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Home My WebLink AboutInsurance Certificate: Lithia Artisans Market ■8 11 10:13e Kelli Powell 591 7476640 P.1 ' °c R°� CERTIFICATE OF LIABILITY INSURANCE �'""�°°"YY ■ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RtGHT3 UPON THE CERTIFICATE HOLDER.DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXPEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES W. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER TANT: H the certificate holaer is an ADDITIONAL INSURED, the POUCANO) mu at be endoleed. If SUBROGATION IS WAIVED,eub(ect to ms and conditions of the Policy,certain POII1Je5 may requlra an endotsoment. A statement On this Certificate dose not confer rights to the Cafe hold--In IIBU of each entlonemOnl e. R A KELLI S POWELL NAME: L INSURANCE ASSOCIATES INC 'PgoI+E ........ ..... P WD,NO.RIM 541.747-6080 .... . FAX E-MAIL ko Dl d+ _AUGPFIELD OR 87477 .....__. wsu"DRLELAFFORDI NO COVERAOF - _ NAwe - -- !t!WAERA! FIRST NATIONAL INSU RANCE CO OF -4 - .._. ...—. . .._._. it NNRFR B LI7NIA ARTISANS MARKET INC I NCLUDING.V VENDORS IRsuaER c_- PO BOX 3585 .Prsueen o rN9URERE: ASHLAND OR 87520 . _. ... ...._... .. . . _ HBURER P f -. .. .. .. . COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THC INSURED NAMED ABOVE FOR THE POLICY PEW OD INDICATED. NOTWITHSTANDING ANY RCOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESP[CT 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 CDNDITONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR ... .- .._ .. '•ADD 506141 ._ .-._. .. ._ .. TYPE OF INSURANCE roLTi:YnO OLICY�1p - --- UNITS POLICY NUMBER - GENERAL LIABILrtY GCN OCCURRENCE S 1,000.000 XCOMMERCW,GENERAL LIABR.ITV "p'AMACETO �---"'� rv1 PREM_!$E9IEe occ�P-opal 3 1.000,000 GLAm6-MADE 1^J UCCUq --. 00 _ME O naP M va leol x 10.000 A X 01CH-933884-4 10/142011 1/114/2012 ) 1 M )-_ .. ...._ ... .. - ---- - -- PFJV$ONAU 4DVINNPY_ s__ 1,000,0170 - ..._. _ . .. .. . GENERAL AGGRCGATF E 2,000,000 CEWL AOORCGATE PRP UMITAPPLIF$PER LW PR O DU CTS-COIA+/Op .. x . .._Z 000.000 IN X POLICY CTS ._._ 'AVrOMO&IE LNBR,RY S ••- ANY AUTO I IM mdS ') L _ i ._.... . ... ALL OYMED f RCHF.OUIED I BODLLYPIJURY(Ps Pw�o.11 S .... AUTOS AUTO! -.._. . NON.OWNEO aockI INJURY fPNrerda j S - HIFtiO AUTO9 -__ AUTOS I FROPCkTY OPM1KGC uNegELU LIAS Occuq x EICEae u" LACK OCCURRENCE 5 C AIMR-MADE . . ...-_. .. _..-... ACGREGATF' g DFD R[1FNnON ._. ....... ....... ... ... .. MORNEM C°MPEN9ATIDN x AND EMPLOWRO-LIABILITY WC STATU. OTN. ANV VgppRl[IOgIPARRICPrEXFCVrNC IN TORY IIMITS .- kJl OxfICERMEMBCR EaCLUDCO'J NIA C.L.EACH ACCIDENT x 1Mendeory M NMI — . O dealm Omer .E:L.IaREA$G EA EMMOYE f lscgmrloN Of'OrEnAnons rowN C.L.DLSEASF-POLICY LIMIT S DE$CRI%ION OF OPERATWNB!IOCATONe I V aNICLEB IAIYAN AGORD Ia1,AeeENgel ibmeb BMeE V IA,II MOh FPFCA IA INIfV Ind) CITY OF ASHLAND A$AN ADDITIONAL INSURED PER FORM Ocg7635(02 07)ATTACHED CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD AN OF THE ABOVE De3CRR7ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN 20 E MAIN ACCORDANCE WITH THE POLICY PROVISIONS. ASHLAND OR 07520 FAX:541-488-5311 AUTNOAcmD REPResENTATIYE KELLI S POWELL ACORD 25(2010103) 01988.2010 ACORD CORPORATIO rights reserved. The ACORD name and logo are registered marks of ACORD Aug 2911 10:13a Kelli Powell 541 747 6610 p.2 Liberty Nor•thwcst. COMMERCIAL GENERAL LIABILITY CG 76 35 02 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ADDITIONAL INSURED — BY WRITTEN lease or occupy, subject to the following CONTRACT, AGREEMENT OR PERMIT, OR additional provisions; SCHEDULE (a) This insurance dogs not apply to The following paragraph is added to WHO IS AN any -Occurrence"which takes place INSURED (Section II): after you cease to be a tenant in any premises leased to or rented to 4. Any person or organization shown in the Sched. you; ule or for whom you are required by written con- tract, agreement or permit to provide insurance any structural alterations, new con- is an insured, subject to the following additional any stru or demolition operations provisions: performed by or on behalf of the a. The contract, agreement or permit must be person or organization added as an in effect during the policy period shown in insured; the Declarations, and must have been exe- cuted prior to the -bodily injury", "property (2) Your ongoing operations for that in- damage", or "personal and . advertising sured, whether the work is performed — injury". by you or for you; b. The person or organization added .as an in- 13) The maintenance, operation or use by o sured by this endorsement is an insured only You of equipment leased to you by such to the extent you are held liable due to: person or organization, subject to the following additional provisions: (1) The ownership, maintenance or use of that part of promises you own, rent, (a) This insurance does not apply to any "occurrence" which takes place af tor the equipment lease expires; Includes Copyrighted Material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services, 2001 CG 78 35 02 07 Page 1 of 6 EP Aug 29 11 10:13a Kelli Powell 541 747 8840 p.3 (b) This insurance does not apply to This exclusion applies even if the Claims "bodily injury" or "property darn- against any insured allege negligence or age" arising out of the sole negli- other wrongdoing in the supervision, hiring, gence of such person or employment, training or monitoring of others organization; by that insured, if the "occurrence" which (4) Permits issued by any slate or political caused the "bodily injury^ or "property subdivision with respect to operations damage" involved the ownership, mainte- pertormod by you or on our behalf nance, use or entrustment to others of any Y aircraft, 'auto" or watercraft that is owned subject to the following additional pro- or oporatod by or rented or loaned to any in. vision: sured. This insurance does not apply to "bodily This exclusion does not apply to: injury", "property damage", or "personal and advertising injury" arising (1) A watercraft while ashore on premises out of operations performed for the state you own or rent; or municipality, (2) A watercraft you do not own that is: C. The insurance with respect to any architect, (a) Less than 52 feet long; and engineer, or surveyor added as an insured by this endorsement does not apply to (b) Not being used to carry persons or "bodily injury", `property damage", or "per- property for a charge; sonal and advertising injury' arising out of (3) Parking an "auto" on, or on the ways the rendering of or the failure to render any next to, promises you own or rent, pro. professional services by or for you, includ- vided the "auto" is not owned by or ing: rented or loaned to you or the insured; (1) The preparing, approving, or failing to (4) Liability assumed under any "insured prepare or approve maps, drawings, contract" for the ownership, mainto- opinions, reports, surveys, change or- nanco or use of aircraft or watercraft; or ders, designs or specifications; and (5) "Bodily injury" or "property damage" (2) Supervisory, inspection or engineering arising out of: services, (a) the operation of machinery or d. This insurance does not apply to "bodily equipment that is attached to, or injury" or 'property damage^ included within part of, a land vehiclo that would the 'products-completed operations haz- qualify under the definition of and". 'mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor ve- A person's or organization's status as an insured un- dor this endorsement ends when our where insurance law i r the state your for where it is licensed or principally that insured are completed. garaged; or � No coverage will be provided if, in the absence of this (b) the operation of any of the machin- ondorsement, no liability would be imposed by law on ery or equipment listed in Paragraph you, Coverage shall be limited to the extent of your f•(2) or f.(3) of the definition of negligence or fault according to the applicable princi- "mobile equipment Pies Of comparative fault, (6) An aircraft you do not own provided it is NON-OWNED WATERCRAFT AND NON-OWNED not operated by any insured, AIRCRAFT LIABILITY TENANTS' PROPERTY DAMAGE LIABILITY Exclusion g, of COVERAGE A (Section 1) is replaced when a Damage To Premises Rented To You Limit is by the following; shown in the Declarations, Exclusion j. of Coverage g. "Bodil 1 A. Section I is replaced by the following: Y �n1urY" or "property damage" arising out of the ownership, maintenance, use or j- Damage To Property entrustment to others of any aircraft, "auto, or watercraft owned or operated by or rented Property damage" to: or loaned to any insured. Use includes oper- (1) Property you own, rent, or occupy, including ation and "loading or unloading". any costs or expenses incurred by you, or Paps 2 of 4 LM,33PnItlTOpbiygT�1•-6