Loading...
HomeMy WebLinkAboutInsurance Certificate: General Information Solutions LLC DATE(MM/DD/Yl YY) • 'AC�® `.� CERTIFICATE OF:LIABILITY INSURANCE 05/26/2022� ' 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 thepolicy,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). c 'PRODUCER . CONTACT; . 0 Aon Risk insurance Services West, Inc. . PHONE FAX Los Angel es CA Offi ce (A(C.No.Ext): (866)_.283-7122. (NC.No.): (600),363-0105 - 707 Wi l shi re Boulevard .. E-MAIL p Suite 2600 . . ADDRESS: _ • Los Angeles CA 90017-0460 USA 'INSURER(S)AFFORDING COVERAGE NAIL# INSURED INSURER,A: Berkshire Hathaway Specialty Ins Company 22276 General Information Solutions LLC ' , INSURER B: American Casualty Co: of Reading PA . 20427 917 Chapin Road - Chapin SC 29036 USA INSURER C: ..Transportation.insurance Co. ,' 20494 INSURER D: The Continental Insurance Company 35289 ' • ' INSURER Valley Forge-Insurance Co - 20508. , INSURER F:. r • COVERAGES . CERTIFICATE NUMBER 570093312064 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. Limits shown are as requested 'INSR ADDL SUBR -' POLICY EFF 'POLICY tXP - LTR ,-TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYYYL� ((MMIDD/YYY1) - LIMITS B X COMMERCIAL GENERAL LIABILITY 6083326918 06/01/20i2 06/01/2023 EACH OCCURRENCE - , ' $1,000,000 DAMAGE TO RENTED CLAIMS-MADE 11 OCCURPREMISES(Ea occurrence). • $1,000,000 • MED EXP(Any one person) $15,000 PERSONAL&ADV..INJURY $1,000,000 ,''� GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY JECT I I LOCC 2 • PRODU TS-COMP/OPAGt3 : $2;000,000 OTHER: o ., - n C AUTOMOBILE LIABILITY • ' ,6083145026 - - 06/01/2022 06/01/2023 cOMBINED SINGLE LIMIT '$1,000,000 . (Ea accident) ' to ANY AUTO BODILY INJURY(Per person) G • Z. OWNED —SCHEDULED, ' BODILY INJURY(Per accident) 0�. AUTOS — X HIRED AUOTOS 'X NON-OWNED PROPERTY DAMAGE V . —ONLY _AUTOS ONLY (Per accident D X UMBRELLA LIAR . X' OCCUR - .6076599220 06/01/2022 06/01/2023 EACH OCCURRENCE , '$5,000,000 lJ — SIR applies._per'policy terns & conditions . EXCESS LIAB . CLAIMS-MADE' AGGREGATE . . $5,000,000 DED X' RETENTION. E WORKERS COMPENSATION AND' 6083189639 06/01/2022 06/01/2023 X PER STATUTE. OTH EMPLOYERS'LIABILITY Y/N (AOS). ER B -ANYPROPRIETOR/PARTNER/EXECUTIVE' n E.L.EACH ACCIDENT. $1,000,000 :` OFFICER/MEMBEREXCLUDED? - I I N/A 6083236037 06/01/2022 06/01/2023 (Mandatory in NH) (CA) . E.L.DISEASE-EA EMPLOYEE $1,000,000 ' If yes,describe under DESRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000",000 A E&O-PL-Primary . 42EPP31858001- 11/15/2021 11/15/2022 Sublimit • $5,000,000 Claims:made , • SIR applies per policy terns & condi ions DESCRIPTION OF OPERATIONS/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. 9f the General.Liability policy. 14 CERTIFICATE HOLDER ' . . ' CANCELLATION ' _ . • • . ' e SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE !m=m'' a EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE r, S POLICY PROVISIONS. F,'. City'of Ashland • . _ AUTHORIZED REPRESENTATIVE - - . ' c For. . Attn: Kari ann..Olson ' . a- Purchasing Representative �1 ],;x/.' ., ob. 90 N. Mountain Avenue • ty/ i M a' r / � Ashland OR 97.520 USA PA ylQCGtlljlEYi GfiLVEYd 7dG ` ' ©1988-2015 ACORD CORPORATION:All rights reserved. " • ACORD 25(2016/03) The ACORD name and,logo are,registered marks of ACORD • • AGENCY CUSTOMER ID: 570000077537 " :LOC#: . ADDITIONAL `REMARKS SCHEDULE Page _ of Aon Risk Insurance services west, Inc.' • General 'InformationSolutions LLC POLICY NUMBER See' Certificate Number: 570093312064 ,. CARRIER 'MAIC CODE. . See Certificate Number:'570093312064 EFFECTIVE DATE:,.` ADDITIONAL REMARKS THIS ADDITIONAL.REMARKS FORM IS:A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE. • NAIC# INSURER.," INSURER INSURER INSURER • ADDITIONAL POLICIES If a policy below does not include limit information,:refer to the corresponding policy on the ACORD certificate form for policy limits:. POLICY POLICY • INSR ADDL SUBR . POI4CY NUMBER EFFECTIVE EXPIRATION LIMITS LTR TYPE OF INSURANCE INSD.WVD DATE . DATE (MM/DD/YYYY) (MM/DD/YYYY) . . OTHER A Cyber Liability 42EPP3185800I . 11/15/2021 11/15/2022 Sublimit ., $5,000,000 • Claims made SIR applies per policy terms & conditions. • • • • • • ACORD 101(2008/01) ©2008 ACORD CORPORATION All rights reserved.. The ACORD name and logo are registered marks of-ACORD