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HomeMy WebLinkAboutInsurance Certificate: Standing Stone Brewing Co --lasse'll OP ID: KCF '4`�° CERTIFICATE OF LIABILITY INSURANCE DATE(J2711YYYY) 12/27111 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 CONTACT United Risk Solutions,Inc. `-+41.245-1111 NAME: KC Ferguson PO Box 936 541-245-1112 s"NO Eat.541-4947752 ac NO: 541-245-1112 Medford,OR 97501.0067 nnoaess:kc.ferguson @unitedrisk.com Cindi L.Jayubo,CIC,CRM PRODUCER STAN03W STOMERID . INSURUERB AFFORDING COVERAGE NA1Ce INSURED Standing Stone Brewing Co. INSURER A:Oregon Employers Trust 101 Oak St. INSURER B:(Self-Insured Group Ashland,OR 97520-1802 INSURER C:NY Marine&General Ins Co INSURER D:(Excess Insurance Company) INSURER E:c/o Empire Pacific Risk Mgmt INSURER F: 503-968-6300 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. INSR ADOL SUBN POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR MD POLICY NUMBER IMMIDDIYYYYI (MM/DD1YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED UP(Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ G 1.AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC $ IECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALLOWNEDAUTOS BODILY INJURY(ParaaAdanU $ SCHEDULEDAUTOS PROPERTY DAMAGE HIREDAUTOS (Per accident) $ NON-OWNEDAUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- ANDEMPLOYERS'LIABILITY T RV /MIT ER A ANY PROPRIETORIPARTNER/EXECUTIVE YIN DBBWC120208 01101/12 01/01113 E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 2,000,000 H yes,describe under DE SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) All Operations of the Named Insured Cancellation:30 Days Notice,Except 10 days for non-payment of premium CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N.Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520.2014 AUTHORIZED REPRESENTATIVE ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD