HomeMy WebLinkAboutInsurance Certificate: UKG Inc. ACoR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
12/01/2025
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 CONTACT
MARSH USA,LLC. NAME`
PHONE 99 HIGH STREET (A/C,No Ext: FAX
No):
BOSTON,MA 02110 E-MAIL
Attm Boston.Certrequest@marsh.com ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
CN 101 980216-US-MA-GAWU P-25- wsURERA: Federal Insurance Company 20281
INSURED UKG Inc. INSURER B: Great Northern Insurance Company 20303
900 Chelmsford Street INSURER C: ACE American Insurance Company 22667
Lowell,MA 01851 INSURER D: Arch Insurance Company 11150
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: NYC-012396492-04 REVISION NUMBER: 0
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 SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICYNUMBER MM/DD MM/DD
A X COMMERCIAL GENERAL LIABILITY Y 3606-40-33 12/01/2025 12/01/2026 EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X� PREMIS
OCCUR DAMAGEES Ea ocS( RENcurreTED
nce $ 1,000,000
MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000
X POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
B AUTOMOBILE LIABILITY Y 7361-70-85 12/01/2025 12/01/2026 COEaMBINED ident SINGLE LIMIT $ 1,O1,000,000acc
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
A X UMBRELLALIAB X OCCUR Y 7819-27-57 12/01/2025 12/01/2026 EACH OCCURRENCE $ 10,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED X RETENTION$ 10,000 $
C WORKERS COMPENSATION 7183-44-74 12/01/2025 12/01/2026 PER OTH-
AND EMPLOYERS'LIABILITY Y/N X STATUTE ER ANYPROPRIETOR/PARTN ER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
D PROF LIAB/TECH E&O/CYBER NPL0067548-04 12/01/2025 12/01/2026 Limit: 10,000,000
A COMMERCIAL PROPERTY 3606-40-33 12/01/2025 12/01/2026 ALL RISK
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
City of Ashland is listed as additional insured as per Omnia terms.
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
@ 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD