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HomeMy WebLinkAboutInsurance Certificate: Professional Credit Holdings; Ray Klein Inc i DATE(MM/DD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 07/07/2021 . 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 Angie Diethelm NAME: • Christensen Group PHONE (952)653-1000 FAX (952)653-1100 - - _ (A1C.No.Eat): (A/C,No): 9855 West 78th Street,Ste 100 E-MAIL adiethelm@christensengroup.com - ADDRESS: INSURER(S)AFFORDING COVERAGE - NAIC# Eden Prairie MN 55344INSURERA: Hanover Ins Group INSURED - INSURER B: Evanston Insurance Company Professional Credit Holdings Corporation;Ray Klein,Inc INSURER C: Hudson Excess Insurance Company 400 International,Way,Ste 250INSURER D: Travelers Casualty and Surety Co of America INSURER E: - Springfield OR 97477 INSURER F: • COVERAGES CERTIFICATE NUMBER: 21-22 LIABILITY ` 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 TYPE OF INSURANCE ADDL s- POLICY EFF •POLICY EXP INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) • LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000- • CLAIMS-MADE OCCUR PREM SESDAMAGE O(EaEE occurrence) $D 300,000 • MED EXP(Any one person) $ 10,000 A ZDXH67267900 06/30/2021 06/30/2022 PERSONAL&ADV INJURY $ 1,000,000 , GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 PRO- n 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OPAGG $ _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED ZDXH67267900 06/30/2021 06/30/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS _ >/ HIRED NON-OWNED PROPERTY DAMAGE $ • X AUTOS ONLY X AUTOS ONLY (Per ac0 ciden X UMBRELLA LIAB OCCUR EACH OCCURRENCE( $ 10,000,000 A EXCESS LIAB CLAIMS-MADE UHXH67269600 06/30/2021 06/30/2022 AGGREGATE $ 10,000,000 DED X RETENTION-$'10,000 �/ $ WORKERS COMPENSATION - X STATUTE ETH AND EMPLOYERS'LIABILITY A ANY'ROPRIETOR/PARTNER/EXECUTIVE Y7 N/A WZXH63911600 06/30/2021 06/30/2022 •E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? 1,000,000 (MamJatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Cyber Limit $5,000,000 ' BIC Cyber Excess Cyber Liability MKLV5PCY000044/EET1361701 06/30/2021 06/30/2022 Excess Cyber Limit $5,000,000 ' DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) The City of Ashland,its elected officials, officers&employees are included as an Additional Insured under the General Liability on a Primary/Non-Contributory basis when required by written contract. o 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 .�1 n�•�4 ff� Ashland OR 97520 C �� '�<l_.+. I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: �r..++� ® LOC#: A U ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED ' Christensen Group Professional Credit Holdings Corporation;Ray Klein,Inc POLICY NUMBER CARRIER NAIC CODE • EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes Professional Liability-6/30/21-6/30/22-Policy#107470356-Limit:$3,000,000 • • • • • • • ACORD 101(2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD