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HomeMy WebLinkAboutInsurance Certificate: OnTrack ONTRINC-01 JDEGARMO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/16/2016 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 NAME: Tami Walsh Alliance Insurance Group PHONE FAX 941 Oak St. A/c No Ext): (A/C, No): Eugene, OR 97401 ADMDRESS: tami.walsh@allianceinsgrp.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B : SAIF Corporation 36196 OnTrack Inc INSURER C 300 W Main INSURER D Medford, OR 97501 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. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAG TO X ! PHPK1488129 05/01/2016 05/0112017 P REM EISES S( Ea occurrence) $ CLAIMS-MADE OCCUR X PREM 100,000 MED EXP (Any one person) $ 5,000 FGEN'L PERSONAL & ADV INJURY 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 XI PRO- X POLICY I ' ` I JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident A ANY AUTO i,PHPK1488129 05/01/2016 05/01/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS X AUTOS j BODILY INJURY (Per accident) $ PROPERTY DAMAGE ^ $ X HIRED AUTOS X AUTOWNED (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE FHUB538740 05/01/2016 05/01/2017 AGGREGATE $ 3,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- X STATUTE ER AND EMPLOYERS' LIABILITY Y/N! B ANY PROPRIETOR/PARTNER/EXECUTIVE 451050 07/01/2016 07/01/2017 E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? _ J I N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE' $ 500,000 If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional 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 / 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 Kristy Blackman, Administrative Assistant ACCORDANCE WITH THE POLICY PROVISIONS. 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