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HomeMy WebLinkAboutInsurance Certificate: Airport Taxi Service ACc)Rc.® DATE(MM/DD/YYYY) `�. CERTIFICATE OF LIABILITY INSURANCE 03/10/2022 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(les)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 Gina Stiller NAME: Oswald Taxi and Transportation Insurance Services PHONE Ext): 541-223-5222 FAX No): - 2225 Pacific Blvd E-MAIL service@ottiservices.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Albany • OR 97321 INSURER A; United States Liability Insurance Company 25895 INSURED INSURER B; UNITED FINANCIAL CAS CO 11770 AIRPORT TAXI SERVICE INSURER C 215 Tolman Creek Rd Spc 21 INSURER D: INSURER E Ashland OR 97520 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER _ (MMIDD/YYYY) (MM/DD/YYYY) LIMITS- X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A X GL1047654B 03/14/2022 03/14/2023PERSONALBADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO --. BODILY INJURY(Per person) $ •B AUTOS ONLY X SCHEDULED X 01916695-1 03/14/2022 03/14/2023 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNERIEXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A - - -- (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) SCHEDULED AUTO: 2006 FORD CROWN VICTORIA-2FAHP71 W46X141227 2007 FORD CROWN VICTORIA-2FAHP71 W47X144131 CERTIFICATE HOLDER CANCELLATION • City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AU.IHORIZPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD t,.N..; THE HARTFORD BUSINESS SERVICE CENTER THE �, 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 March 28, 2022 MB 01 000306 24369 Fl 1 D 'llli'iillll1111•1 1111111'II111II111i1IIIIII1'1l 'II'11111111" City of Ashland 20 E MAIN ST ASHLAND OR 97520-1814 m 0 m 0 0 0 Policy Information: Ca Policy Holder Details Contact Us Need Help? BALLET FOLKLORICO RITMO ALEGRE Start a live chat online or call us at Policy Number Policy Term (866)467-8730. 76 WEG ARICSA 01/21/22 to 01/21/23 We're here weekdays from 8:00 AM to -_ 8:00 PM ET. Additional Information: NMI MOM Policy Type: Workers' Compensation Dear Customer, Our records indicate that a Certificate of Insurance was issued, providing proof of insurance, on behalf of the above named insured. This is to inform you that effective 04/14/22,all coverage shown on the certificate for the above policy number is cancelled. Should you have any questions, please do not hesitate to contact our office. Sincerely, Your Hartford Service Team CertlnsRC