HomeMy WebLinkAboutInsurance Certificate: Lithia Arts Guild of Oregon Inc
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY)
TM. 05116/2008
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 AL TI'R THF RY THF PrlI 1r.IF~ RFI )W
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 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.
INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P~~~; =~~N LIMITS
LTR INSRD DATE fMMlDDIYY\
GENERAIL LIABILITY CLS1330620 05117/08 05117/09 EACH OCCURRENCE $ 1,000,000
r--
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000
I-- ~ CLAIMS MADE[!] OCCUR PREMISES (Eo occuronco)
MED. EXP (Anyone person) $ 5,000
r--
A PERSONAL & ADV INJURY $ 1,000,000
I--
GENERAL AGGREGATE $ 2,000,000
I--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 2,000,000
rl n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I-- (Ea accident) $
ANY AUTO
I--
ALL OWNED AUTOS BODILY INJURY
I-- (Per person> $
SCHEDULED AUTOS
I--
HIRED AUTOS BODILY INJURY
I-- $
NON-OWNED AUTOS (Per accident)
I--
r-- PROPERTY DAMAGE $
Per accidentl
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $
C:1 OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I~STATU- I I OTHER
TORY LIMITS
EMPLOYERS' LIABILITY
ANY PROPRIETORJPARTHERJEXECUTIVE E.L. EACH ACCIDENT $
0FF1CERIIIE1IBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE $
tf y.., deacribe under E.L. DISEASE-POLICY LIMIT $
SPECIAL PROVISIONS bolow
OTHER:
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTI 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 L:. 0d..~
LLC .i..""C-1
.
Attention: Herman R Deiss
ACORD 25 (2001/08)
Certificate #
37667
@ACORD CORPORATION 1988