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Home My WebLink AboutInsurance Certificate: Peruvian Point CERTIFICATE OF LIABILITY INSURANCE D5/13/2016' 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. PRODUCER THE INSURANCE CENTER CONTACT NAME: PO BOX 6 PHONE FAX JACKSONVILLE, OR 97530 A/C, No. Ext : A/C, No.): E-MAIL ADDRESS: PHONE NO. (541)899-9535 INSURER(S) AFFORDING COVERAGE NAIC # INSURED CHRISTIAN AINZUAIN INSURER A: RED SHIELD INSURANCE COMPANY 41580 DBA: PERUVIAN POINT INSURER B: 139 CASEY WAY INSURER C: CENTRAL POINT, OR 97502 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 POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE 1,000,000 A Ea oc COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES 100,000 X CLAIMS-MADE OCCUR X CLP 024299 3124/2016 3/24/2017 MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 2,000,000 X POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT CE,. ccident ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE (Per accident) AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION WC STATUTORY OTHER AND EMPLOYERS' LIABILITY Y/N LIMITS ANY PROPRIETOR PARTNER/EXECUTIVE ❑ N/A E. L. EACH ACCIDENT OFFICER MEMBER EXCLUDED? (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) FOOD VENDOR/CATERING Event: Siskiyou De Mayo, May 14, 2016 The Certificate Holder is included as an additional insured pursuant to ISO form GL 1097(04/15) a copy of which is attached hereto for informational purposes. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE THE CITY OF ASHLAND, OREGON: PARKS CANCELLED BEFORE THE EXPIRATION DATE THEREOF, COMMISSION, ITS OFFICERS, EMPLOYEES, AND NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE AGENTS POLICY PROVISIONS. ATTN: RACHEL DIAZ AUTHORIZED REPRESENTATIVE 20 E MAIN ST ASHLAND, OR 97520 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CLP 024299 COMMERCIAL GENERAL LIABILITY GL 10970415 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY NON-CONTRIBUTORY WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): THE CITY OF ASHLAND, OREGON: PARKS COMMISSION, ITS OFFICERS, EMPLOYEES, AND AGENTS ATTN: RACHEL DIAZ 20 E MAIN ST ASHLAND, OR 97520 Location/Project: All locations where the insured performs ongoing business operations. A. Section II - Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only with insurance afforded to such additional insured respect to "bodily injury", "property damage", and will not be broader than that which you are "personal and advertising injury" occurring required by the contract or agreement to provide subsequent to this endorsement being added to for such additional insured. your policy, while performing your ongoing C. If other insurance is available to the additional operations at the person's or organization's insured scheduled above, we will share with all that premises, and caused only by your negligence in other insurance as described in D. below. the performance of those operations. The person's or organization's status as an additional insured D. Method of sharing: If all the other insurance ends when your personnel are no longer present at available to the additional insured permits the premises of the person or organization. contribution by equal shares, we will follow this B. This insurance is primary and non-contributory with method also. Under the equal shares approach, respect to any additional insured shown in the each insurer contributes equal amounts until it has schedule who you have agreed in an applicable paid its applicable limit of insurance, or none of the written contract or written agreement to provide loss remains, whichever comes first. If any of the primary and non-contributory insurance. Primary other insurance available to the additional insured and non-contributory means we will waive any does not permit contribution by equal shares, we rights we may have to seek contribution or will contribute by limits. Under this method, each subrogation from that additional insured. insurers share is based on the ratio of its applicable limit of insurance to the total applicable limits of However: insurance of all insurers. 1. Any insurance afforded to such additional E. With respect to the insurance afforded to the insured by this endorsement only applies to the additional insureds shown in the schedule, the extent permitted by law; and following additional exclusions apply: GL 10 97 04 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 This insurance does not apply to, and the person(s) 3. Coverage afforded to the additional insured is no or organization(s) shown in the Schedule are not greater than that provided to you and is subject insureds for: to all policy terms, conditions, and exclusions to the same extent they are applicable to you. 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the 4. The following duties are added to the Duties in rendering of, or the failure to render, any Event of Occurrence, Offense, Claims or Suit professional architectural, engineering or Condition of this policy: Additional insureds surveying services, including: under this endorsement shall tender any claim a. The preparing, approving, or failing to or "suit" to all available insurance and shall give written notice to us of any "occurrence" which prepare or approve, maps, shop drawings, may result in a claim or "suit" under this opinions, reports, surveys, field orders, change orders or drawings and insurance. specifications; and F. With respect to the insurance afforded to the b. Supervisory, inspection, architectural or additional insured shown in the Schedule, the engineering activities. following is added to Section III - Limits Of Insurance: This exclusion applies even if the claims against any The most we will pay on behalf of the additional insured allege negligence or other wrongdoing in the insured is the amount of insurance: supervision, hiring, employment, training or monitoring of others by that insured, if the 1. Required by the written contract or agreement "occurrence" which caused the "bodily injury" or you have entered into with the Additional "property damage", or the offense which caused the Insured; or "personal and advertising injury", involved the 2. Available under the applicable Limits of rendering of or the failure to render any professional Insurance shown in the Declarations; architectural, engineering or whichever is less. 2. "Bodily injury", "property damage" or "personal This endorsement shall not increase the applicable and advertising injury" occurring after: Limits of Insurance shown in the Declarations. a. All work, including materials, parts or equipment furnished in connection with such work, or the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. GL 10 97 04 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2