HomeMy WebLinkAboutInsurance Certificate: Noble Coffee I
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID TM DATE (MM OOM Y)
9NOBLCO 02/18/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hart Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND -OR
3389 Crater, Lake Hwy I ALTER THE COVERAGE AFFORDED BY THE•POLICIES BELOW.
Medford_ .OR..,97504
Phone: 541- 779 -4232 Fax:541= 772 3963 INSURERS AFFORDING COVERAGEo I NAIL
INSURERA: American Casualty co
I HT u.. INSURER S:
i I Nob1e:cCoffee Roasting LLC INSURER C I
281 Fourth Street INSURER D:
Ashland OR 97520
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 TI-115 CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN•REDUCED BY PAID CLAIMS.
IN•H ;LW L POLICY EFFECTIVE POLICY EXPIRATION
LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) DATE (MM/DDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE 1000000
A X X COMMERCIAL GENERAL LIABILITY 4017379993 04/13/10 04/13/11 PREMISES (E occur 300000
CLAIMS MADE 1X 'OCCUR MED EXP (Any one person) 10000
PERSONAL SADV INJURY 1000000
GENERAL AGGREGATE 2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG 2000000
-E POLICY JERC n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S
ANY AUTO (Ea accident)
ALL OWNED AUTOS
BODILY INJURY S
'SCHEDULED ALTOS (Per person)
IHIREDAUTOS'- _a •r n.r=_ 1 I' 1
X NON -OWNED AUTOS (Per accident)
;n3 PROPERTY ONAAGE
r nt r •IPer accident) I
,GARAGE LIABILITY O N L Y
PNY AUTO 'Z. u OTHER TFWJ n: EA'ACC ..t
AUTO ONLY: AGG S I
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE
OCCUR CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE g
RETENTION S
WOR OR LKERS COMPENSATION AND II GIR-
EMPLOYERS' LIABILITY TORY LIMMITS TS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E. L. EACH ACCIDENT S
OFFICERsAENBER EXCLUDED? E. L. DISEASE EA EMPLOYEE Y
If yes. describe under
SPECIAL PROVISIONS below E.L. DISEASE POLICY LIMIT S
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
CITYASH 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
City of Ashland IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
20 E. Main Street REPRESENTATIVES.
Ashland OR 97520 AUTHORREDREPRESENTATIVE
Hart Insurance Medford
ACORD 25 (2001 /08) OO ACORD RPORATION 19