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HomeMy WebLinkAboutInsurance Certificate: OnTrack Inc i_"S ONTRINC-01 JDEGARMO 144c"M" DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/12/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 'ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 3ELOW. 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 NCONTACT AME: Tami Walsh Alliance Insurance Group PHONE FAX 941 Oak St. A/C No E,):(541) 687-4799 A/C No): (541) 687-4718 E-MAIL Eugene, OR 97401 A DDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Great American Assurance CO INSURED INSURER B : OnTrack Inc INSURER C 221 W Medford, Main OR 97501 INSURER INSURER E D: : 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. IN$R ADDL, UBW POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE INSD WVDPOLICY NUMBER MM/DDIYYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED__ CLAIMS-MADE X OCCUR X PAC6536160 0510112015 05101/2016 PREMISES Ea occurrence$ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ _ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $ 3,0005000 X POLICY JECT LOC _PRODUCTS - COMP/OP AGG 17 $ 35000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A ANY AUTO X CAP5374267 05/01/2015 05/01/20161 BODILY INJURY (Par person) $ ALL OWNED SCHEDULED X BODILY INJURY (Per accident) $ AUTOS 1X AUTOS P'~ X NON-OWNED rPROPERTY DAMAGE $ HIRED AUTOS {AUTOS accde I Per accident 1$ X -1 UMBRELLA IAB OCCUR X EACH OCCURRENCE rII$ 3,000,000 A EXCESS LIAB CLAIMS-MADE I UMB3070034-05 05/01/2015 05/01/2016 AGGREGATE is 3,000,000 DED X RETENTION $ 10,0001, $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS' LIABILITY STATUTE ER YIN' ANY PROPRIETOR/PARTNER/EXECUTIVE ~I N /A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 1 E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab. !PAC6536160 05/01/201511 05/01/2016 LEach Act 1,000,000 A IPAC6536160 05/01/20151, 05/01/2016 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ashland, its officers, and employees are included as additional insured as respects general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Kristy Blackman, Administrative Assistant 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD