HomeMy WebLinkAboutInsurance Certificate: Ashland Springs Hotel
PRODUCER
ACORD.
CERTIFICATE OF LIABILITY INSURANCE 9!:S'llL~C T DAT;~M;;;7o';)
THIS CERTIFICATE 15 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.
-~--------- ~ :~S~:REARS Ai;,:D~~~~~~-:G:';;;'ran;;;'C;-~~ #
! INSURER B. National tJni~n Fire In~ur.nce
!INSURER C:
INSURER D:
!INSURER E:
United Risk Solutions, Inc.
PO Box 936
Medford OR 97501-0067
Phone: 541-245-1111 Fax:541-245-1112
INSURED
The Ashland Springs Hotel
Mark Antony H1storic
Property, LLC
212 E Ma1n St
Ashland OR 97520
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
~~~" I.
L TR INSRI] TYPE OF INSURANCE I POLICY NUMBER
J ~NERAL LIABILITY i
ffiMMERCIAL GENERAL LIABILITY 0 1LXO 19 6 5 8 0771
H--.J CLAIMS MADE [!J OCCUR I
, I 1
o~____-= I
tlGEN-'L AGGREGATE LIMIT APPLIES PER: I
r: PRO- n
X POLICY I j JECT, LOC
~TOMOBILE LIABILITY I
ANY AUTO I
- I
ALL OWNED AUTOS
- I.
SCHEDULED AUTOS
HIRED AUTOS I
= NON-OWNED AUTOS '
-- _______.____u.____._ I
I I
EXCESSlUMBRELLA LIABILITY
~ OCCUR D CLAIMS MADE 29UD0158456521
h DEDUCTIBLE
lx-i RETENTION $ 10 , 00 0
I WORKERS COMPENSATION AND I
- EMPLORYOEpRRS~ LT'OABILlTRY R EXEC I.. '-
I ANYP 1<:: RlPA TNE I UT VE I
I OFFICER/MEMBER EXCLUDED? !
1 ~~~biis~~~V'SfoNS below Iii
OTHER I
A Liquor Liability 101LX0196580771 '11/17/09 11/17/10
A Emolovee Benefits .,01LX0196580771 11/17/09 i 11117/10
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS
re: operations of the named insured
A
I POOCV-E'F"FeCTM:1PO[lC'{EXPIRAT12N 'I.
DATE fMMIDDNY\ DATE IMMIODIYYI
; EACH OCCURRENCE
- DAMAGE TO RENTED
, 11/17/09 I 11/17/10 _~~EMISE~l!-.~_?,~u:~l;_e~_S.30.2_!...OO_O_
i
i
I
I
I
I
,
I
LIMITS
'$ 1. 000,000
MED EXP (Anyone person)
$ 5,000
$1,000,000
$2,000,000
$2,000,000
PERSONAL & ADV INJURY
GENERAL AGGREGATE
i PRODUCTS - COMP/OP AGG
1------- --
! COMBINED SINGLE LIMIT
i (Eaaccldent)
$
~AGE LIABILITY
I ANY AUTO
!lBOOIL Y INJURY I $
(Per person} ~
r;;~~~YIN~;-- I
(PeraCCidenll $
! PROPERTY DAMAGE
i (Peraccidenl)
I AUTO ONLY. EA ACCIDENT $
f~-
I OTHER THAN EA ACC $
I AUTO ONLY: AGG $
I EACH OCCURRENCE $5,000,000
I AGGREG_A__TE i $ 5,000,000
. i$
1$
,--.-.------.-.- -.---
i 1$
IOJ~1
n_ -Is..
$
I
I
11/17/09 I
I
I
I
I
B
11/17/10
I i To',i/LII~:rS i
.LE.L. EACH ACC/DENT.
E.L. DISEA.SE . EA EMPLOYEE! $
j E.L. DISEASE. POLICY LIMIT i $
$1000000
$1000000
Limit
Limit
CERTIFICATE HOLDER
CANCELLATION
CITASOl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Ashland NOTICE TO THE CERTIFICATE HOLDER,NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
20 E. Main St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ashland OR 97520-1814 REPRESENTATIVES.
A~RE .
ACORD 25 (2001108)
@ACORDCORPORATION 1988