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HomeMy WebLinkAboutInsurance Certificate: TruView BSI, LLC (2) TRUVBSI-01 CMALLAPU R CERTIFICATE OF LIABILITY INSURANCE DATE 818/2 DlYYY() /8/2025 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 Chloe Domange HUB International Insurance Services Inc. PHONE $� &2 Fax 548 W Cromwell Avenue Arc,No,Ext:( ) 5-26$1 mac,Nc;(951)231-2572 Suite 101 EMAIL cal.cpu@hubinternational.com V Fresno,CA 93711 ADDRESS: pa INSURERS AFFORDING COVERAGE NAIC IN$URERA:Summit Specialty Insurance Company 16889 INSURED INSURER is,Hartford Accident and Indemni Company 22357 Truview BSI,LLC INSURER c:At-Bay Specialty Insurance Company CompaLiy 19607 225 Broadhollow Road Suite 304 INSURER D Melville,NY 11747 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 ISSUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDITYPE OF INSURANCE INSI) VD POL.ICYNUMBER POLICYEFF POUICYEXP LTR INS VJVA M1DD MMlDD LIMITS A X COMMERCIAL GENERAL LtaBWTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE L^J OCCUR X I X SCGLD05000216500 8/1/2025 8/1/2026 FPAbAEMAGETO RENTED occurrenqje $ 100,000 HGEWL Ded:$2,500 MED EXP An one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 AGGREGATELIMITAPPLIESPER: GENERAL.AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMPIOPAGG $ 2e0DO,D00 OTHER Error&Omissi $ Included AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ccM $ ANY AUTO BODILY INJURY LPer persori S OWNED SCHEDULED AUTOS ONLY AUTNOpSWN BODILYINJURY Per accident $ AifFOS ONLY AUr05 ONLY pR�a�entOAMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS MADE SXCS005600086300 8/1/2025 8/1/2026 AGGREGATE $ 4,000,000 DED I X I RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILRY STA R ANY PROPRIETORIPARTNERIEXECUTIVE YIN X 16 WE QY5C2P 8/1/2025 8/1/2026 1,00o,000 �FFICERIM£MBER EXCLUDED? N I A E.L.EACH ACCIDENT $ MandatoryinNH) EL.DISEASE-EAEMPLOYE $ 1,000,000 If yes,describe under 1,00O,OOp DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY Li MIT $ C CyberlPrivacylNetwor B-6748201-04 4/15/2025 4/15/2026 Limit 3,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLJ_S (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 Insured with regard to the Genera[Liability policy,when required by written contract,per the attached endorsement forms CG2010 04113 and CG203712119,Primary&Non-Contributory included.Waiver of Subrogation applies to the General Liability policy,when required by Written contract,per the attached endorsement form CG2404 05109.Waiver of Subrogation applies to the Workers Compensation policy,when required by written contract,per the attached endorsement form WC000313. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland City N.Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 ArfUT14OREZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Insured name: TruView BSI, LLC Policy number: SCGL005000216500 Policy term: 8/1/2025 to 8/1/2026 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Nacre Of Additional Insured Person(s) Or Organization(s) Locatlon s Of Covered Operations As required by written, and properly executed, contract As per written, and properly executed, contract prior to prior to loss, if required by your written contract or written loss, if required by your agreement with such agreement with such Additional:Insured. If anyone,other Additional Insured than the Additional Insured, provides similar insurance for the Additional Insured,then this insurance will apply as outlined in SECTION IV—COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. Additional Insureds shown in a written contract, or written agreement that includes primary and non-contributory wording The inclusion of one or more Additional Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section Il — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or equipment 1. Your acts or omissions; or furnished in connection with such work, on the 2. The acts or omissions (if those acting on your project (other than service, maintenance or behalf; repairs) to be performed by or on behalf of the in the performance of your;ongoing operations for additional insured(s) at the location of the the additional insured(s)' at the location(s) covered operations has been completed; or designated above_ 2. That portion of "your work" out of which the However: injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization other than another contractor or subcontractor insured only applies to the extent permitted by law; and engaged in performing operations for a principal as a part of the same project. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract cr agreement to provide for such additional insured. CG 20 10 04 13 c0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we Limits of Insurance shown in the Declarations. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or i Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 11 Insured name: TruView BSI, LLC Policy number: SCGL005000216500 Policy term: 8/1/2025 to 8/1/2026 COMMERCIAL GENERAL LIABILITY CG 20 37 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written, and properly executed, As per written, and properly executed, contract prior to contract prior to loss, if required by your written loss, if required by your agreement with such Additional contract or written agreement with such Additional Insured. Insured. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV - COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. Additional Insureds shown in a written contract, or written agreement that includes'{primary and non- contributing wording. The inclusion of one or more Insured(s) under the terms of this endorsement does.not increase our limits of liability. All other terms and conditions remain unchan ed. Information required to com lete this Schedule, if not shown above,will be shown in the Declarations. A. Section Il — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for"bodily injury"or"property If coverage provided to the additional insured is damage" caused, in whole or in part, by"your work" required by a contract or agreement, the most we at the location designated and described in the will pay on behalf of the additional insured is the Schedule of this endorsement performed for that amount of insurance: additional insured and included in the "products- 1. Required by the contract or agreement; or completed operations hazard". However: 2. Available under the applicable limits of e; c 1. The insurance afforded to such additional whichever insurance; Tess. insured only applies to the extent permitted by law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 12 19O Insurance Services Office, Inc., 2018 Page 1 of 1 Insured name: TruView BSI, LLC Policy number: SCGL005000216500 Policy term: 8/1/2025 to 8/1/2026 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED:OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As per written, and properly executed, contract prior to loss, if required by the agreement Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV--Conditions: 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 ongoing operations or"your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 16 WE QY5C2P Endorsement Number: Effective Date: 08/01/25 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: TRUVIEW BSI LLC 255 BROADHOLLOW RD STE 304 MELVILLE NY 11747 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: 06/20/25 Policy Expiration Date: 08/01126