HomeMy WebLinkAboutInsurance Certificate: OCAT Inc dba Agave
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I Di~ (MMJDDIYYYY)
3 2/2009
PRODUCER (541)772-1111 FAX: (541)772-3785 THIS CERTIFICATE IS ISSUED AS A MA ITER OF INFORMATION
Beecher Carlson Insurance Agency LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Monterey Insurance Co
OCAT Inc, DBA: Agave INSURER B:
1305 Lee Street INSURER C:
INSURER D:
Ashland OR 97520 INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING 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.
LIMITS SHOWN MAY' ....- --- ~~nl ...AIL! CLAIMS.
INSR ADD'L TYPE OF INSURANCE POUCY NUMBER P~A~~:~8,w:: Pg~~,f1:6~~N UMITS
LTR INUO
GENERAL UABIUTY Ilgg~l\Jr~ $ 1,000,000
r-- DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY -, $ 75,000
A I CLAIMS MADE W OCCUR 27SSA3l3l938l 2/21/2009 2/21/2010 MED EXP (Anv one D81'Son\ $ 5,000
,& $ 1,000,000
r--
GENERAL AGGREGATE $ 2,000,000
r--
GEN'L AGGREGATE LIMIT AnES PER: I ~ - COMP/OP AGG $ 1,000,000
ril n PRO-
X POLICY JECT LOC
AUTOMOBILE UABILITY COMBINED SINGLE LIMIT
I-- (Ea accident) $
- ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
- (Per person)
- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ Nf'( AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA UABIUTY EACH Is
=:J OCCUR D CLAIMS MADE AGGREGATE $
$
R oeouCTlBLE $
RETENTION S Is
WORKERS COMPENSATlON AND I T~~~I~W~ I I Om-
EMPLOYERS' UABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under Is
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT
A OTHER Liquor Liability 27SSA3l3l938l 2/21/2009 2/21/2010 Bach Common Cause/
Aggregate $1,000,000
DESCRIPT10N OF OPERAT10NSlLOCAT10NSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: 92 N Main Ashland, OR
Certificate holder included as additional insured as respects general liability where required by written contract.
This form is subject to policy terms, conditions, and exclusions.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
City of Ashland EXPIRAT10N DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAil
20 E Main Street 10 DAYS WRITTEN NOT1CE TO THE CERT1FICATE HOLDER NAMED TO THE LEFT, BUT
Ashland, OR 97520 -
FAilURE TO DO SO SHALL IMPOSE NO OBUGATlON OR llABIUTY OF ANY KIND UPON THE
INSURER ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA T1VE ere ~~~
e Damstra-Lepley,
ACORD 25 (2001/08)
INS025 (0108),08a
@ ACORD CORPORATION 1988
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