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HomeMy WebLinkAboutInsurance Certificate: TruView BSI, LLC � • TRUVBSI-01 VGONZALEZ2 ACC7/eO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/3/2023 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 License#0757776 CONTACT NAME: Amanda Duke HUB International Insurance Services Inc. PHONE I FAX 548 W Cromwell Avenue (A/C,No,Ext): (A/C,No): Suite 101 AE-MAIL amanda.duke@hubinternational.com Fresno,CA 93711 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Everest Indemnity Insurance Company 10851 INSURED INSURER B:Hartford Underwriters Insurance Company 30104 TruView BSI,LLC INSURER C:Scottsdale Insurance Company 41297 25 Newbridge Road,Suite 210 INSURER D: Hicksville,NY 11801 ' INSURER E: 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDDIYYYYI (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X 51GL013241-231 8/1/2023 8/1/2024 PREM SES Ea occu ence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: E AND 0 $ Included A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO 51GL013241-231 8/1/2023. 8/1/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X NON-OWNEDTS LPROPERTY acEcidentDAMAGE $ X GOA/Hired incl w NOA/Hired w GL - $ 1,000,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE 51E0004193-231 8/1/2023 8/1/2024 AGGREGATE $ DED X RETENTION$ 10,000 $ 4,000,000 B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY _ STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X 16WEQY5C2P 8/1/2023 8/1/2024 1,000,000 OFFICER/MEMBER EXCLUDED? Y N/A E.L.EACH ACCIDENT $ (Mandatory in NH) • E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A General Liability 51GL013241-231 8/1/2023 8/1/2024 Incl w GL/Limit 1,000,000 C Excess Cyber Liabili EKS3475463 4/15/2023 4/15/2024 Limit 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Ashland,Oregon,and its elected officials,officers and employees are Additionally Insured on policies with respect to contractors services provided under this contract.Insurance is Primary and non-contributory.Notice of Cancelation applies. Endorsements Attached:CG2038 0413,ECG24520 0805,ECG245200805,ECG24522 0402,Workers Comp Endorsement to follow. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N.Mountain AAve. Ashland,OR 97520 AUTHORIZED REPRESENTATIVE 6,41 ESENTATIVE 6,41F '�P j • 'd I . ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy No. 51GL013241231 COMMERCIAL GENERAL LIABILITY CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. . -ADDITIONAL-INSURED - OWN-ERS LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured: additional insureds, the following additional 1. Any person or organization for whom you are exclusions apply: performing operations when you and such This insurance does not apply to: person or organization have agreed in writing 1. "Bodily injury", "property damage" or "personal in a contract or agreement that such person or and advertising injury" arising out of the organization be added as an additional insured rendering of, or the failure to render, any on your policy; and professional architectural, engineering or 2. Any other person or organization you are surveying services, including: required to add as an additional insured under a. The preparing, approving, or failing to the contract or agreement described in prepare or approve, maps, shop drawings, Paragraph 1. above. opinions, reports, surveys, field orders, Such person(s) or organization(s) is an additional change orders or drawings and insured only with respect to liability for "bodily specifications; or injury", "property damage" or "personal and b. Supervisory, inspection, architectural or advertising injury"caused, in whole or in part, by: engineering activities. a. Your acts or omissions; or This exclusion applies even if the claims against b. The acts or omissions of those acting on any insured allege negligence or other wrongdoing your behalf; in the supervision, hiring, employment, training or in the performance of your ongoing operations for monitoring of others by that insured, if the the additional insured. "occurrence" which caused the "bodily injury" or However, the insurance afforded to such "property damage", or the offense which caused the "personal and advertising injury", involved the additional insured described above: rendering of, or the failure to render, any a. Only applies to the extent permitted by law; professional architectural, engineering or and surveying services. b. Will not be broader than that which you are 2. "Bodily injury" or "property damage" occurring required by the contract or agreement to after: provide for such additional insured. a. All work, including materials, parts or A person's or organization's status as an equipment furnished in connection with additional insured under this endorsement ends such work, on the project (other than when your operations for the person or service, maintenance or repairs) to be organization described in Paragraph 1. above are performed by or on behalf of the additional completed. insured(s) at the location of the covered operations has been completed; or CG 20 38 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 b. That portion of"your work" out of which the 2. Available under the applicable Limits of injury or damage arises has been put to its Insurance shown in the Declarations; intended use by any person or organization whichever is less. other than another contractor or subcontractor engaged in performing This endorsement shall not increase the operations for a principal as a part of the applicable Limits of Insurance shown in the same project. Declarations. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III—Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 38 0413 Policy No. 51GL013241231 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. - HIRED AND.NON-OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE* Insurance is provided only with respect to those coverage's for which a specific premium charge is shown: Coverage Additional Premium Non-Ownership Liability 50.00 Hired Auto Liability 50.00 *Information required to complete this Schedule, if not shown on this endorsement,will be shown in the Declarations. A. HIRED AUTO LIABILITY The insurance provided under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY applies to"bodily injury"or"property damage"arising out of the maintenance or use of a "hired auto"by you or your"employees"in the course of your business. B. NON-OWNED AUTO LIABILITY The insurance provided under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY applies to"bodily injury"or"property damage"arising out of the use of a"non-owned auto" by any person other than you in the course of your business. 1. With respect to the insurance provided by this endorsement: a. Exclusions 2.c.,2.e.,2.g.,2.h.,2.j.,2.k.,2.1.,2.m., 2.n.and 2.o. under COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE LIABILITY are deleted. b. Exclusion 2.p.and 2.q.under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY are added: p. "Bodily injury': (1) To an"employee"of the insured arising out of and in the course of employment by the insured;or (2) To the spouse,child, parent, brother or sister of that"employees"as a consequence of(1)above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity;and (2) To any obligation to share damages with or repay someone else who must pay damages because of injury. ECG 04 509H 1099 Page 1 of 3 Includes.copyrighted material of Insurance-Services Office,Inc.with its permission Copyright, Insurance Services Office, Inc., 1999 This exclusion does not apply to: (1) Liability assumed by the insured under an"insured contract';or (2) "Bodily injury"arising out of and in the course of domestic employment by the insured unless benefits for such injury are in part either payable or required to be provided under any workers compensation law. q. "Property damage"to: (1) Property owned or being transported by,or rented or loaned to the insured;or (2) Property in the care,custody or control of the insured. 2. SECTION II—WHO IS AN INSURED is deleted and replaced by the,following: Each of the following is an insured under this insurance to the extent set forth below: 1. You; 2. Any other person using a"hired auto"with your permission; 3. With respect to a"non-owned auto",any partner or"executive officer"of yours, but only while such"non-ownedauto"is being used in your business; 4. Any other person or organization, but only with respect to their liability because of acts or omissions of an insured under 1.,2.or 3.above. None of the following is an insured: 1. Any person engaged in the business of his or her employer with respect to"bodily injury"to any co-employee of such person injured in the course of employment; 2. Any partner or"executive officer"with respect to any"auto"owned by such partner or officer or a member of his or her household; 3. Any person while employed in or otherwise engaged in duties in connection with an"auto business"; , .. - 4. The owner of less(of whom you are a sub-lessee)of a"hired auto"or the owner of"non- owned"auto"or any agent or"employee"of such owner of lessee; 5. Any person or organization with respect to the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. 3. SECTION III—LIMITS OF INSURANCE The General Aggregate Limit shown in the Declarations does not apply to the insurance provided by this endorsement. 