HomeMy WebLinkAboutInsurance Certificate: Etzel Enterprises Inc DATE(MMIDDIYYYY)
,44C- AP CERTIFICATE OF LIABILITY INSURANCE TE(MMID TYY
22
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(les) must be endorsed. If SUBROGATIONIS WAIVED,
subject to the terms and conditions of the policy,certain policies may require en endorsement.A statement on this certificate does not
confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
GASPAR INSURANCE SERVICES/PHS NAME:
72255917 PHONE (886)467-8730 FAX
(A/C,No,Ext): (A/C,No):.
The Hartford Business Service Center
3600 Wiseman Blvd E-MAIL
San Antonio,TX 78251 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAICd
INSURED INSURER A: Sentinel Insurance Company Ltd. 11000
ETZEL ENTERPRISES INC INSURER B: Hartford Fire and Its P&C Affiliates 00914
3500 VICKSBURG LN N STE 411 INSURER C:
MINNEAPOLIS MN 55447
INSURER 0
INSURER E:
INSURER F: N
N
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 6"
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD o
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
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 WVD (MMIDO/YYYY)- (MM/DDIYYYY)
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000
–
CLAIMS-MADE X OCCUR BOE TO RENTED $1,000,000
PREMISES(Ea occurrence)
X General Llabll ty MED EXP(Any one person) $10,000
A _ 72 SBA BD7519 12/20/2022 12/20/2023 PERSONAL&ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $4,000,000
POLICY❑PRO" x LOC PRODUCTS-COMP/OP AGO $4,000,000
JECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Eaaccident)
ANY AUTO BODILY INJURY(Per person)
—ALL OWNED —SCHEDULED BODILY INJURY(Per accident) dem
AUTOS —AUTOS — :;I.:.
— HIRED NON-OWNED • PROPERTY DAMAGE ;lir'
AUTOS AUTOS (Per accident) i1-1,i,
UMBRELLA LIAB _
OCCUR EACH OCCURRENCE
:II:
EXCESS LIAB CLAIMS- AGGREGATE
MADE _
DED RETENTION
WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS'LIABILITY STATUTE ER
ANY YIN EL,EACH ACCIDENT $1,000,000 _
B PROPRIETOR/PARTNERIEXECUTIVE — NIA 72 WEC AABVBR 01/01/2023 01/01/2024
• OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000
(Mandatory In NH)
If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OP OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space le required)
Those usual to the Insured's Operations,
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
90 North Mountain Avenue BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
Ashland OR 97520 IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
cl' .•, `7 G'aa-r te
• O 1988.2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks Of ACORD
VM.:r;t THE HARTFORD
BUSINESS SERVICE CENTER
THE ' 3600 WISEMAN BLVD
HARTFORD SAN ANTONIO TX 78251 December 3, 2022
MB 01 004253 94942 H 16 A
I1I1II'II'I'I'I'IIIIIIII1I11IIII1II1III'II"I'IIII1I1II'II'IIIIII
City of Ashland
90 North Mountain Avenue
Ashland OR 97520-2014
N
Account Information:
Cl Contact Us
Policy Holder Details : ETZEL ENTERPRISES INC
Need Help?
Start a live chat online or call us at
(866)467-8730.
We're here weekdays from 8:00 AM to
8:00 PM ET. ..1
Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us If you have any ;,��
questions or concerns. ;Slit
Sincerely,
Your Hartford Service Team
WLTR005