HomeMy WebLinkAboutBob's Golf Shop
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
07/11/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CNA Sales & Service Center ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO Box 946580 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Maitland, FL 32794-6580
877 724-2669 INSURERS AFFORDING COVERAGE NAIC#
'INSURED INSURER A: National Fire Insurance Company
Bob's Golf Shop Inc. INSURER B:
3070 Highway 66 INSURER c:
Ashland, OR 97520 INSURER D:
INSURER E:
Client#: 48121
BOBSGOLF
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 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PJ>1-~~~:~~~8,wIE ~~~l,ir~~~N LIMITS
A ~NERAL LIABILITY 2084398946 07/13/07 07/13/08 EACH OCCURRENCE $1.000 000
X COMMERCIAL GENERAL LIABILITY ~~~~~~J9E~~;'~~MM\ $300 000
I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $10000
- PERSONAL & ADV INJURY $1.000 000
- GENERAL AGGREGATE $2.000000
~'L AGG~EnE LIMIT APrilS PER: PRODUCTS. COMP/OP AGG $2 000 000
POLICY FJr8i X LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
- ALL OWNED AUTOS BODILY INJURY
$
,SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
$
NON.OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY AUTO ONLY. EA ACCIDENT $
. ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
OESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T~g-N~~~ I JbJ);!'
EMPLOYERS' LIABILITY EL EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? EL DiSEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE. POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is Named as Additional Insured - Managers or Lessors
of Premises.
LoC# 1.3070 HIGHWAY 66; ASHLAND, OR
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
340 South Pioneer Street
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -30- DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08) 1 of 2
#163028
PAG
@ ACORD CORPORATION 1988