4. The following definitions apply: "Auto business"means the business or occupation of selling, repairing,servicing,storing or parking"autos". "Hired auto"means any"auto"you lease, hire or borrow. This does not include any"auto"you lease, hire or borrow from any of your employees or members of their households,or from any of your partners or"executive officers". "Non-owned auto"means any"auto"you do not own, lease, hire or borrow which is used in connection with your business. However, if you are a partnership,a"non-owned"does not include any"auto"owned by any partner. The following is added to the definition of"insured contract": ECG 04 509H 1099 Page 2 of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission Copyright, Insurance Services Office, Inc., 1999 g. "Insured contract"means that part of any contract or agreement entered into,as part of your business, by you or any of your"employees"pertaining to the rental or lease of any"auto"; An"insured contract"does not include that part of any contract or agreement: (1) That pertains to the loan, lease or rental of any"auto"to you or any of your"employees". If the"auto"is loaned, leased or rented with a driver;or (2) that holds a person or organization engaged in the business of transporting property by "auto"for hire harmless for your use of an"auto"over a route or territory that person or organization is authorized to serve by public authority. 5. OTHER INSURANCE The insurance provided by this endorsement is excess over any other valid and collectible insurance available to the insured. All other policy provisions apply. • ECG 04 509H 1099 Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.with its permission Copyright, Insurance Services Office, Inc., 1999 Policy No. 51GL013241231 COMMERCIAL GENERAL LIABILITY ECG 24 520 08 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - OTHER INSURANCE (PRIMARY NONCONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Condition 4. Other Insurance of SECTION IV (2) Any other primary insurance available to COMMERCIAL GENERAL LIABILITY CONDITIONS you covering liability for damages arising is replaced by the following: out of the premises or operations, or the a. Primary Insurance products and completed operations, for which you have been added as an addition- This insurance is primary except when b. below al insured by attachment of an endorse- applies. If this insurance is primary, our obliga- ment. tions are not affected unless any of the other insurance is also primary. Then, we will share When this insurance is excess, we will have no with all that other insurance by the method de- duty under Coverages A or B to defend the in- scribed in c. below, except that we will not seek sured against any"suit" if any other insurer has contribution from any party with whom you have a duty to defend the insured against that"suit". agreed in a written contract or agreement that If no other insurer defends, we will undertake to this insurance will be primary and noncontribu- do so, but we will be entitled to the insured's tory, if the written contract or agreement was rights against all those other insurers. made prior to the subject "occurrence" or of- When this insurance is excess over other in- fense. surance, we will pay only our share of the b. Excess Insurance amount of the loss, if any, that exceeds the sum of: This insurance is excess over: (1) The total amount that all such other insur- (1) Any of the other insurance, whether prima- ance would pay for the loss in the absence ry, excess, contingent or on any other basis: of this insurance; and (a) That is Fire, Extended Coverage, Build- (2) The total of all deductible and self-insured er's Risk, Installation Risk or similar amounts under all that other insurance. coverage for"your work"; We will share the remaining loss, if any, with (b) That is Fire insurance for premises any other insurance that is not described in this rented to you or temporarily occupied by Excess Insurance provision and was not you with permission of the owner; bought specifically to apply in excess of the (c) That is insurance purchased by you to Limits of Insurance shown in the Declarations cover your liability as a tenant for "prop- of this Coverage Part. erty damage" to premises rented to you c. Method Of Sharing or temporarily occupied by you with permission of the owner; or If all of the other insurance permits contribution by equal shares, we will follow this method al- (d) If the loss arises out of the maintenance so. Under this approach each insurer contrib- or use of aircraft, "autos"or watercraft to utes equal amounts until it has paid its applica- the extent not subject to Exclusion g. of ble limit of insurance or none of the loss Section I — Coverage A — Bodily Injury remains,whichever comes first. And Property Damage Liability. ECG 24 520 08 05 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 0 with its permission. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this meth- od, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. • ECG 24 520 08 05 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 ❑ Used with its permission. Policy No. 51 GL013241231 COMMERCIAL GENERAL LIABILITY ECG 24 522 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract; (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your operations or "your work" done under a written agreement that requires you to waive your rights of recovery. The written agreement must be made prior to the date of the "occurrence". This waiver applies only to the person or organization shown in the Schedule above. • ECG 24 522 04 02 Includes copyrighted material of Insurance Services Office, Page 1 of 1 ❑ Inc.,with its permission.