HomeMy WebLinkAboutInsurance Certificate: Ashland Bed & Breakfast Assoc
Certificate of Insurance
~ Stale Farm Fire and Casualty company, Bloomington, Illinois
Stale Farm General Insurance Company, Bloomington, Illinois
Stale Farm Fire and Casualty Company, Aurora, Ontario
State Farm Florida Insurance Company, WirIer Haven, Rorida
State Fann Lloyds. Dallas, Texas '
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This certifies tI1at
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insures the following policyholder for the coverageS indicated below:
Policyholder ASHLAND BED & BREAKFAST NETWORK INC
Address of policyholder 586 E MAIN ST ASHLAND OR 97520
Location of operaoons
Description of operations
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subjeclto all the lenms, exciusions, and oondltions of those policies. The limits of liability shown may haVa been reduced by any paid claims.
Policy Period
Type at Insurance Effectlvs DaIs i Expiration Oats
Comprehensive 11/14109! 11/14/10
Business Liability i
.Thi;i~-;'~;~~-i;;;i~d;;;- ~-prOd.Ud8-~-COOipTeteci Operations-----..-~t--:---------------------
~ Contraclual Liability Each Occurrence
Personal Injury
Advertising Injury
Pollcv Number
97-BC.U619-5
Pollcv Number
EXCESS LIABILITY
o Umbrella
o Other
Policy Period
Effective Date ! Expiration Date
!
Polley Psrlod
Effective Date ! Exolratlon Date
Workers' Compensation
and Employers Liability
,
,
i
Policy Period
Effectlvs Date : ExplraJlon Dale
!
t
Pollcv Number
Type ot Insurance
Limite of Liability
(at bsglnnlng 01 policy period)
BODILY INJURY AND
PROPERTY DAMAGE
General Aggregate
$
$
$
500,000.00
1,000,000.00
1,000,000.00
Producl- Completed
Operations Aggregate
BODILY INJUKY AND PROPERTY DAMAGE
(Combined Single Limitl
Each Occurrence $
Aggreoate $
Part I - Workers Comoensation - StatutorY
Part II - Employers Liability
Each Accident $
Disease - Each Employee $
Disease - Policy Limit $
. . Limits 01 Liability
(at beginning 01 polley psriod)
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGA TIVEL Y
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
Name and Addrsss of Certification Holder
CITY OF ASHLAND
ITS OFFICERS & EMPLOYEES
20 E MAINS T
ASHLAND, OR 97520
1001260
If any of the described policies arB canceled beforB
their expiration date, State Fanm<ll will try to mall a
written notice to the certificate holder 30 days
before cancelletion. If we fail to mail such notice, no
obligation or liability will be imposed on State Fenn or
its agents or representatives.
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Sign of uthorized Representative
L TCP, AGENT
Tille
BRIAN CONRAD
Agent.Name
Telephone Number (541) 482-8470
12114120W
Date
Ag.nrBCod.IrOONRAD 37-2155
Agent Code
AFO Code FIRE 37
MO SOUTHERN OREGON flI'1!"o
08-25-Z009: