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HomeMy WebLinkAboutInsurance Certificate: Moonlight BPO LLC .. AC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/02/2022 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(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 Temple Christensen • NAME: Century Insurance Group,LLC PHONE Ext): (541)382-4211 FAX No): (541)382-7468 320 SW Upper Dr. EMAIL temple@centuryins.com . pp ADDRESS: Suite 104 INSURER(S)AFFORDING COVERAGE NAIC# Bend OR 97702 INSURER A: Continental Casualty Company 20443 INSURED INSURER B: Nat'l Fire ins Co of Hartford 20478 Moonlight BPO LLCINSURERC: SAIF I 2463 NE 4th ST STE 100 INSURER D: Hiscox Insurance Company J INSURER E: Bend OR 97701 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 22/23 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;TERMOR 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGET $ 2,000,000 CLAIMS-MADE X OCCUR PREMS SO(EaoRErccurrence) $D 1,000,000 MED EXP(Any one person) $ 10,000 A Y 6025480068 -01/10/2022 ' '01/10/2023 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 1 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: DATA BREACH $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _ (Ea accident) • X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 6080288076 01/10/2022 01/10/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 • A EXCESS LIAB CLAIMS-MADE 6074618836 01/10/2022 01/10/2023 AGGREGATE $ 3,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N STATUTE ER , , C 1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 100020303 01/01/2023 01/01/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? • (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 - =--If yes,describo under-- —.- _-- - -.___ --- _ _- -_-_ 1,00(4000 . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ PROFESSIONAL LIABILITY . D MPL4359668 01/10/2022 01/10/2023 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City.of Ashland,Oregon,its officers,agents and employees is an Additional Insured with respects to claims arising out of the provision of work in the agreement.Coverage is Primary and Non-Contributory.Waiver of Subrogation Applies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 975201 I `` ©1988-2015 ACORD CORPORATION. All rights reserved. _ ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD