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HomeMy WebLinkAboutUZEP Documents05/14/2019 FIG Financial Insurance Group - National 6206 N Discovery Way, Ste 102 BOISE, ID 83713 Carissa Chamberlain 208-991-3494 carissa.chamberlain@fignow.com 00000000-0 10 HERITAGE HOP HAUS 729 N MAIN ST MERIDIAN, ID 83642-2603 USLI 32700 A CP1664694 12/01/2018 12/01/2019X X X 1,000,000 300,000 10,000 1,000,000 1,000,000 1,000,000 Auto Owners Insurance 32700 B 5039643200 04/26/2019 04/26/2020 X X X 500,000 USLI 25895 C XL 1583267A 12/01/2018 12/01/2019 X X 1,000,000 Auto Owners Insurance 18988 D 57110642 06/23/2018 06/23/2019 X 100,000 100,000 500,000 USLI 32700 A CP1664694 12/01/2018 12/01/2019Inland Marine Inflatable Tent $10,000 USLI 32700 A CP1664694 12/01/2018 12/01/2019Liquor Liability $1,000,000 neUdesign Architecture 725 E 2nd St MERIDIAN, ID 83642 (CAC) Printed by CAC on May 14, 2019 at 02:18PM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 have ADDITIONAL INSURED provisions or 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE In consideration of an additional premium of $75 it is hereby agreed that the following All other terms and conditions of this Policy remain unchanged. is(are) added to the Policy: CG2011 04/13 - Additional Insured - Managers or Lessors of Premises ENDORSEMENT #2 This endorsement, issued by United States Liability Insurance Company to HERITAGE HOP HAUS, LLC forms a part of Policy Number CP 1664694B effective on 3/2/2020 (MO. DAY YR.) at 12:01 A.M. Add/Remove/Amend General Liability Additional Insured Endorsement ADD_REM (03-01) CITY OF MERIDIAN 33 E. BROADWAY AVE MERIDIAN, ID 83642 03/02/2020 12:01 AMEffective Date: Name of Person(s) Or Organization(s) (Additional Insured): Designation of Premises (Part Leased To You): Additional Premium: $ Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions:With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: A. B. 1. 2. Any "occurrence" which takes place after you cease to be a tenant in that premises. Structural alterations, new construction or demolition operations performed by or on behalf of the person (s) or organization(s) shown in the Schedule. 1. 2. The insurance afforded to such additional insured only applies to the extent permitted by law; and If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. However: whichever is less. 1. 2. Required by the contract or agreement; or Available under the applicable Limits of Insurance shown in the Declarations; If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amout of insurance: This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. This insurance does not apply to: 729 N MAIN ST MERIDIAN, ID 83642 POLICY NUMBER:CP 1664694B COMMERCIAL GENERAL LIABILITY CG 20 11 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE © Insurance Services Office, Inc., 2012CG 20 11 04 13 Page 1 Of 1 EXISTING SIDEWALK TO REMAIN3' - 0"3' - 0"CLR. 3' - 0" MIN. EXISTING TREE TO REMAIN EXISTING (RELOCATED) TRASH RECEPTACLE EXISTING (RELOCATED) PLANTER DECORATIVE STRING LIGHTS PROVIDED BY TENANT TABLES AND CHAIRS PROVIDED BY TENANT COUNTER AND CHAIRS PROVIDED BY TENANT COUNTER AND CHAIRS PROVIDED BY TENANT DECORATIVE STRING LIGHTS PROVIDED BY TENANT DECORATIVE STRING LIGHTS PROVIDED BY TENANT EXISTING (RELOCATED) RECYCLE RECEPTACLE 2 8' - 0" LICENSED ARCHITECT AR 984486 JAMES L. ESCOBAR STATE OF IDAHOCLIENT:JOB NUMBER CONSULTANT 725 E 2nd St Meridian, ID 83642 208.884.2824 PROFESSIONAL SEAL THIS DOCUMENT IS THE PROPERTY OF NEUDESIGN ARCHITECTURE, LLC AND IS NOT TO BE DUPLICATED WITHOUT WRITTEN AUTHORIZATION. © NEUDESIGN ARCHITECTURE LLC DRAWN BY 1.27.19 18093HOP HAUS TI77 E. IDAHO AVEMERIDIAN, ADA, IDAHO 83642A-102CODY CUCCIANEW PATIO PLAN BPB 3/8" = 1'-0"1 ENLARGED PATIO PLAN 2 NO. DESCRIPTION DATE 1 For Permit 9.5.19 2 Client Revisions 1.27.19