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HomeMy WebLinkAboutInsurance Certificate: Etzel Enterprises Inc '4 - t:;9 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/15/2021 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 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 lieu of such endorsement(s). PRODUCER CONTACT TIMOTHY K GASPAR INS SVCS INC/PHS NAME: 72255917 PHONE (866)467-8730 FAX (888)443-6112 The Hartford Business Service Center (AIC,No'rat): (NC,No): 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Fire and Its P&C Affiliates 00914 ETZEL ENTERPRISES INC INSURER B: 2560 1ST AVE STE 105 SAN DIEGO CA 92103 INSURERC: INSURER D: INSURER E: N INSURER F: css COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: o_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWFrHSTANDING 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD , (MM/DDIYYYY) (MMIDDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE — CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ POLICY PRO- LOC PRODUCTS-COMP/OP AGG JECT OTHER: — AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) — — ALL OWNED �SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) HIRED ^NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY YIN E.L.EACH ACCIDENT $1,000,000 A PROPRIETOR/PARTNER/EXECUTIVE — NIA 72 WEC AABVBR 01/01/2022 01/01/2023 OFFICER/MEMBEREXCLUDED? E.LDISEASE-EAEMPLOYEE $1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 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. 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 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 At THE HARTFORD - BUSINESS SERVICE CENTER '• • • 7 , THE ."-- 3600 WISEMAN BLVD December3;64', HARTFORD SAN ANTONIO TX 78251 MB 01 000035 13082 H 1 A 111111111111111111111111111"11111111"11111"1111111111111111'11 City of Ashland 90 North Mountain Avenue Ashland OR 97520-2014 • - 0- . e•-.1 Account InfotthatiOp:. • Contact Us = PolicyHolder , • CI-• E' - = - Business Service = Business Hours Mdnday Friday Time) '11-77 - •°: -:" ; . - Phone:'(866),467=8730 Fax: (888)443-6112 Email: agency.services@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 Hattford Senrit:e Team'— WLTR005