HomeMy WebLinkAboutInsurance Certificate: Neighborhood Gourmet Partners
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-e-R CERTIFICATE OF LIABILITY iNSURANCE OP 10 KD I DATE (MMlDDIYVYY)
12/10/10
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IM~OKT"N r:1IlIii cOrIItICalOl1OliiTs an ;lIli pOllCYl1OS/muSfOo enaorsea. ,sUbJecllo
the leons and conditions of the policy, certain policies may require an endorsement. A statement on this certlftcate does not confer rtghts to the
certlflcate holder In lieu of such endorsement(s).
PRODUCER NAME:
Hart :Insurance I r,ngN:o Ext': 1(~,N'I'
33B9 Crater Lake Hwy I io"-"R'Ess:
Medford OR 97504 CUSTOMER ID If: 9ALLYAS
Phone:541-779-4232 Fax:541-772-3963 INSURERIS) AFFORDING COVERAGE NAlC .
INSURED INSURER A : Valley Forae J:ns,
Neighborhood Gour.met Partners INSURER B :
J:nc.
DBA A1~.on's Kitchen INSURER C :
115 B 1n street
Ashland OR 97520 INSURER 0 :
INSURER E :
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTlrY IHAI R<POllCIES OF INSURANCE LISTED BELOW HAvE BEE~ ISSITmro THE INSU D 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 POllC~ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
fm TYPE OF INSURANCE IrNSR POLICY NUMBER MMIOO1YYYY) {~ LIMITS
~NERAL LIABILITY EACH OCCURRENCE $2,000,000
A X COMMERCI.AJ. GENERAL LIABILITY 2099854345 01/2B/11 01/2B/12 , PREMISES (Ea occurrence) $300,000
I CU\IMS-MJIDE ~ OCCI.J': MED EXP {Any one p9f5on) $0
~ liquor liabili ty X PERSONAL & /lDV INJl...Jl:Y $2,000,000
- GENERAl. AGGREGATE $4,000,000
;mAGGR,EA ~~ ~n~ER: PRODUCTS. Cat.PIOP AGG $4,000,000
POLICY JEcr LOC .
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
- (Eaaccid9l1l)
- ANY AUTO 80DIL Y IN..llRY (Per person) $
'- AlL OWNED AUTOS
800IL Y IN..uRY (Per accident) $
'- SCHEDULED AUTOS PROPERTY DAMAGE
$
'- HIRED AUTOS (Per accident)
~ t>lJN-O'/olNEDAllTOS $
$
UMBRELLA LIAS H OCCUR EACH OCCURRENCE $
'-
EXCESS LIAS ClAIMS-OAADE AGGREGATE $
'- DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION lTORY LIMIT:] I I o~
AND EMPLOYERS' LIABILITY VIN
ANY PRQPRIETORIPARTh'ERlEXECUTIVE 0 IA EL. EACH ACCIDENT $
OFFICERlMEM8ER EXCLUDED?
(Mandatory In NHI E.L. DISEASE. EA EMPLOYE $
gE~~~I~~ ~~PERATIONS below EL. DISEASE - POliCY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS' VEHICLES (Attach ACORD 101, Addition" Rem..-k. Sch.dul., It mort .pact I. r.qUlr.d)
Fax 54~-488-600t
RE: s1dewa1k d DiDq per.mit .
CERTIFICATE HOLDER
CANCELLATION
, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CJ:TYASH THE EXPIRATION DATE THEREOf, NOTice WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland AUTHORIZED REPRESENTATIVE
Dept of Public Works
~~,B. Main Street Hart Insurance / Medford
hland OR 97520
ACORD 25 (2009/09)
@ 1B9B.2008 ACORD CORPORATION, All rights resorvod,
The ACORD name and logo are registered marks of ACORD