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HomeMy WebLinkAboutInsurance Certificate : PFM Financial Advisors LLC • • �....14, PFMIILL-01 JBOLAND2 .4 RO° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 4....----- 12/23/22021021 Y) 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 Janice Boland NAME. Crystal IBC,LLC PHONE l FAX 32 Old Slip 29th Fl (NC,No,Ext): I(NC,No): New York,NY 10005 E-MAIL ADDRESS:Janice.Boland@alliant.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Valley Forge Insurance Company 20508 INSURED INSURER B:Continental Insurance Company 35289 PFM Financial Advisors,LLC INSURER C: 1735 Market Street,42nd Floor INSURER D: Philadelphia,PA 19103 • 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 7018019790 12/7/2021 12/7/2022 DAMAGE TO RENTED 1,000,000 X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 - PERSONAL&ADV INJURY _$ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY raj X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER:. $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO X 7018019806 12/7/2021 12/7/2022 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS yV Ep BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTNOS ONLY (Per accident)AMAGE $ $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 20,000,000 EXCESS LIAB CLAIMS-MADE X 7018019840 12/7/2021 12/7/2022 AGGREGATE 20,000,000 DED X RETENTION$ 0 $ B AND EMPLOYERS'LIABILIITY Y/N X STATUTE I EERH 7018019823 1/1/2022 1/1/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ Fagg/PPM-17 EXCLUDED? N/A 1,000,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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 Additional Insureds on a primary and non-contributory basis on the above referenced Commercial General Liability,Automobile Liability and Umbrella Liability Policies if required by written contract. 30 Days Notice of Cancellation Applies/10 Days Notice for Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION LL W N 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. I; 20 E Main St G Ashland,OR 97520-0000 a AUTHORIZED REPRESENTATIVE Co n. 2 I 0 N ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. 0 o The ACORD name and logo are registered marks of ACORD 1 0 0 0 0 0 Tr 0 0 0 000140 0,60 GMS_164061473700110EF CRYSTAL Financial Institutions A DIVISION OF ALLIANT 32 Old Slip,New York,NY 10005 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1814 1 To Whom It May Concern: Attached please find requested certificate. In order to comply with green standards Crystal will no longer be mailing out hard copy certificates. Please provide Mervyn Meng (FIGCOI@alliant.com) with an email address to send certificates to going forward. Please also include "Named Insured XYZ" or"Agency-Customer ID#"in the subject line of your email. , Look forward to hearing from you. Thanks. U- W N N m nM O O al (7 N S O O O O 0 O 0 O 0 0