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HomeMy WebLinkAboutInsurance Certificate: Beam Consulting ,lt• �AOR 0 M/ ® CERTIFICATE OF LIABILITY INSURANCE DATE(MDDIYYYY) 04/02/2019 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). PRODUCER CONTACT Michael B Miller Hart Insurance Agency - Medford PHONE FAX PO Box 1240 IAIC.No.Fat): (541) 779-4232 (A/C,No): E-MAIL ADDRESS: mmiller®hartineuranCe.COm Grants Pass OR 97528 INSURER(S)AFFORDING COVERAGE NAIL IS INSURER A:SAIE Corporation 36196 INSURED (541) 482-0119 INSURER B:Mutual of Enumclaw Insurance Co. 14761 Beam Consulting & Ventures LLC Sesame Asian Kitchen INSURER C: 21 Winburn Way INSURER O: Ashland OR 97520 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 11794 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 EFF POLICY EXP LIMITS LTR INSD DI WVD POLICYNUMBER (MM/DYYYY) (MM/DDM-YY) B X COMMERCIALGENERALLIABILITY EACHOCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR Y HOP0015982 05/18/2019 05/18/2020 PREMSES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000__ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPIJES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS — HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR — OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS - $ A WORKERS YIN 776045 01/01/2018 01/01/2020 X PER TATUTE ERH AND EERSOYERS'NIABILITY ANYPROPRIETORIPARTNEIVEXECUrIVE NIA E.L.EACH ACCIDENT $ 500,000 RAN OFFICEEMBEREXCLUOED'! (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 I/yes,describe antler DESCRIPTION OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 H Main Street AUUTHORRIIZEDDRREPRESENT TAATIVE�/ Ashland OR 97520 tt ! �- "`2a ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 n L. POLICY NUMBER: BOP 0015982 02 BUSINESSOWNERS BP 04 52 07 13 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II—Liability is amended as follows: b. This insurance does not apply to: A. The following is added to Paragraph C.Who Is An (1) "Bodily injury", "property damage" or Insured: "personal and advertising injury" arising 3. Any state or governmental agency or out of operations performed for the subdivision or political subdivision shown in the federal government, state or Schedule is also an additional insured, subject municipality; or to the following provisions: (2) "Bodily injury" or "property damage" a. This insurance applies only with respect to included within the "products-completed operations performed by you or on your operations hazard". behalf for which the state or governmental B. With respect to the insurance afforded to these agency or subdivision or political additional insureds, the following is added to subdivision has issued a permit or Paragraph D. Liability And Medical Expenses authorization. Limits Of Insurance: However: If coverage provided to the additional insured is (1) The insurance afforded to such required by a contract or agreement, the most we additional insured only applies to the will pay on behalf of the additional insured is the extent permitted by law; and amount of insurance: (2) If coverage provided to the additional 1• Required by the contract or agreement; or insured is required by a contract or 2. Available under the applicable Limits Of agreement, the insurance afforded to Insurance shown in the Declarations; such additional insured will not be whichever is less. broader than that which you are required by the contract or agreement to This endorsement shall not increase the provide for such additional insured. applicable Limits Of Insurance shown in the Declarations. BP 04 52 07 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1