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HomeMy WebLinkAboutInsurance Certificate: OnTrack Inc ONTRINC-01 IPETRIE F DATE (MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 412912016 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 NCONTACT AME: Tami Walsh PHONE FAX Alliance Insurance Group - - - 941 Oak St. A/C No Ex~am LW81Sh allianceins (A/c, Nol_ E-MA Eugene, OR 97401 A DRIESS: 9rp•com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Philadelphia Indemnity Insurance Company [18058 INSURED INSURER B SAIF Corporation 6196 OnTrack Inc INSURER C 300 W Main INSURER D Medford, OR 97501 INSURER E : _ INSURER F : I 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. INSRT ADDL`SUBR POLICY EFF POLICY EXP T LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000_,000 PHPK1488129 05101/2016 05/0112017 PREMISES DAMA ET (EaoccuRENTEDrrencel $ CLAIMS-MADE OCCUR 100,000 ' X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. ~GENERAL AGGREGATE $ X POLICY X JECT X LOC PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _____1,000,000 Ea accident _ l 05/0112017 BODILY INJURY (Per person) $ A X PHPK1488129 05/01/2016 - - ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED !PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident~_ _,i $ X X X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB ~ CLAIMS-MADE PHUB538740 05/01/2016 05/01/2017'i AGGREGATE $ 3,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y/N STATUTE 451050 0710112015 07/01/2016 E L ER EACH ACCIDENT $ 500,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE / EXCLUDED? /E ECUTIVE N/A OFFICER/MEMBER 1 (Mandatory in NH) E.L DISEASE _ _EMPLOYEE $ - - 500 OQO, If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 A iProfessional Liab. PHPK1488129 05/01/2016'', 05/01/2017 Each Act 1,000,000 A PHPK1488129 05/01/2016 05/01/2017 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / 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 Y 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