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HomeMy WebLinkAboutInsurance Certificate: Standing Stone Brewing Company A~~ ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/21/2018 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 have ADDITIONAL INSURED provisions or 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 Brown & Brown Northwest N AME: Susan Wilson 3256 Hillcrest Park Drive PHONE - - FAX A/C,No,Ext): 541-494-2658 _fA/C No):_ 541-494-2758 Medford, OR 97504 E-MAIL - ADDRESS: _ Swllson@d bbnw. com _ INSURER(S) AFFORDING COVERAGE _ NAIC# _ www.bbnw.com INSURER A: AMCOInsurance Company_ 19100 INSURED INSURER B : Standing Stone Brewing Company 101 Oak Street INSURER c Ashland OR 97520 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 40916487 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. ILTR R' TYPE OF INSURANCE ~ N DL W - POLICY NUMBER MMIDDYIYYYY MM DD/YYYY LIMITS ✓ COMMERCIAL GENERAL LIABILITY ✓ EACH OCCUR. RENCE $ 1_,000,000 A ACP3006604826 7/24/2017 7/24/2018 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 . ✓ I POLICY r _ PE 0 [1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER Liquor Liability $1,000,00o AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000,00D (Ea accident/ _ -_i _ A ✓ ANY AUTO ACP3006604826 7/24/2017 7/24/2018 BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY ✓ AUTOS ONLY Per accident) . ✓ Hired Auto PD Included Uninsured Motorist CSL $1,000,000 A ✓ UMBRELLALIAB OCCUR 'ACP3006604826 7/24/2017 7/24/2018 EACH OCCURRENCE $5,099,600 L/ i EXCESS LIAB CLAIMS--.MADE AGGREGATE _ S5,000,000 DED ✓ RETENTIONS 10,000 $ WORKERS COMPENSATION STATUTE OTRH- AND EMPLOYERS' LIABILITY ANYPROPRIETORiPARTNFR/EXECUTIVE YN / A E.L. EACH ACCIDENT (OFFICER/MEMBER EXCLUDED? L-J - _ (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ i i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Operations of Named Insured This form is subject to policy terms, conditions and exclusions Re: Rogue Valley Earth Day Celebration at ScienceWorks Hands-On Museum, 1500 East Main St.. Ashland, OR . Saturday, April 21, 2018 - 11:00 a.m. to 4:00 p.m. - Additional Insured overage included per attached endorsement GL00030001009. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Clty of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Brenda Barker 20 East Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE J Susan Wilson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT (PRIMARY AND NON-CONTRIBUTORY WHERE REQUIRED UNDER CONTRACT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II - Who Is An Insured is amended to include any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy. However, the insurance provided will not exceed the lesser of: a. The coverage and/or limits of this policy; or b. The coverage and/or limits required by said contract or agreement. Coverage afforded to these additional insured parties will be primary to, and non-contributory with, any other insurance available to that person or organization where required of you by written contract or agreement. GL 00030 00 (10/09)