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HomeMy WebLinkAboutInsurance Certificate: OnTrack Inc ONTRINC-01 LBAKER Ate.--'~~ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 0512512017 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). PRODUCER CONTACT Taml WaISh NAME: _ _ Alliance Insurance Group PHONE FAX 9410ak St. (arc, No, Ext): (Arc, No): Eugene, OR 97401 a~oR'~ss: ~mi.walsh~allianceinsgrp.com _ INSURER(S) AFFORDING COVERAGE NAIC # - INSURER A . Capitol Specialty Insurance, Corporation INSURED INSURER B : SAIF Corporation .36196 OnTrack Inc INSURER C - - 300 W Main INSURER v : _ _ _ Medford, OR 97501 _ _ _ _ INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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 WH1CH 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 SUBR POLICY EFF T POLICY EXP LIMITS LTR TYPE OF INSURANCE IN D D' POLICY NUMBER NUDD D RAL LIABILITY 1 000,000 A X COMMERCIAL GENE EACH OCCURRENCE _ $ ~ CLAIMS-MADE x 'OCCUR DAMAGE TO RENTED 1 OO,000 HS02794413.01 05101!2017 x 0510112018 PREMISES~a occurrence) 1 $ _ MED EXP (Any one person) $ 5,000 _ 1,000,000 _ PERS_ ONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER_ 3 OOO,OOO GENERAL AGGREGATE $ ' POLICY PRO- LOC _ _ _ _ I_ _ 3 OOO,OOO _ JECT PRODUCTS - COMPIOP AGG $ ' ;OTHER: A AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT ' 1,000,000 (Ea acciden~__ ! $ ANY AUTO HS02794413.01 ' 05101!2017 05101/2018 BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY X 'AUTOS BODILY INJURY (Peraccident~ $ HIRED X 'NON-0 ED PROPERTY DAMAGE AUTOS ONLY ;AUTOS ONLY (Per accidents $ A ' X 'UMBRELLA LIAB X ,OCCUR ! 'EACH OCCURRENCE $ 3,000,000 - 4-01 0510112017 EXCESS LIAB CLAIMS-MADE ' 0510112018 3 000,000 ~ AGGREGATE ; $ ' DED X RETENTIONS 10,DODI B '.,WORKERS COMPENSATION X PER OTH- ANDEMPLOYERS' LIABILITY Y r N !STATUTE _ER ANY PROPRIETOR/PARTNEWEXECUTIVE 451050 07101!2016 0710112017 SOO,000 E.L. EACH ACCIDENT , $ OFFICERIMEMBER EXCLUDED? N 1 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 HS02794413.01 ' 05/0112017 0510112018 ,;Each Act 1,000,000 A .,Professional Liab HS02794413.01 ' 0510112017 0510112018'Aggregate 3,000,000 DESCRIPTION OF OPERATIONS 1 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 REPRESENTATNE ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD