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HomeMy WebLinkAboutInsurance Certificate: Bradford Pizza BRAADPIZ-01 RICKIE ,~►coR° CERTIFICATE OF LIABILITY INSURANCE DATE[lYYYY} 10/33120/2016 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). PRODUCER CONTACT NAME: Fullhart Insurance of Sisters PHONE FAX 704 W. Hood Ave, _IAIC, No, Exty: (541) 549-39 72 (/VC, No): (541) 549-9374 P.O. Box 1890 E-MAIL ADDRESS: info@fullhartinsurance.com Sisters, OR 97759 INSURER(S) AFFORDING COVERAGE NAIC # €NSURFRA:Oregon Mutual Insurance 14907 INSURED INSURER B : SAIF Corporation 36196 Bradford Pizza Inc. (Ashland) INSURER C: 1467 Siskiyou Blvd. PMB 232 INSURER U: Ashland, OR 97520 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 POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR X BSP720052 11/1212016 11112/2017 DAMAGE TO RENTED— 100 000 PREMISES Ea occurrence $ r MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY D jECT n LOC PRODUCTS - COMPIOP AGG $ 2,000,000 OTHER: Liquor Liab. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ H WORKERS COMPENSATION X SPER I TATUTE OR _ AND EMPLOYERS' LIABILITY B ANY PROPRIETORIPARTNERIEXECUTIVE YIN 774382 11101/2016 11/01/2017 E.L. EACH ACCIDENT $ 500,000 OFFICFRlMEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE -EA EMPLOYE $ 500,000 If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD