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Home My WebLink AboutInsurance Certificate: Reliable Resources Liquid Assets ~ ® DATE (MMIDDIYYYY) A~ o CERTIFICATE OF LIABILITY INSURANCE 6/1/2017 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 Marcene Forne NAME; y - - - _ _ PHONE Ashland Insurance Inc (541) 857 0679 FAX (541)857-9863 (AlC, No, E_xt): _ _ - - - - - ~ (AIC, No): - - _ 801 O'Hare Parkwa Ste 101 E-MAIL mforney@ashlandinsurance.com Y r ADDRESS: _ - INSURER(S) AFFORDING COVERAGE _ ' NAIC # Medford OR 97504 INSURERA:Monterey _Insurance Co 23540 INSURED INSURER B : _ Reliable Resources Inc, DBA: Liquid Assets Wine Bar INSURERC: , 96 N Main #201 INSURER D INSURER E : _ Ashland OR 97520 INSURER F COVERAGES CERTIFICATE NUMBER;CL176107198 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 i TYPE OF INSURANCE ~ POLICY NUMBER MMIDDIYYYY ~ POLICY EXP r MMIDDlYYYY ' LIMITS LTR X 'COMMERCIAL GENERAL LIABILITY ~ EACH OCCURRENCE ~ $ 300, 000 ~ _ OCCUR ~ DAMAGE TO RENTED 75, 000 ~ PREMISES_(Ea occurrence) $ - A CLAIMS-MADE X I ~ - r t ~ - 6/1/2017 6/1/2018 ' MED EXP (Any one person) ~ $ 5, 000 X 27SSA31326012 I- - - PERSONAL & ADV INJURY ~ $ 300, 000 - - - _ _ - GEN'LAGGREGATE LIMIT APPLIES PER: I ~ ~ I' GENERAL AGGREGATE ~ $ 600, 000 X ~ - ~ S - COMPIOP AGG _ ,PRODUCT POLICY ~ i JE ~ i LOC ! - _ _ $ 300, 000.. r - I ~ ~ ! ,Liquor Liability ' $ 300 , 000 ' 'OTHER: AUTOMOBILE LIABILITY ~ !COMBINED SINGLE LIMIT $ - ANY AUTO I BODILY INJURY (Per person) $ _ - - - - - SCHEDULED ' ~ i ~ BODILY INJURY (Per accident) $ AUTOWNED AUTOS ~ - _ ~ ~ `PROPERTY DAMAGE ~ $ NON- WNED i ~ ~ I AUTOS , ~ (Per accident) - HIRED AUTOS I' UMBRELLA LIAB I ~ ~ I ~ EA_CH OCCURRENCE I $ OCCUR ~ - - I - _ i~ _ ~ ~ EXCESS LIAB 'AGGREGATE - $ _ _ CLAIMS-MADE i r - - ~ - - - - ! i - DED ~ ~ RETENTION $ I ~ $ i WORKERS COMPENSATION ~ ! I~ I~! ~ STATUTE II ~RH iANDEMPLOYERS'LIABILITY _ _ - Y / N E.L. EACH ACCIuENT $ i ANY PROPRiETORIPAR i NERIEXECUTIVE ~ N! A - _ ~ OFFICERIMEMBER EXCLUDED? ~ I ~ ~ ~I (Mandatory in NH) ~~i ~ E.L. DISEASE - EA EMPLOYEE $ i If yes, describe under ~ ;DESCRIPTION OF OPERATIONS below I ' E.L. DISEASE -POLICY LIMIT $ i , i I 'i I I ~ I DESCRIPTION OF OPERATIONS !LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is listed as Additional Insured for General Liabiolity per form CG20120798. This form is subject o policy terms, conditions and exclusions. 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 Its Employees and Officers ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St. Ashland ~ OR 97520 AUTHORIZED REPRESENTATIVE Marcene Forney/MARL ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (2o1ao1)