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HomeMy WebLinkAboutInsurance Certificate: HireRight LLC AC�® IM2/2021 YY) CERTIFICATE OF LIABILITY INSURANCE DATE 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). e PRODUCER CONTACT D NAME: Aon Risk Insurance Services West, Inc. PHONE - FAX 'U" (NC.No.Ext): 8662837122 (NC.No.): (800) 363-0105 0! Los Angeles CA Office p 707 wilshire Boulevard E-MAIL Suite 2600 ADDRESS: Los Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE ,NAIC# INSURED INSURER A: Transportatiofl Insurance CO. 20494 HireRight, LLC INSURER B: Valley Forge Insurance Co 20508 3349 Michelson Drive, suite 150 Irvine CA 92612 USA INSURER C: American Casualty Co. of Reading PA 20427 INSURER o: The Continental Insurance Company 35289 INSURER E: National Fire & Marine Ins Co 20079 INSURER F: 7: COVERAGES CERTIFICATE NUMBER:570090299472. REVISION NUMBER: l 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY bXP ' - LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYYY) (MM/DD/YYYYY)� LIMITS A X COMMERCIAL GENERAL LIABILITY 6083326918 06/01/2021 d6/O1/2022'EACH OCCURRENCE $1,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RENTED $1,000,000 PREMISES(Ea occurrence) – MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 n GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,006 m RPRODPOLICY JE O- I I LOC UCTS-COMP/OP AGG $2,000,006 cal OTHER: O r- A. AUTOMOBILE LIABILITY 6083145026 06/01/2021 06/01/2022'COMBINED SINGLE LIMIT $1,000,-000 . (Ea accident) „ ANY AUTO BODILY INJURY(Per person) C Z — OWNED —SCHEDULED BODILY INJURY(Per accident) a) — AUTOS ONLYAUTOS (0X HIRED AUTOS — NON-OWNED PROPERTY DAMAGE V —.ONLY AUTOS ONLY (Per accident) - ::. t: O X .UMBRELLALIAB X OCCUR 6076599220 . '06/01/2021 06/01/2022 EACH OCCURRENCE $5,000,000 0 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$10,000 • B WORKERS COMPENSATION AND 6083189639 06/01/2021 06/01/2022'x PER STATUTE 0TH- EMPLOYERS'LIABILITY Y/N AOS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E,L,EACH ACCIDENT , S1,000,000 O OFFICER/MEMBER EXCLUDED? El NIA 6083236037 ,06/01/202106/01/2022 (Mandatory In NH) CA E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— E E&0-PL-Primary 42EPP31858001 11/15/2021 11/15/2022'Sublimit $5,000,000 VII Claims made SIR applies per policy terms & condi ions DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)' Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. 1 ■ti■ iill o_ CERTIFICATE HOLDER CANCELLATION o 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE o EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE o POLICY PROVISIONS. �..! S :p"." City of Ashland AUTHORIZED REPRESENTATIVE - _ S Attn: Kariann Olson Purchasing Representative 90 N. Mountain Avenue Ashland OR 97520 USA Jfa ahe taX:5 .- g al ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD