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HomeMy WebLinkAboutInsurance Certificate: Moonlight BPO LLC 7 ® DATE(MMIDD/YYYY) AR v - CERTIFICATE OF.LIABILITY INSURANCE 2/02/2021 THIS CERTIFICATE IS ISSUED ASA 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- _ PHO No,Ext): (541)382-4211 p/C,No): (541)382-7468 , 320 SW Upper Terrace Dr. E-MAIL temple@centuryins.com pP ADDRESS: Suite 104 . - INSURER(S)AFFORDING COVERAGE NAIC# Bend , OR 97702 INSURER A: Continental Casualty Company 20443 INSUREDINSURERB: Nat'l Fire,ins Co of Hartford 20478 Moonlight BPO LLC INSURERC:-SAIF " - 2463 NE 4TH ST STE.100 INSURER D: Hiscox Insurance Company • - INSURER E: - BEND -"- - -OR 97701 INSURERF: - -- " _- • I 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,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. ILNSR -TR TYPE OF INSURANCE ADDLUBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERALLIABILITYEACH OCCURRENCE $ 2,000,000 D CLAIMS-MADE ❑X OCCUR PREM SESDAMAGE TO(Ea occurrence)R $ 1,000,000 • - MED EXP(Any one person) $ 10,000 A Y •6025480068 01/10/2022 01/10/2023 PERSONAL 8 ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY n PO- 4,000,000 JERCT LOC • PRODUCTS-COMP/OPAGG $ 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 XAUTOS HIRED ONLY X AUTNONOS ON-OWNELY D PROPERTY DAMAGE (Per accident) $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAR CLAIMS-MADE 6074618836 " 01/10/2022 01/10/2023 AGGREGATE $ 3,000,000 DED RETENTION$ ' $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY . • STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N TIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBEREXCLUDED? Y N/A .. 100020303 01/01/2022 01/01/2023 (h"•andator/in.NH)---_ -------- -----_ -- -—- - _- -- - ------ - --, -- - - ------ -- - ——- E:L.DISEASE-EA Eh1PLOYEE=-$-1.,000,000- --_ -_ If yes,describe under 1,000,000 DESCRIPTION OFIOPERATIONSbelow 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 97520yit 1e~ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD