Certificate 4
Certificate 4
Certificate 4
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 8/30/2024
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 # 0I96350
CONTACT
NAME:
The Insurance Store (A subs. of Storrs Insurance Group, Inc.) PHONE FAX
(A/C, No, Ext): (A/C, No):
41811 Ivy St. Ste B E-MAIL
Murrieta, CA 92562 ADDRESS: [email protected]
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Oregon Mutual Insurance Company 14907
INSURED INSURER B :
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Vehicle Schedule is on file with the company.
With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply
unless modified by this endorsement.
lncludes copyrighted material of lnsurance Services Office, lnc., with its permission
M2855A (8-19) Page 1 of 3 190321.FRM
The most we will pay under this coverage is This coverage does not apply while there
the least of: are spare or reserve "autos" available to you
1. $50,000; or for your operations.
2. The actual value at the time of loss; or If "loss" results from the total theft of a
covered "auto" of the private passenger
3. The cost of repairing or replacing the type, we will pay under this coverage only
damaged or stolen property with other that amount of your rental reimbursement
property of like kind or quality. expenses which is not already provided for
8. Loan Lease Gap under another Physical Damage Coverage
The following is added to Section III – Physical Extension.
Damage Coverage, A. Coverage: 11. Towing
Loan Lease Gap Section III – Physical Damage Coverage, A.
In the event of a total "loss" to a covered "auto" Coverage, 2. Towing is replaced with the following:
that is covered for Comprehensive or Specified We will pay up to $100 for towing and labor
Causes of Loss and Collision coverage, we will costs incurred each time a covered "auto" of the
pay the "outstanding balance" on the lease or private passenger or Light Local Service
loan for that covered "auto" up to $2,500. (0 – 10,000 lbs. GVW) type is disabled.
9. Personal Effects However, the labor must be performed at the
place of disablement.
The following is added to Section III – Physical
Damage Coverage, A. Coverage, 4. Coverage 12. Additional Insured by Contract or Agreement
Extensions: A. The following is added to Section II – Liability
Personal Effects Coverage, A. Coverage, 1. Who Is An Insured:
For any owned "auto" that is involved in a When you have agreed in a written contract
covered "loss", we will pay up to $500 for or agreement to include a person or
"personal effects" that are lost or damaged as a organization as an additional "insured", such
result of the covered "loss", without applying a person or organization is included as an
deductible. "insured" subj ect to the following:
10. Rental Reimbursement 1. Such person or organization is an
additional "insured" only to the extent
The following is added to Section III – Physical such person or organization is liable for
Damage Coverage, A. Coverage, 4. Coverage "bodily inj ury" or "property damage"
Extensions: because of the conduct of an "insured"
Rental Reimbursement under Paragraphs a. or b. under Section
If a covered "auto" owned by you is covered for II – Liability Coverage, Paragraph A.1.
Comprehensive or Specified Causes of Loss Who Is An Insured, caused by an
and Collision coverage, we will pay for rental "accident" and resulting from the
reimbursement expenses incurred by you for the ownership, maintenance or use of a
rental of an "auto" because of "loss" to a covered "auto"; and[TD1][TD2]
covered "auto". Payment applies in addition to 2. The written contract or agreement
the otherwise applicable amount of each described above must have been
coverage you have on a covered "auto". No executed prior to the "accident" that
deductibles apply to this coverage. caused the "bodily injury" or "property
We will pay only for those expenses incurred damage" and be in effect at the time of
during the policy period beginning 24 hours after such "accident"; and
the "loss" and ending, regardless of the policy's 3. The insurance afforded to any such
expiration, with the lesser of the following additional "insured" does not apply to
number of days: any "accident" beyond the period of time
1. The number of days reasonably required to required by the written contract or
repair or replace the covered "auto". If "loss" agreement described above.
is caused by theft, this number of days is B. The most we will pay on behalf of such
added to the number of days it takes to additional "insured(s)" is the lesser of:
locate the covered "auto" and return it to 1. The Limits of Insurance specified in the
you, or written contract or agreement described
2. Up to $75 per day up to 30 calendar days. above; or
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M2855A (8-19) Page 2 of 3 190322.FRM
2. The Limits of Insurance shown in the 13. Waiver of Subrogation by Contract or Agreement
Declarations. The following is added to Section IV – Business
This provision shall not increase the Limit of Auto Conditions, A. Loss Conditions, Paragraph 5.
Insurance shown in the Declarations in this Transfer Of Rights Of Recovery Against Others To
policy or coverage part. Us:
C. The following change is made to Section II – We waive any right of recovery we have against
Liability Coverage, A. Coverage, 1. Who is An a person or organization because of payments
Insured: we make for "bodily inj ury" or "property damage"
Paragraph 1.c. is deleted in its entirety. when you and such person or organization have
D. The following changes are made to Section IV – agreed in writing in a contract or agreement to
Business Auto Conditions, B. General waive such right of recovery, provided:
Conditions, Paragraph 5. Other Insurance: 1. Such written contract or agreement was:
1. The following is added to Paragraph 5.a.: a. Made prior to the "accident" or "loss"
If required by the written contract or resulting in the covered "bodily inj ury" or
agreement described above, the insurance "property damage"; and
afforded to the additional "insured" under b. Was in effect at the time of the covered
this provision will be primary to, and will not "bodily inj ury" or "property damage".
seek contribution from, the additional 2. The covered "bodily inj ury" or "property
"insured’s" own insurance. damage" must arise out of the operations
2. Paragraph 5.c. is deleted in its entirety. specified in such written contract or
E. Section V – Definitions, "insured contract" is agreement.
amended to add the following: 3. At our request you must provide us with a
An "insured contract" does not include that copy of the aforementioned written contract
part of any contract or agreement: or agreement.
That pertains to the ownership, Additional Definitions
maintenance or use of an "auto" and The following Paragraphs are added to Section V –
which indemnifies a person or Definitions:
organization for other than the vicarious Q. "Personal effects" means your tangible property
liability of such person or organization that is worn or carried by you, except tools,
for "bodily inj ury" or "property damage" jewelry, money or securities.
caused by your operation or use of a R. "Outstanding balance" means the amount you
covered "auto". owe on the lease or loan at the time of the "loss"
However, a person or organization is an less any overdue lease/loan payments, security
additional "insured" under this provision deposits not returned by the lessor, costs for
only to the extent such person or extended warranties or insurance purchased
organization is not named as an with the loan or lease, or carry-over balances
"insured" by separate endorsement to from previous loans or leases.
this policy.
Includes copyrighted material of Insurance Services Office, Inc., with its permission
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