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HomeMy WebLinkAboutInsurance Certificate: William Olsen Designs LLCA� ® DATE (MM/DD/YYW) CERTIFICATE OF LIABILITY INSURANCE 11/19/2024 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 Hart Insurance Agency NAME: Michelle El FAX PHONE PO Box 1240 (541) 779-4232 A/c No:(541) 772-3963 E-MAIL mely@hartinsurance.com Grants Pass OR 97528 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURERA:Ohio Security Insurance CO 24082 INSURED INSURERS: William Olsen Designs LLC INSURER C : _ 216 Houston Rd INSURERD: Phoenix OR 97535 1 INSURERE: INSURER F : COVERAGES SM CFRTIFICATF NIIMRFR• Cart TD 30520 (21 RFVISION NIIMRFR- 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. ILTR 'I YPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x ] OCCUR BKS57159382 12/17/2024 12/17/2025 EACH OCCURRENCE $ 1,000,000 DAGE TO RENTED PRREEMISES(Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 Is AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Ea BINEDtSINGLE LIMIT S BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ UMBRELLALIAB EXCESS LIAR OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ LIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) fi yes, describe under DESCRIPTION OF OPERATIONS below N/A STATUTE ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) t 1=11 I II-ICA l E HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1