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HomeMy WebLinkAboutInsurance Certificate: Tree House Bookstore CERTIFICATE OF LIABILITY INSURANCE 06;25/2'®" 015" 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, Agent CT Jon Snowden 420 Bridge St MM, Ea, 541 482-2461 ~ No : 541 482 4957 5' - Farm Ashland, OR 97520 ADDRESS-. jon@jonsnowden.com INSURER(S) AFFORDING COVERAGE KW # INSURER A: State Farm Fire and Casualty Company 25143 INSURED ALMQUIST, JANE & PRICE, DIRK INSURER B: DBA TREE HOUSE BOOKSTORE INSURERC: 1237 ASHLAND MINE RD INSURER D: ASHLAND OR 97520-9604 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. I R TYPE: OF INSURANCE AOUL BR POLICY NUMBER POLICY EFF Y LILY EXP LTR LIMITS LT A GENERAL LIABAM 97-BH-B486-0 0411512015 0441512016 EACH OCCURRENCE $ 1,000,000 1:1 [A DAMAGE TO RENTE[Y- X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 300.000 CLAIMS-MADE a OCCUR MED EXP (Arty one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY PRO- LOC $ COM -1 F-1 AUTOMOBILE LIABILITY (Ee.61NEDISINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS $ NON-OWNED PROPERTY tPer HIRED AUTOS AUTOS $ -1 El UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS _ EXCESS CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTL+ AND EMPLOYERS' LIABILITY Y I N EL EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTrVE F-1 NIA OFFICEIMEMBER EXCLUDED? -1 (Mandatary in NH) EL DISEASE - EA EMPLOYE Y If yes. describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below F-1 El DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addkforrai Remarks Schedule, If more space is required) Business - Mercantile: 15 N Main St. Ashland, OR 97520 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE VATH THE POLICY PROVISIONS. AUTHOR REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.8 01-23-2013