HomeMy WebLinkAboutInsurance Certificate: Ballet Folklorico Ritmo Alegre (2) DATE(MM/DO/YYYY)
CERTIFICATE OF LIABILITY INSURANCE . ,
•••••••••-- ft 08/24/2023
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 .
PENFOLD-LEAVITT INS AGCY INC/PHS. NAME;
PHONE ' (866)467-8730 , FAX
57110454' . (A/C,No,Est): (A/C,No):
,
The Hartford Business Service Center . .
3600 Wiseman Blvd E-MAIL •
San Antonio,TX 78251 ADDRESS: •
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED ' INSURER A: Sentinel Insurance Company Ltd. 11000
BALLET FOLKLORICO RITMO ALEGRE INSURER B:
PO Box 8225 ' '
MEDFORD OR 97501-0525 INSURER C.
INSURER D
INSURER E:
Csl
• INSURER P
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 §
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 ADDL SUBR . POLICY EFF POLICY EXP
TYPE OF INSURANCE POLICY NUMBER' LIMITS
LTR INSR WVD (M1111/DD/YYYY) (MM/DO/Y YYY) .
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000
'
CLAIMS MADE X OCCUR , DAMAGE TO RENT LET— ' $1,000,000 •
PREMISES(Ea Occurrence) '
X General Liability , . . MED EXP(Anyone person) $10,000
A X 57 SBM RI3047 09/09/2023 09/09/2024 PERSONAL 8,/WV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: • GENERAL AGGREGATE $4,000,000
POLICY 1-1 JECTPRC)" Tyl LOC , PRODUCTS-COMP/OP AGG $4,000,000
1 1
OTHER: .
AUTOMOBILE LIABILITY , COMBINED SINGLE LIMIT
_ (Ea accident)
ANY AUTO . BODILY INJURY(Per person)
ALL OWNED —SCHEDULED , i;11!1
• AUTOS AUTOS . BODILY INJURY(Per accident)
:17
HIRED NON-OWNED PROPERTY DAMAGE
' AUTOS —AUTOS . (Per accident)
• :,:;.:!
. ' • :4.1..
UMBRELLA LIAB
OCCUR EACH OCCURRENCE
,
' EXCESS LIAB CLAIMS- , AGGREGATE
MADE , .
,
DEC RETENTION$ .
.
WORKERS comPENsATioN . - PER 0TH-
AND EMPLOYERS'LIABILITY STATUTE ER
'
ANY -Y/N . "EL.EACH ACCIDENT . --
PROPRIETOR/PARTNER/EXECUTIVE .
— NI A .
• -OFFICER/MEMBER EXCLUDED? , E.L.DISEASE-EA EMPLOYEE
(Mandatory In NH) — , ,
If yes,describe under E.L.DISEASE-POLICY LIMIT '
DESCRIPTION OF OPERATIONS below
. .
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace 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 fora 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
C 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 August 24, 2023
MB 01 000320 85883 H 2 A
1111111111111111111111111'III11.lluI1.11111111•111111111111111u11
City of Ashland
20 E MAIN ST
ASHLAND OR 97520-1814
N
C
Account Information:
BALLET FOLKLORICO RITMO . Contact Us
Policy molder Details ALEGRE Need Help?
Chat online or call us at
(866)467-8730, _..
We're here Monday- Friday.
Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any ,��9•
questions or concerns. ;..•I
Sincerely,
Your Hartford.Service Team
WLTR005