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HomeMy WebLinkAboutInsurance Certificate: Ballet Folkloico Ritmo Alegre A4C: DATE(MM!DDJYYYY) 4,......--- CERTIFICATE OF LIABILITY INSURANCE 02/04/2022 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: lithe certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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 Ileu of such endorsement(s). PRODUCER CONTACT NAME: AP INTEGO INSURANCE GROUP LLC 76250846 PHONE (888)289-2939 FAX (888)289-2988 375 WOODCLIFF DRIVE STE 103 (A/C,No,Ext): (A/C,No): FAIRPORT NY 14450 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Twin City Fire Insurance Company 29459 INSURED INSURER B: BALLET FOLKLORICO RITMO ALEGRE INSURER C: PO BOX 8225 - MEDFORD OR 97501-0525 INSURER D D. INSURER E: INSURER F: N 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 N INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS g CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE o TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR MD IMM/00/YYYYI lMM/DD/Y MI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) — MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE POLICY❑PRO- JECT El LOC _PRODUCTS-COMP/OP AGO OTHER: _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS _AUTOS — HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- AGGREGATE MADE _ DED RETENTION WORKERS COMPENSATION X IPEATUTE I PER 10TH AND EMPLOYERS'LIABILITY ER ANY Y/N E.L.EACH ACCIDENT $500,000 A PROPRIETOR/PARTNER/EXECUTIVE C WA 76 WEG AR1CSA 01/21/2022 01/21/2023 - OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 • (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Those usual to the Insured's Operations.City of Ashland,It's officers,agents,and employees are listed as an additional insured per the Business Liability Coverage Form SS0008 attached to this policy.RE:Grant funding for a 2019-20 Economic,Cultural,Tourism,Sustainability Grant from the City of Ashland. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 20 E MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED ASHLAND OR 97520-1814 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 February 4, 2022 SP 01 000247 67816 H 1 CSNGLP IIIIIII�'lll'�"'IIIIIIIIIIII'III'IIIIII'll'I'I'liI'I"II'I'IIIII City of Ashland 20 E MAIN ST ASHLAND OR 97520-1814 Account Information: Contact Us PolicyHolder Details : BALLET FOLKLORICO RITMO ALEGRE Business Service Center Business Hours: Monday- Friday (7AM -7PM Central Standard Time) Phone: (877)287-1316 Fax: (888)443-6112 =_ Email: aaencv.services at�.thehartford.com =_ Website: https://business.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTR005