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HomeMy WebLinkAboutInsurance Certificate: Arbor E&T, LLC dba Equus Workforce Solutions �..1 GRANASS-03 MITCHELLGLENNON ACORO° DATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 10/9/2023 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 CONTACT Zach Walsh NAME: Thompson Flanagan Executive Liability Group,LLC p PHONE FAX 626 West Jackson Blvd (ac,No,Ext):(312)566-4726 (NC,No): 5th Floor Raligss,zwalsh@thompsonflanagan.com Chicago,IL 60661 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:AXIS Insurance Company 37273 INSURED INSURER B:Pennsylvania Manufacturers Indemnity Company 41424 Arbor E&T,LLC dlbla Equus Workforce Solutions INSURER C:Underwriters at Lloyds London(IL) 15792 9200 Shelbyville Road,Suite 210 INSURER D:Allied World Assurance Company(U.S.)Inc. 19489 Louisville,KY 40222 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 CONTRACTOR 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 (MM/DDIYYYYI (MMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR P00100125229701 9/30/2023 9/30/2024 DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY J 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY n JECT PRO- LOC PRODUCTS-COMP/OP AGG $ OTHER: $ 2,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 (Ea accident) $ X ANY AUTO 152375 1489673 9/30/2023 9/30/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOSBODILY INJURY(Per accident) $ J AUTOS ONLY _AUUTNOS W��ED ONLY (Per accident4AMAGE _ $ $ C X UMBRELLA UAB X OCCUR EACH OCCURRENCE _$ 3,000,000 EXCESS LIAB CLAIMS-MADE XS1168323 9/3012023 9/30/2024 AGGREGATE $ 3,000,000 DED RETENTION$ • $ • B WORKERS COMPENSATION "'•'CSPLOYERS'LIABILITY X STATUTE - ER 5. ': Y/N 2023751489673A ' 9/30/2023 9/30/2024 1000000 p''',,, " ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ' ' OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) - - ------ EL-DISEASE-EA EMPLOYEE $ ', 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Umbrella Excess 0314-0098 9/30/2023 9/30/2024 $5M x$3M 5,000,000 A Excess General Liab. P00100125139101 9/30/2023 9/30/2024 $1M x$1M 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Sexual Abuse and Molestation-Syndicate 2623/623 at Lloyd's(Beazley)-Policy Number:W33C90220101-11 /2022 to 11/1/2023-Occurrence Limit: $2,000,000 Aggregate Limit:$4,000,000 Group Accident-National Union Fire Insurance Company of Pittsburgh,PA-Policy Number:SRG 0009159184-9/30/2023 to 9/30/2024-Limit:$25,000 Professional Liability/Errors&Ommissions-Gemini Insurance Company-Policy Number:VPPL019887-9/30/2023-9/30/2024-Occurrence Limit:$5,000,000 Aggregate Limit:$5,000,000 SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland,OR 97520 AUTHORIZED REPRESENTATIVE C ' .stns ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:GRANASS-03 MITCHELLGLENNON LOC#: ACCPREY ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Thompson Flanagan Executive Liability Group,LLC Arbor E&T,LLC d/b/a Eguus Workforce Solutions 9200 Shelbyville2o2ad,Suite 210 POLICY NUMBER Louisville,Mf 40222 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Medical Professional Liability/Errors&Ommissions-Landmark American Insurance Company-Policy Number:LHM852495- 9/30/2023-9/30/2024-Occurrence Limit:$1,000,000 Aggregate Limit:$3,000,000 Fidelity Bond/Crime-Ironshore Insurance Ltd-Policy Number: FI4NACKT51001 -7/19/2022 to 11/30/2023-Limit:$3,000,000 Certificate holder is included as an additional insured(on a primary&non contributory basis)where required by written contract with the named insured.A waiver of subrogation is in favor of the certificate holder where required by written contract with the named insured.Coverage applicable to work performed under the National Fish&Wildlife grant. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD