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HomeMy WebLinkAboutInsurance Certificate: Moonlight BPO LLC • ® I DATE(MM/DD/YYYY) ACCMCP CERTIFICATE OF LIABILITY IN, 12/11/2020 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 A/C No,Ext): (541)382-4211 FAXX,No): (541)382-7468:. 572 SW Bluff Dr. E-MAIL ADDRESS: temple@centuryins.com Suite 100 I 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 LLC INSURERC: SAIF 2491 NE Twin Knolls Dr,SuiteINSURER D: Hiscox Insurance-Company INSURER E: ---BEND - — - --- OR-97=x01------- - - ------ - ---- -- --- INSURER F:' `-' -- - - COVERAGES CERTIFICATE NUMBER: Master 21/22 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 ADDL SUBR POLICY EFF POLICY EXP • LTR • TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITYEACH OCCURRENCEDAMAGET $ 2,000,000 CLAIMS-MADE OCCUR PREMSESO(Ea oEccu ence) $ 1,000,000 — MED EXP(Any one person) $ 10,000 A Y 6025480068 01/10/2021 01/10!2022PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PRO JECT LOC 000040 , 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 01/10/2021 01/10/2022 BODILY INJURY(Per accident) $ AUTOS ONLYAUTOS X v^HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Peraccident) - X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE 6074618836 01/10/2021 01/10/2022 AGGREGATE $ 3,000,000 DED RETENTION$ 10,000 $ WORKERS COMPENSATION • PER OTH- ) AND EMPLOYERS'LIABILITY Y/N STATUTE ER I , , ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C 1000000 OFFICER/MEMBER EXCLUDED? Y N/A 100020303 01/01/2021 01/01/2022 —_`(Mandatdry'-in,NH)— - ---- --------.. -`- - - --: -__- ==T=---<—=-- _-_----- h —.-- t,E:L.-DISEASE-.EA-EMPLOYEE_--$_1,000,000 _______ -- If yes,describe under 1,000,000 I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ ERRORS&OMISSIONS • D MPL4359668 01/10/2021 01/10/2022 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 I 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 97520eohn• I .' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ,