretion, will issue revocable access permits to Concessionaire according to limited purposes and for limited tirnes to facilitate set up, take down, and removal of restaurant equipment and other materials authorized by this License. b. Vehicles will exclusively ingress and egress from Winburn Way, and will not enter or exit from the plaza end of Calle Guanajuato; nor will they extend beyond the area designated for the Concession. c. At no time will the Concessionaire interfere with the eight (8) foot path required Calle Guanajuato Restaurant Outdoor Dining Concession 2 for emergency vehicles. d. The Concessionaire shall ensure that appropriate pedestrian safety precautions are maintained while vehicles using the access permits are in the vicinity. e. Concessionaire shall procure and maintain insurance in accordance with the requirements of Exhibit C in full force and effect throughout the term of this License. 8. SERVICE OF ALCOHOL. This license suspends compliance by Concessionaire to AMC 10.40.030 prohibiting public consumption of alcoholic beverages under the following conditions: a. Maintain, in force, a comprehensive liability policy including an endorsement for liquor liabili~ eir own expense and at all times during the Concession duratio Initial From Concessionaire) b. Serve alcoholic beverages only in conjunction with prepared meals. 9. INSURANCE: Concessionaire shall, at its sole cost and obligation, procure and maintain insurance in accordance with the requirements of Exhibit C in full force and effect throughout the term of this License. Concessionaire shall provide the City with copies of said insurance certificates and shall name the City of Ashland as additional insureds. 10. INDEMNITY AND HOLD HARMLESS: Concessionaire will defend, indemnify and hold City and/or Parks Commission, their officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death,) or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to this license or the activities that take place on licensed property. Concessionaire waives the right of subrogation regarding the insurance policy as described in the Insurance Section in this License. Concessionaire will not be held responsible for damages caused by negligence of City and/or the Parks Commission. a. The obligation to indemnify is expressly understood to survive termination of this License for any reason, and includes reasonable attorneys' fees, including attorneys' fees on appeal, and investigation costs and all other reasonable costs, expenses and liabilities incurred by City or its attorney from the first notice that any claim or demand is to be made or may be made. 11. TERMINATION: Notwithstanding any other provision herein, the City may terminate this license, in whole or in part, at any time for any reason considered by the City, in the exercise of its sole discretion, to reasonably be in the public interest. The City will provide the Concessionaire seven (7) days prior written notice of a termination for public convenience. a. Concessionaire's remedy to contest termination of the license by City is provided in AMC 2.30, Uniform Administrative Appeals Process. b. Notwithstanding any other provision herein, City may order vacation of the Concession Area or immediately remove the Concessionaire or any other person who may be occupying the Concession Area without resort of a Court Order sanctioning such action. c. Upon failure to vacate, City is expressly authorized to remove all Concessionaire property from the Concession Area at the Concessionaire's expense. i. City will reasonably maintain the property of the Concessionaire for at least 30 days and shall leave it reasonably available for Concessionaire to take possession. City may dispose of any property that remains Calle Guanajuato Restaurant Outdoor Dining Concession 3 unclaimed after 30 days. The City may use reasonable discretion to immediately dispose of non-durable or solid waste, including but not limited to food and other putrescible waste. 12. SURRENDER: Upon the expiration of the original term or terms, as extended by the parties, Concessionaire shall surrender to the City the Concession Area in as good or better condition and order as was originally received, except as allowed for within the typical wear and tear. 13. DISPUTE RESOLUTION AND ATTORNEY FEES: The preferred method of resolving disputes between the parties under this License shall be first by mediation. Mediation shall be conducted by a mediator chosen by mutual agreement of the parties; if there is no agreement, the mediator shall be appointed by the elected Municipal Court Judge or Judge pro tem. a. Any mutually incurred cost from the provision of these services, except costs associated with building a case including but not limited to.attorney fees or fees for expert witnesses, shall be shared equally between the two parties. b. In any administrative appeal or litigation between the parties arising out of this license, the prevailing party shall recover its reasonable attorneys fees incurred at trial and upon appeal. "Attorneys fees" shat! include the reasonable value of the services of in-house counsel. 141. MISCELLANEOUS PROVISIONS. a. Notice. Any notice affecting the rights of the parties under this License shall be delivered in writing either in person or to the following parties by first class mail: City: Director, Michael A. Black Ashland Parks and Recreation Commission 340 South Pioneer Street Ashland, Oregon 97520 (Telephone 541-488-5340; FAX: 541-488-5314) Copy to: City Administrator, Dave Kanner City of Ashland 20 East Main Street Ashland, Oregon 97520 (Telephone: 541-552-2100; Fa;:: 541-488-5311) Concessionaire: Name of business: Cl~e~1r'~ f Attn: brrlnlej, C lw%btkl. Address: yq 01 M LlS1 Phone Number:Za19)4L'Zi~ b. Governing Law. This License, and all matters relating to this License, shall be governed by the laws of the State of Oregon in force at the time any need for interpretation of this License or any decision or holding concerning this License arises. The parties to this License do not intend to confer on any third party any rights under this License. c. Severability. If any provision of this License is held by a court of competent jurisdiction to be either invalid, void, or unenforceable, the remaining provisions of this License shall remain in full force and effect. d. Merger. THIS LICENSE CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES HERETO AND SUPERSEDES ANY AND ALL PRIOR EXPRESS AND/OR Calle Guanajuato Restaurant Outdoor Dining Concession 4 IMPLIED STATEMENTS, NEGOTIATIONS AND/OR AGREEMENTS BETWEEN THE PARTIES, EITHER ORAL OR WRITTEN, AND MAY NOT BE AMENDED, CHANGED OR MODIFIED IN ANY WAY, EXCEPT BY WRITTEN AGREEMENT SIGNED BY ALL PARTIES HERETO. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed in two (2) duplicate originals, either as individuals, or by their officers, thereunto duly authorized. DATED this DO day of _ ►'C ~ , 2015 Licensee / Concessionaire: Licensor/ City of Ashland, Oregon: Parks and Recreation Commission Name Printed: Michael A. Black, Director Ashland Parks and Recreation Dater ' Date,/,: 1-7 7G'l Dave Kanner, City Administrator Ap ved as to form: Dave man, City Attorney Calle Guanajuato Restaurant Outdoor Dining Concession 5 Exhibit A- Concession Area See attached picture and highlight entire area of interest. Calle Guanajuato Restaurant Outdoor Dining Concession 6 M~ Exhibit B. Proposal Documents Ashland Parks & Recreation Department REQUEST FOR RESTAURANT SERVICE SPACE-CALLE GUANAJUATO NAME OF\R\ESTAURANT WK PHONE MESSAGE PHONE EMAIL ADDRESS NAME OF AUTHORIZED REPRESENTATIVE 0 WHAT IS THE BEST'WAY TO CONTACT YOU? *(Circfe one) email/phone MAILING ADDRESS CITY STATE ZIP DESCRIPTION OF AREA. SEE i:TTTACHED PICTURE (Exhibit A) ARE YOU REQUESTING A NEW SPACE THAT IS NOT CURRENLY A SEATING AREA? (Circle One) YES NO i TOTAL NUMBER OF SQUARE F nET REQUESTED? per square foot) WILL ALCOHOLIC BEVERAGE! BE SERVED? YES NO Date Signature (owner or representative) Total Square Footage x Date Paid The following items m st be catained before license can be issued: • Business License Number: • Copy of OLCC License for outdoor seating • Copy of Insurance Certificate naming City of Ashland as additional insureds Calle Guanajuato Restaurant Outdoor Dining Concession 7 Exhibit C Insurance Requiremem,'s The Concessionaire, at its sole cost and expense, commencing on the effective date of this License, shall procure and maintain insurance acceptable to the City in full force and effect throughout the term of this License. It is agreed that any insurance maintained by City shall apply in excess of, and not contribute with, insurance provided by Concessionaire. Concessionaire's Insurance shall be primary and non-contributory and have a cross-liability clause. During the term of this contract, Concessionaire shall maintain in full force, all the insurance coverage noted below with the City named as additionally insured: 1. Comprehensive General Liability insurance, with a general aggregate limit of not less than $2,000,000 and $2,000,000 per occurrence. Each policy shall contain a blanket contractual liability endorsement to cover the Concessionaire's indemnification and other obligations under this License as well as owners' and contractors' protective insurance, products and completed operations coverage, fire damage, personal and advertising injury coverage. It shall also include, if appropriate for the contract, coverage for Concession Area operations, explosion and collapse hazard, underground hazard, products, completed operations, contractual insurance, and independent contractors. 2. Comprehensive Automobile Liability insurance, with a general aggregate limit of not less than $2,000,000 and $2,000,000 per occurrence, including coverage for owned, hired or non-owned vehicles. 3 Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days written notice from the Concessionaire or its insurer(s) to the City. 4. Certificates of insurance. As evidence of the insurance coverage's required by this contract, the Concessionaire shall furnish acceptable insurance certificates to City at the time Concessionaire returns signed contracts. For general liability insurance and automobile liability insurance the certificate will provide that the City, Parks Commission, its officers, employees and agents are Additional Insureds. The certificate will include the 30-day cancellation clause, and will include the deductible or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to the City. The Concessionaire shall be financially responsible for all pertinent deductibles, self-insured retention's, and/or self-insurance. Certifcates of Insurance shall be forwarded to: (Ashland Parks and Recreation 340 S. Pioneer St., Ashland OR 97520). 5. Workers Compensation insurance in compliance with Oregon Statutes, [ORS 656.017] which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers. (Required of Concessionaires with one or more employees, unless exempt under ORS 656.027). ) Only if Concessionaire does not employ workers subject to ORS Chapter 656, Concessionaire shall sign the following affidavit: EXEMPTION AFFIDAVIT Concessionaire declares, under penalty of perjury and false swearing, that Concessionaire does not currently employ, and will not employ any individuals for work under this contract during the term this License is in force. Date: Concessionaire Calle Guanajuato Restaurant Outdoor Dining Concession 8 Exhibit B Proposal Documents Ashland Parks & Recreation Department REQUEST FOR RESTAURAN SERVICE SPACE-CALLE GUANAJUAT,OI d NAME OF RESTAURANT ~LA.~e c WK PHONE 7 ~.k. ~ t "e Li MESSAGE PHONE k-'EMAIL ADDRESSZ~6-ylk' crr,-eC34L NAME OF AUTHORIZED REPRESENTATIVE \ 1 I 1A G1111U I+~ WHAT IS THE BEST WAY TO CC,NTACT YOU? *(Circle one mail 'Phone MAILING ADDRESS /Y" 6 CITY STATE ZIP DESCRIPTION OF AREA. SEE A`TACHED PICTURE (Exhibit A) ARE YOU REQUESTING A NEW SPACE THAT IS NOT CURRENLY A SEATING AREA? i el J -J I- _ (Circle One) YES NO c~5 7 e- TOTAL NUMBER OF SQUARE FEET REQUESTED? 7 per square foot) WILL ALCOHOLIC BEVERAGES 3E SERVED? YES NO Date Sfg'nature (owner or representative) ************----5~'FFQNL`{ PJGLOI,J'rt-hSLI~~ `J Total Square Footage x $ - 6/31-00, Date Paid 9 The following items must be obtained bef license can be issue ; • Business License Number, ~ Copy of OLCC License for o _tdoor seating n 0 Copy of Insurance Certificate naming City of As land as additional insuredsL' Calle Guanajuato Restaurant Outdoor Dining Concession 7 C~ i j ~ ~ ~ Exhibit D Minimum Policies, Procedures, and Concession Standards for Ou-:door Dining on Calle Guanajuato The Ashland Parks and Recreation Commission may award a concession on the Calle Guanajuato to Plaza restaurants, adjacent to Calle, for the specific purpose of placing outdoor food service tables on approved concession sites, said sites designated and approved by the Parks Director on an annual basis The Policies, Procedures and 5tandards below govern this process [Subject to change by the Parks Commission]. Definitions For the purpose of this document, all references, certain words and phrases are defined, and certain provisions shall be constructed as herein set out, unless it appears from their context that a different meaning is intended. • "Restaurants" shall pertain strictly to City of Ashland Plaza Restaurant owners and establishments adjacent to Calle Guanajuato. These restaurants are in the business of selling or causing to be sold for cash or consideration of any kind any of the following items: food or edibles of any type whether hot, cold, fresh prepared or packaged. This definition includes an offer for sale. • "Concession" is that City authorization which provides the restaurant owner the right to maintain a restaurant venture at a certain location on the Calle Guanajuato. • "Calle Guanajuato" is that area behind the Ashland Plaza business area, adjacent to the south side of Ashland Creek, between North Nain Street and Winburn Way. • "Restaurant Equipment" includes but is not limited to any materials, merchandise, tools, carts, tables chairs, podiums, or other items owned by, in possession of or associated with a licensed restaurant owner. • "Restaurant Owner" is a person or legal entity who is the legal owner of the restaurant business. • "Employee" means any person hired or paid compensation by, or any person under contract to, a licensed restaurant owner. • "Site Location" (also referred to as "concession area", or "premises" is that useable space or area on Calle Guanajuato which has been allocated for individual plaza restaurant use by the Ashland Parks Director. • "Licensed" is that business license required by the City of Ashland constituting a tax for revenue purposes, and is not a regulatory permit fee. The payment of a license tax required by, and its acceptance by the City, and the issuance of such license to any person, shall not entitle the holder thereof to carry on any business on the Calle Guanajuato unless he or she has complied with all the requirements of the City and all other applicable site permit policies and rules of the Ashland Parks and Recreation Commission as agreed upon when obtaining a site permit. Restaurant Concession Application. • Every plaza restaurant, adjacent to Calle Guanajuato, desiring an outdoor dining concession on the Calle Guanajuato shall file an application with the Ashland Parks and Recreation Commission upon a form obtained from the Ashland Parks and Recreation Department. The applicant shall meet the application deadline and place the same on file with the department. Review of Concession Applications. Restaurants shall have first priority for all Calle Guanajuato alcove use as site locations. Calle's alcove position, design and square footage provides an appropriate setting for restaurant traffic and layout. Upon receipt of applications, the Ashland Parks and Recreation Commission shall review each according to the following "priority" criteria: Calle Guanajuato Restaurant Outdoor Dining Concession 9 • Restaurant proximity shall constitute a major determining factor for a site location on Calle Guanajuato. Only restaurants that are adjacent to and have the greatest accessibility to a designated location shall have contractual preference. • Restaurant "seniority" shall take precedence when two or more restaurants are within the same proximity to a site location. "Seniority" shall be determined by a review of past year's site permit agreements affording privilege status to most recent and ( or continuous use. Final selection shall be made by the Commission. Restaurant Concession Fee Schedule. The Calle,Guanajuato Restaurant C ncession Fee Schedule shall be set at $7.00 per square foot of use. March b through November shall constitute a concession season. "he site permit fee shall be paid by the second Friday of May of each year covered under the permit. Minimum Period of operation is between Memorial Day and Labor Day. Restaurant Concession Reservation and Duration. 1. Any restaurant concession shall be nontransferable and shall be valid for one season in a single calendar year. 2. No Plaza restaurant may hold or be issued more than one concession. (Owners with interests in multiple restaurants are not restricted by this provision). 3. Should a restaurant "abandon" a reserved site, it shall be "awarded" through the competitive process under the selection "Review of Applications." 4. At the end of each year, during the month of December, an "intent" notification shall be required of the restaurant owner regarding continued use of the original reservation. After the third (3) consecutive "intent" notification, the restaurant must reapply for a new concession and no reservation will held. 5. In considering "intent" notifications, the Ashland Parks and Recreation Commission shall consider the original application criteria in the section "Review of Applications" and the restaurant owner's compliance with other applicable City laws and regulations. Any site permit reservation which is rescinded shall receive in writing an explanation of such action from the Commission. Restaurant Cancellation. • A restaurant issued a concession may be canceled at the request of the restaurant owner. In such case, the annual site permit fee requirement shall be null and void. • In the event of a cancellation, the restaurant site vacated shall be available for another licensed plaza restaurant owner or designated as part of the Calle Guanajuato Marketplace Concession. • The Ashland Parks and Recreation Department reserves the right to revoke any restaurant's concession for a designated Calle area at any time if that individual restaurant does not conform to applicable law, including but not limited to the rules and regulations established by the Ashland Parks and Recreation Commission. Restaurant Concession Regulations. • Concessionaires shall be required to enter into a standard Concession agreement with the City to lawfully operate a concession on city park property. Calle Guanajuato Restaurant Outdoor Dining Concession 10 ARY OF INSURANCE Prepared: 111512014 Page 1 ,reenleaf Restaurant Daniel Greenblatt 49 North Main St. Ashland, OR 97520 541-482-2808 overage Amount Company' Policy No Eff Exp Premium usiness Owners Policy CIG/Eagle West Insurance 27CMA21420818 11/30/14 11/30/15 ther Named Insured oa Greenleaf Restaurant iability Limits 31 & PD Per Occurrence Limit 1,000,000 31 & PD Aggregate Limit 2,000,000 Jledical Expense (Per Person) Limit 5,000 damage to Rented Premises Limit 150,000 _iquor Liability Aggregate Limit 1,000,000 ocation 1 Building 1 restaurant Irimary Location 19 N Main Street 4shland, OR 37520 Personal Property Amount 300,000 i Coin % 90% Deductible 500 Valuation RC kdd'I Insured: Ashland Parks & Re reation 340 S P oneer Street Ashland, OR 97520 >dditional Coverages \dditional Coverages Extra Expense Actual Loss Sustained Number of Months: 12 Extra Expense Endorsement #s NO WAIT Loss of Income Actual Loss Sustained Number of Months: 12 Loss of Income Endorsement #s NO WAIT Valuable Papers Limit 15,000 Valuable Papers Ded 500 Valuable Papers Endorsement #s SISKIYOU - LISA 482 3378 DT DT DT DT DT DT DT DT DT DT DT DT DT DT DT DT DATE: WALNUTS- CHOCOLATE CHIPS - - RAISINS SWEETENED COCONUT FLAKES,/ - - r . PITTED OLIVES WHOLE OLIVES TOFU 4 / 1 1 ®i ~ r. r NATURAL BACON' FRENCH FRIES °0` p ! 1' UNSALTED BULK BUTTER ) s ( t ` Ii I 1 I ! CREAM CHEESE SHRED. CHEESE BLEND 5# BAG C 4b a i SHREDDED PARM 5# BAG -5.00 I / GRATED PARM TUB BLUE CHEESE - RICOTTA ~ I PICKLE SPEARS TAH/NI - / _ u PEANUT BUTTER DELI - PLASTIC FORKS PLASTIC KNIVES PLASTIC SPOONS _ SOUP SPOONS - DOLMAS -It2DAR CHEESE SVV'S6 i HEESE Ive, NATURAL TURKEY STONEGROUND,14USTARD - _ - KITCHEN/FREEZER CHERRY CHICKEN SAUSAv- 411 "oe HOT ITALIAN LINKS 411 CANOLA LIQUID FRY ► r f r y 75/25 OIL BLEND Lox NAT GROUND TURKEY. MISO l-A ARIONBERRIES 3 vie/ I i ATTIC BIO PACK #1 W B I O PACK #3 BIO PACK #4 BIO PACK #8 6 X 6 PAPER CLAMSHELL - FOOD PAIL QT FOOD PAIL PT Y _ . STYRENE LID 2 OZ STYRENE CUP 2 OZ STYRENE LID 4 OZ STYRENE CUP 4 OZ _ 80 UNCESOUP 8 OUNCE SOUP LID 16 OUNCE SOUP SUMMARY OF INSURANCE Prepared: 11/5/2014 Page 2 For Greenleaf Restaurant Daniel Greenblatt 49 North Main St. Ashland, OR 97520 541-482-2808 :overage Amount Company: Policy No Eff Exp Premium iusiness Owners Policy (Continued) 03-438 accounts Receivable Limit 15,000 accounts Receivable Ded 500 \ccounts Receivable Endorsement #s 03-438 iign Limit 25,000 >ign Ded 500 iign Endorsement #s 03-438 mployee Dishonesty Limit 5,000 mployee Dishonesty Ded 500 mployee Dishonesty Endorsement #s 03-438 Aoney & Securities In Limit 15,000 Aoney & Securities In Ded 500 Aoney & Securities In Endorsement #s BP0002 Aoney & Securities Out Limit 10,000 Aoney & Securities Out Ded 500 Aoney & Securities Out Endorsement # BP0002 ipoilage Limit 25,000 >poilage Ded 500 spoilage Endorsement #s )3-397 :omputers Limit 30,000 :omputers Ded 500 :omputers Endorsement #s )3-438 )EP PRO BI Limit 440,000 ;EWER BU Limit 100,000 ;EWER BU Ded 500 usiness Auto CIG/Eagle West Insurance 27BAA21420818 11/30/14 11/30/15 ability 5L 1,000,000 utos Specified on Schedule 16 OUNCE SOUP LID o _ C 8 OONCE DELI CLEAR 16 OUNCE DELI CLEAR DELI CLEAR LID 8" PIZZA BOX CORRUGATED _f . VINYL GLOVES I - . , 12" FILM i ` !T_ f 18" FOIL r 18 FILM ~ NAPKINS #735 GROCERY BAG - - - #8 BAGS - i - - _ #12 BAGS - #20 BAGS _ Page 3 UMMARY OF INSURANCE Prepared: 11/512014 -or Greenleaf Restaurant Daniel Greenblatt 49 North Main St. Ashland, OR 97520 541-482-2808 Policy No Eff Exp Premium" rverage Amount Company isiness Auto (Continued) ired Autos on-Owned Autos II Owned Autos Which Require No- utos Specified on Schedule iinsured Motorists SL 1,000,000 )wned Autos Subject To Compulsory nderinsured Motorists SL 1,000,000 )wned Autos Subject To Compulsory omprehensive kutos Specified on Schedule ollision \utos Specified on Schedule ndorsements, Forms, Conditions. rental Reimbursement incl $100 per See Attached Vehicle Schedule See Attached Driver Schedule :ommercial Application CIG/Eagle West Insurance 27BAA21420818 11/30/14 11/30/15 (remises premise 1 Building 1 Restaurant 49 North Main St. Ashland, OR 97520 Nature of Business: Family style restaur nt Umbrella CIG/Eagle West Insurance 27CUL21420818 11/30/14 11/30/15 -lability Limit Each Occurence 1,000,000 Aggregate 1,000,000 letained Limit 10,000 J SISKIYOU - LISA 482 3378 DTI, DT DT DT DT DT DT DT DT DT DT DT DT DT DT DT DATE: WALNUTS d CHOCOLATE CHIPS RAISINS M SWEETENED COCONUT FLAKES v - , 'r I T T E EE OLIVES - r X 1 _ OLIVES 4B TOFU C L ( / ! 1 - - I , / / . of NATURAL BACON I /•L / FRENCH FRIES / UNSALTED BULK BUTTER / , I 7,~~ CREAM CHEESE t41~ SHRED. CHEESE BLEND 5# BAG 4/j. Zt- y` c - ~ SHREDDED PARM 5# BAG / GRATED PARM TUB _1 I Z I 1 y 1 Z- BLUE CHEESE RICOTTA 1 PICKLE SPEARS TAHI NI -:-il PEANUT BUTTER - - _ - DELI - PLASTIC FORKS _ - - - PLASTIC KNIVES PLASTIC SPOONS SOUPSPOONS DOLMAS CHEDDAR CHEESE Z 1 1 I 1 (-r -I f SWISS CHEESE I I A 1 ~ NATURAL HAM / NATURAL TURKEY STONEGROUND MUSTARD - - - - KITCHEN/FREEZER CHERRY CHICKEN SAUSAGE 411 +o a .6 Q _ HOT ITALIAN LINKS 411 CANOLA LIQUID FRY - 75/25 OIL BLEND NAT GROUND TURKEY / I I O MARIONBERRIES D.: ATTIC BIO BIO PACK#1 - PACK #3 BIO PACK #4 C S'/~' - - - - BIO PACK #8 -2,7 - - e FOOD PAIL QT 1 - s - - - - FOOD PAIL PT I / _ - 1- W.. J STYRENE LID 2 OZ - - i STYRENE CUP 2 OZ STYRENE LID 4 OZ STYRENE CUP 4 OZ 8 OUNCE SOUP 8 OUNCE SOUP LID - - 16 OUNCE SOUP SUMMARY OF INSURANCE Prepared: 1/512014 Page 4 For Greenleaf Restaurant Daniel Greenblatt 49 North Main St. Ashland, OR 97520 541-482-2808 overage Amount Company Policy No Eff Exp Premium Imbrella (Continued) Inderlying Insurance Automotive Liability Eagle West 276AA21420818 11/30/14 11/30/15 Combined Single Limit 1,000,000 General Liability Eagle West 27CMA21420818 11/30/14 11/30/15 Each Occurrence 1,000,000 General Aggregate 2,000,000 Products & Comp Ops 2,000,000 Personal & Adv Injury 1,000,000 Damage to Rented Premises 150,000 Medical Expense 5,000 Employer Liability LNW WC41 NC972455017 11/30/14 11/30/15 Each Accident 500,000 Disease Policy Limit 500,000 Disease Each Employee 500,000 16 OUNCE SOUP LID - - - - 8 OUNCE DELI CLEAR 16 OUNCE DELI CLEAR DELI CLEAR LID 8" PIZZA BOX CORRUGATED VINYL GLOVES -Af' ` 12" FILM 18" FOIL 18" FILM - NAPKINS #735 GROCERY BAG #8 BAGS #12 BAGS #20 BAGS r ~ (n, n Cn T c z m O M m tQ M cn CD -I 0 z m m O = _ G) ;o 0 Z m n~ m O rn 0 o zm ° -i z cn = -n C m Z m o m D ~r- m m • OO o r 0:~ o C - n ~ ~n c--~-I-I A m o0 - C rD m 00 N m m D m X Z z z M U) D m 71 z n m o n y m rn r O m O m 0 cn C) > z Z m -n o O m 0o m m =z m Cl) m <D ° A z CA) 2) Z M CY) z n -n o 'n N y ~ Cl) co ;u r- m 0 m (D 0 N _ v co - _ C/) c CC D . D C7 cr O m Z < cn ° C71 D m - m n PO 0 :2; o 0 O ( D Z ] m -u Fn N m cn O m U) (D 0 m rn b 0 ;a OD M U) C-Ti N O = m Lin m = ~r -I D (1) O m cOnZr- ct) v m 0 ym0 v Z 0 o Zvm z -n z p Z -0 N 00rnm m D --4 mU)r o m r ODcl) ~ O o ~Z~ m 03 C mD m 00 Byrn m cDnmo th N > m ~~m o , n C7 MOrn r p rn O Z ~ O z Z 0DG) D 0 -I -gym: y C)MZ > m m 00 m r D z D 0 -i r N mtVmi~ Z Z m m m < D T - r - std Gf3 o~mm z > rn z n -Tl w N m71 0 cn -n C ► 0 X • m om0 U 0 U) mc o CD C ~M~ C r c 0 Un a O ~OZz < Cl) 71 co m z C) 0 cn ml pm Z z 9GREERE OP ID: PB 11105120Y4 CERTIFICATE OF LIABILITY INSURANCE F I D 11 /05/2014 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). CONTACT PRODUCER Phone: 541-779-4232 N AME: Hart Insurance Fax: 541-772-3963 PHONE FAX 1123 Royal Ave. A/C No Ext : A/C No Medford, OR 97504 E-MAIL Hart Insurance / Medford ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:CIG/Eagle West Insurance 008028 INSURED Greenleaf Restaurant INSURER B: 49 North Main St. Ashland, OR 97520 INSURER C INSURER D : 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 SUB POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 27CMA21420818 11/30/2014 11/30/2015 PREMISES DAMAGES ( Ea RENTED occurrence $ 150,00 CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $ 5,00 X Liquor Liab PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 LOC Liquor $ 1,000,00 X POLICY PRO CT F AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROP RTY DAMAGE $ 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 ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City, Parks Commission, its officers, employees and agents are listed as addtional insureds per form # CG2010 (07/04) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland Parks & Recreation ACCORDANCE WITH THE POLICY PROVISIONS. Dept. Rachel Dials AUTHORIZED REPRESENTATIVE Hart Insu a ce / Medfor¢ 340 S Pioneer Ashland OR 97520 ~wXGL ©1988-2010 ACORD C I PORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORE POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20100704 r THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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): Locations Of Covered Operations Additional Insureds shown in a written contract, or written agreement that includes primary and non- contributory wording where required. The inclusion of one or more Insured under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or equip- 1. Your acts or omissions; or ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed; or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