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HomeMy WebLinkAboutInsurance Certificate: Flip 9FLIPIN OP ID: PB A ° CERTIFICATE OF LIABILITY INSURANCE DATE ;0MMIDDNYYY) 04/2016 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 NAME: Hart Insurance Fax: 541-772-3963 PHONE AX No : 1123 Royal Ave. A/c No EXt : Medford, OR 97504 A MAIL ADDRESS: Hart Insurance / Medford INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Am. Hallmark Ins. Co of Tx 43494 INSURED Flip, Inc. INSURER B : DBA: Flip INSURER C : 92 N Main Street Ashland, OR 97520 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDIYYYY MM LTR IDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 44PB500035 05101/2016 05/01/2017 DAMAGE TO RENTED 100,00 A X COMMERCIAL GENERAL LIABILITY X PREMISES Ea occurrence $ CLAIMS-MADE X OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY PRO LOC Liquor $ 1,000,00 -7 F COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS X AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED 7 RETENTION $ WC STAT $ - WORKERS COMPENSATION - OTH TORY LIMIU TS OT AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 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 I LOCA € IONS / VEHICLES (Attach ACORD °~01, AddiLonal emarks Schedule, i'rn a space is :'equired) Certificate Holder is an additional insured per form # CBP047 CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Street AUTHORIZED R ESENTATIVE Ashland, OR 97520 Hart Insur =/Me ord 11.1 (A 1~v ©1988-2010 ACORD CO RATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD