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Home My WebLink AboutLithia Arts Guild ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) TM. 05/17/2007 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 6' TF~ RV T"'F Dn, '("F" RF' oW INSURERS AFFORDING COVERAGE NAIC# ~-- .._~ INSURED INSURER A: SCOTTSDALE INSURANCE COMPANY 41297 L1THIA ARTS GUILD OF OREGON INC INSURER B: DBA: BRISCOE ARTWING INSURER c: PO BOX 3194 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 WITH RESPECT TOWHICH 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER Pg;~Y ~:;~~~E ~~~I~,.';=N LIMITS LTR INSRC GENERAL LIABILITY CLS1330620 05/17/07 05/17/08 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED .-- COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ 100,000 I CLAIMS MADE0 OCCUR 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 n nPRO- n POLICY JECT LOC ~OMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ~ ALL OWNED AUTOS BODILY INJURY ~ (Per person) $ SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY - (Per accident) $ NON-OWNED AUTOS - - Pp~~~Zc~~t~AMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCI DENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ ~ESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ u___" $ ~ DEDUCTIBLE $ RETENTION $ $ I WC STATU- I I OTHER WORKERS COMPENSATION AND TORY LIMITS EMPLOYERS' LIABILITY E.L.. EACH ACC:DENT $ ANY PROPRIETORlPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE $ If yes, describe under E.L.. DISEASE-POLICY IlIMIT $ SPECIAL PROVISIONS below OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CITY OF ASHLAND, IT'S AGENTS, DIRECTORS, OFFICERS & EMPLOYEES ARE INCLUDED AS AN ADDITIONAL INSURED PER CG2010(7-04). . CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND, IT'S AGENTS, DIRECTORS, OFFICERS & EMP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS LOYEES WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 20 E. MAIN STREET DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S ASHLAND, OR 97520 AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE MID VALLEY GENERAL AGENCY \-l~_ ~ ;:-) ~...' LLC Attention: Herman R Deiss ACORD 25 (2001/08) Certificate # 33316 @ACORD CORPORATION 1988 ~i~NHQL.1),to COMMERCIAL GENERAL LIABILITY & Q'RAming, DBA: CG 20 10 07 04 ... . BHDOft6llMEm" 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, IT'S AGENTS, DIRECTORS, OFFICERS & EMPLOYEES 20 E. MAIN STREET ASHLAND, OR 97520 location 5 Of Covered 0 erations POLICY PERIOD: 05-17-2007 to 05-17-2008 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG5'J'~iOIton Street, Ashland, OR 97~O Properti~dne.~~82-1921 . Fax (541) .tmg'M5Sf 1 o