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Home My WebLink AboutSt. Clair Productions A~~~.I!I." C ER E McFall General Agency, Inc 6443 SW Beaverton-Hillsdale Hwy Suite 350 Portland, OR 97221 DATE (MM/DD/VY) 7/20/2006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER INSURED St. Clair Productions, Inc. PO Box 835 COMPANY A Penn-Star Insurance Company COMPANY B COMPANY C Ashland, OR 97520 COMPANY o OOXlERAGES THIS IS TO CERTIFYTHA TTHE POLICIES OF INSURANCE LISTED BELOWHA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECTTOVVHICH 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMlDDIYY) DATE (MMlDDIYY) UrRTS A GENERAL LIABILITY PAC6531 033 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONT PROT 8/17/2006 8/17/2007 GENERAL AGGREGATE PRODUCTS-COMP/OP AGG $ PERSONAL & ADII INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyon" person) $2,000,000 $2,000,000 $1,000,000 $1,000,000 $100,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGlE LIMIT $ BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE EACH OCCURRENCE EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AGGRFGATE I THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: INCL EXCL STATUTORY LIMITS EACH ACCIDENT DISEASE - POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ RIPTI N PE I N /L A IN/ I M Certificate Holder is listed as Additional Insured per CG2011-managers or lessors of premises OERTIFICA TE HOLDER City of Ashland 20 E. Main Street OANOELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIE!; BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO, THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ashland, OR 97520 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AU ~7r~ G AOORD OORPORA TION 1993 I ACORD 25-5 (3/93) POLICY NUMBER: ClS1296034 ST. CLAIR PRODUCTIONS, INC COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 Location s Of Covered 0 erations COVERED EVENT: 7TH ANNUAL ROGUE VALLEY BLUES FESTIVAL COVERED DATES: 01/12/07 TO 01/15/07 COVERED LOCATION: HISTORIC ASHLAND ARMORY, 208 OAK ST, ASHLAND OR 97520 Information re uired to com lete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed .by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG20100704 @ ISO Properties, Inc., 2004 Page 1 of 1 c ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNVYY) TM. 12/19/2006 PRODUCER Phone: 503-365-7001 Fax: 503-365-7354 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MID VALLEY GENERAL AGENCY LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3400 STATE ST G 740 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SALEM OR 97301 4. TFR RV TUC an. 'I"'C" RFI lW INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: SCOTTSDALE INSURANCE COMPANY 41297 ST. CLAIR PRODUCTIONS, INC. INSURER B: PO BOX 835 INSURER C ASHLAND OR 97520 INSURER D INSURER E: COVERAGES 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 \^JITH 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 AGGREGATE LIMITS SHO\^il'l MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADD'L TYPE OF INSURANCE POLICY NUMBER ~i~Y,;::~ ~~;:,~:=N LIMITS LTR INSR I GENERAL LIABILITY CLS1296034 01/12/07 01/15/07 EACH OCCURRENCE $ 1,000,000 ,- DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY $ 100,000 - n CLAIMS MADE 0 OCCUR PREMISES (Ee occurence) MED EXP (Anyone person) $ 5,000 A PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 2,000,000 inPRO- n, POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ---; (Ea accident) $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - (Per person) $ SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY - (Per accident) $ NON-OWNED AUTOS - - PROPERTY gAMAGE $ (Per accident GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ .. AUTO ONLY AGG $ ::=JESS I UMBRELLA LIABILITY EACH OCCURRENCE $ .OCCUR 0 CLAiMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ I we STATU- I I OTHER WORKERS COMPENSA nON AND TORY UMITS EMPLOYERS' LIABILITY E.! EACH ACCIDENT $ ANY PROPRlETOR/PARTNERlEXEcunve OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE $ if yes, describe under EL DISEASE-POLICY LIMIT $ SPECIAL PROVISIONS betow OTHER: DESCRIPTION OF OPERATlONS/LOCATlONSlVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS SEE SUPPLEMENTAL CERTIFICATE INFORMATION CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER \^JILL ENDEAVOR TO MAIL 10 DAYS 20 EAST MAIN STREET WRITIEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO ASHLAND OR 97520 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE MID VALLEY GENERAL AGENCY \-l~ ~ ZJ d4.......... LLC Attention: Herman R Deiss ACORD 25 (2001/08) Certificate # 30943 @ACORD CORPORATION 1988 SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #30943 DATE DEC 19 06 DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS THE CITY OF ASHLAND IS INCLUDED AS AN ADDITONAL INSURED PER CG2010(7-04). COVERED EVENT: 7TH ANNUAL ROGUE VALLEY BLUES FESTIVAL COVERED DATES: 01/12/07 TO 01/15/07 . COVERED LOCATION: HISTORIC ASHLAND ARMORY, 208 OAK ST, ASHLAND OR 97520 Certificate # 30943