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HomeMy WebLinkAboutInsurance Certificate: Pasta Piatti Inc.CERTIFICATE OF LIABILITY INSURANCE DATE[Mh�7120 24 06/l/204 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(€es) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 18 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 Hart Insurance Agency PO Box 1240 Grants Pass OR 97528 CONTANAME' Misty D Whorley __ ^... PHONE FAX AkC o Ext): (541) 779-4232 (AlC,No): _ E-MAIL harti ADDRESS;_mwhorle, ye nsurance.com INSURER[S}AFFORofNGCOVERAGE NAfCA _ INSURERA:SAIF Corporation 36196 INSURED Pasta Piatti Inc INSURER B : _ INSURER C : ,_...__.... INSURERD: 1467 Siskiyou Blvd #244 INSURERE: Ashland OR 97520 INSURERF: J541) 488-5493 rnvFRArFc 14w ('1-RTIFlCATF NIHIVIRFR-Cart ID 29235 (61 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 CONTRAGT 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 TYPE OF INSURANCE ADDLISUBR pOLLCY NUMBER 1dMlODY EFF MMIDPOL DIYWY LIMITS COMMERCIAL GENERAL LIABILITY C(.A3%1$-MADE F] OCCUR EACHOCCURRENCE S D"'IE TO KEN'iUtl PRPAISES Ea occurrence S MED F-XP {Any one person} S PERSONAL- & ADV INJURY 5 GEA1'L AGGREGATE LIMIT APPLIES PER: POLICY M jE O LOC OTHER: GENE=RALAGGREGATE S PRODUCTS - COMPIOP AGG S S AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY ECOMBINED a�ctde�ISINGLE LIMIT S BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident1�,,,_„ S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE 15 - AGGREGATE _ DED RETENTIONS ( S A WORKERORIH- AND YERS'LSATIONILIT AHD EMPLOYERS'LIABILITY ANYPROPRIETOFLPARTNERIEXECUTIVE YIN OFFfCER/MFMBEREXCLUDED7 (Mandatory in NH} If yes,desc6be under DESCRIPTK)NOFOPERATIONS below NIA 776005 01/01/2025 01/01/2026' X STATUTE EE E.L. EACH ACCIDENT S 500 , 000 E.L.DISEASE-EAEI.IPLOYEEI _ $ 500,000 E.L. DISEASE -POLICY LIMIT S 500,000 S S DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1