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HomeMy WebLinkAboutInsurance Certificate: Tactical Business Optimization Solutions AC�® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/22/2021 a-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 CONTNAME: Katie Katie Blaser Nielsen Insurance Agency . ,WCC.NN.Ext): (503)684-6598 FAX No): (503)244-6881 12587 SW 68th Ave E-MAIL katie@niagency.com Tigard,OR 972.23 INSURER(S)AFFORDING COVERAGE . NAIC# INSURERA: Mid-Century Insurance Company 21687 INSURED INSURER B: United States Liability Ins 25895 Tactical Business Optimization Solutions • INSURER C: '„ v..,.-. . 4497 Brownridge Terrace INSURER D: Suite 102 INSURERE: Medford,OR 97504 OR. 97504 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 TYPE OF INSURANCE ADDL SUBR . - . . POLICY EFF 1 POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED /� PREMISES(Ea occurrence) $ 75,000 MED EXP(Any one person) $ • 5,000 A Y 60669-36-80 10/1/2021 10/1/2022 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO- POLICY u 1 L,y - JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ . AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED A AUTOS ONLY AUTOS Y 60669-36-80 10/1/2021 10/1/2022 BODILY INJURY(Per accident) $ X HIRED X NON-OWNED / PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) • • UMBRELLA LIAB _ OCCUR • EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE . -$ DED RETENTION$ $ WORKERS COMPENSATION PER 0TH- - - AND EMPLOYERS'LIABILITY Y/N STATUTE. ER • ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? . (Mandatory-in NH) E.L.DISEASE-EA EMPLOYEE $ . If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1xe_.- B Professional Liability SP 1574078A 10/2/2021 10/2/2022 Ea Occurence $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE: FY21-FY23 GEMT contracting services Ashland Fire&Rescue. The City of Ashland, its elected officials,officers&employees are included as additional insured for General and Auto Liability.Coverage is primary and non-contributory. CERTIFICATE HOLDER - CANCELLATION • City of Ashland SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE 20.East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN -'' ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 AUTHORIZED REPRESENTATIV�E/�y �`J� 1 I • / + .' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD