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HomeMy WebLinkAboutInsurance Certificate: Lithia Artisans Market of Ashland ACCORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 10/08/2019 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 Sierra Russell Steele Group Insurance Agency,Inc ONE (A/cNn,Fla).541.687.2600 mac Not:541.744.2697 PO Box 11534 E-MAIL l i serra Steee rou info ADDRESS: @ g p• Eugene,OR 97440 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual Insurance Company 23043 INSURED INSURER B: Lithia Artisans Market of Ashland INSURER C: Including Vendors INSURER D: PO Box 3585 INSURER E: Ashland OR 97520 INSURER F: 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP INSn wvn POLICY NUMBER IMM/DD/YYYYt IMMIDD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A CLAIMS-MADE n OCCUR DAMAGE TO RENTED PRFMISFS(Fa nrcurrence) $1,000,000 Y BLO56744994 10/14/2019 10/14/2020 MED EXP(My one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY n JECT [1 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Fa 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 LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER 0TH-_ AND EMPLOYERS'LIABILITY YIN STATUTE FR ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate holder is listed as additional insured as respects to general liability and where required by written contract. This form is subejct to policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION The City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks&Rec.Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland,OR 97520 AUTHORIZED REPRESENTATIVE • < > ©1988-2015 ACORD CORPORATION. All rights-reserved. ACORD 25(2016/03) _ The ACORD name and logo are registered marks of ACORD