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HomeMy WebLinkAboutInsurance Certificate: St Clair Productions roll, 2015 Y) ADO CERTIFICATE OF LIABILITY INSURANCE 05 /!0404 DATE//2015 - PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION East Main Street Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Will Maddux HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 1298 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Grass Valley, CA 95945 Phone: (530) 477-6521 Email: info@theeventhelper.com INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Essex Insurance Company 39020 St. Clair Productions INSURER B: Ariella St. Clair INSURER 314 Meadow Slope D ER C: Talent, OR 97540 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/Y DATE MM/DD/Y LIMITS GENERAL LIABILITY EACH OCCURRENCE INCLUDes $ 1,000,000 601I1Y INJURY 8 PROPERTY DAMAGE A Y X COMMERCIAL GENERAL LIABILITY x: MED EXP (Any one person) $ 5,000 CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ 1,000,000 X Host Liquor Liability 3DS5402-M768433 06/01/2015 06/02/2016 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1,000,000 GE POLICY E JECT PRO ❑ LOC DEDUCTIBLE $ 1,000 Retail Liquor Liability $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND -L-TORY LIMITS OER _ EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder listed below is named as additional insured per attached CG 20 26 07 04. CERTIFICATE HOLDER CANCELLATION City of Ashland its officers, employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 20 E. Main St. DATE THEREOF, THE ISSUING INSURER WILL EN6EA106R;F@ MAIL 30 DAYS WRITTEN Ashland, OR 97520 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Biel* FAIbWRrm:F19 99 69 61 10 66 AUTHORIZED REPRESENTATIVE ! F ACORD 25 (2001/08) © ACORD CORPORATION 1988