HomeMy WebLinkAboutInsurance Certificate: Arbor E&T, LLC d/b/a Equus Workforce SolutionsrRANASR.ns r.RACEWARD
.44CoR15- CERTIFICATE OF LIABILITY INSURANCE
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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(les) 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
c gcr Xach Walsh
Thompson Flanagan Executive Liability Group, LLC
626 West Jackson Blvd
SthFloor
PHONE FAX
(AIC, No, Ext): (312) 566.4726 AIC, No):
EL�11DAlhss•zwalsh thompsonflanagan,com
Chicago, IL 60661
INSURE S AFFORDING COVERAGE
NAIC It
INSURERA Momesite Insurance Com an of Florida
11156
INSURED
INSURER a: Pennsylvania Manufacturers Indemnity Com an
41424
NSURERc:Underwriters at Lloyds London IL
16792
ArborE&T, LLC dlbla Equus Workforce Solutions
tNSURERD:Allied World Assurance Company U.S. Inc.
119489
9510 Ormsby Station Road, Suite 104
Louisville, KY40223
iNsuRERE:Lexin ton Insurance Company
19437
INSURER F
COVERAGES CERTIFICATE NUMBER: RFVIRIDN NIIMRPR
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.
ILSR TR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
P0003898100
9/30/2024
9/30/2025
EACH OCCURRENCE
1,000,000
IQM,3SESDRENTED
S 100,000
MED EXP (Any one rsm
g 10,000
PERSONAL &ADV INJURY
S 1,000,000
GENLAGGREGATELJMITAPPUESPER:
X POLICY ❑ECT LOC
GENERAL AGGREGATE
g 2,000,000
PRODUCTS -COMPIOPAGG
S 2,000,000
S
OTHER:
B
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
S 2,000,000
BODILYINJURY Per rson
$
X
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUUT�WNEp OS
1524751489673
9130/2024
9/30/2025
BODILY INJURY (Per accident)
$
'a0.Y, A?AAGE
$
ATTOS ONLY AUTO ALLY
$
C
X
UMBRELLA LM13
X
OCCUR
EACH OCCURRENCE
S 3,000,000
AGGREGATE
s 3,000,000
EXCESS LIAB
CLAIMS -MADE
XS1168324
913012024
9/3012025
DED I I RETENTION $
g
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
ANY PROPRIETOfWARTNERIEXECUTIVE ❑
OFFICEWD�EnREREXCLUDED?
Mandato i NNHH)i
If yes, describe under
DESCRIPTION OF OPERATIONS belaw
NIA
202475 1489673A
9r3012024
9/30/2025
X I PER OTH-
'TESTAT E
E.L. EACH ACCtDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYE
1,000,0{}0
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
D
Umbrella Excess
314.0098
9/30/2024
9/3012025
$5M x $3M
6,000,000
E
Excess GL
27734405
9/3012024
9/30/2025
$1M x $1M
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Additional Coverages:
Sexual Abuse and Molestation - Beazley Excess and Surplus Insurance Inc. - Policy Number: D33C90240301 913012024 - 9/30/2025 Occurrence Limit:
$2,000,000 Aggregate Limit: $4,000,000
Group Accident - National Union Fire Insurance Company of Pittsburgh, PA - Policy Number: SRG 0009159184 - 9/30/2024-9/30/2025 - Limit: $25,000
SEE ATTACHED ACORD 101
The City of Ashland
20 East Main Street
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE 1
ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: GRANASS-03
GRACEWARD
AC[]RO°
LOC #:
ADDITIONAL REMARKS SCHEDULE
Page 1 of 1
AGENCY
Thompson Flanagan Executive Liability Group, LLC
NAMED INSURED
Arbor E&T, LLC dlbla Equus Workforce Solutions
9510 Ormsby Statio Road, Suite 104
Louisville, KY
POLiCYNUMBER
EE PAGE 1
CARRIER
EE PAGE 1
NAIL CODE
SEE P 1
EFFECTIVE DATE: SEE PAGE 1
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Llablll insurance
Description of Operations]LocationsfVehicies:
Professional i_iabilitylErrors & Ommissions - Gemini Insurance Company - Policy Number: VPPLO21691 - 913012024 - 9/30/2025 -
Occurrence Limit: $6,000,000 Aggregate Limit: $5,000,000
Medical Professional Liability/Errors & Ommissions - Landmark American Insurance Company - Policy Number: LHM861405 -
9/3012024 - 9/3012026 - Occurrence Limit: $3,000,000 Aggregate Limit: $5,000,000
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.
ALUKIJ 1U1 t'LUUtJ/U1) 02008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD