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HomeMy WebLinkAboutInsurance Certificate: Ashland Springs Hotel OP ID: NR CERTIFICATE OF LIABILITY INSURANCE DAT1 11 1 111 5/11 1 5/1 11 YY) 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 541-245-1111 CONTACT United Risk Solutions,Inc. NAME: Nikki Russell PO Box 936 541-245-1112 wcurva Eat):541-245-1111 ac Nd: 541-245-1112 Medford,OR 97501-0067 EMAIL Linda Lane,CIC ADDRESS: nikki.russell@unitedrisk.com PRODUCER ASHL08C CUSTOMER ID d: INSURERS AFFORDING COVERAGE NAIC N INSURED The Ashland Springs Hotel INSURERA:New Hampshire Insurance Co Mark Antony Historic INSURER B:National Union Fire Insurance Property, LLC. INSURER C: Waterstone Spa 212 E. Main SL INSURER D: Ashland„OR 97520-1829 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CTR TYPE OF INSURANCE INSg 0eR1 POLICY NUMBER MM DDYIYYYY MMIDD/YYYY UNITS GENERAL LIABILITY EACH OCCURRENCE E 1,000,00 AMAGE TOR A X COMMERCIAL GENERAL LIABILITY X 01LX0196580772 11/17/11 11/17/12 DENTED 300,00 PREMISES Ea accunence E CLAIMS-MADE FxI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,00 X POLICY PRO- AUTOMOBILE LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accdent) $ SCHEDULEDAUTOS PROPERTY DAMAGE HIRED AUTOS (Peraccident) E NON-OWNED AUTOS $ E UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 EXCESS LIAR CLAIMS-MAOE AGGREGATE $ 5,000,00 B 29UD0158456522 11117111 11117112 DEDUCTIBLE S X RETENTION $ 10,000 E WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS.LIABILITY YIN RY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS celow EL.DISEASE-POLICY LIMIT E A (Liquor Liability 01 LX0196680772 11/17/11 I 11117/12 1,000,000 Limi A Employee Benefits 01LX0196580772 11/17/11 11/17/12 1,000,000 Liin DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space Is required) The Imagine Project,The City of Ashland,its officers,and employees are Additional Insured as respects operations of the named insured CERTIFICATE•HOLDEV'." " �'''" CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Imagine Project ACCORDANCE WITH THE POLICY PROVISIONS. 20 E.Main St. Ashland,OR 97520-1814 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ✓