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Client#: 1635640 MATRICON2
<br /> ACORDW CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 9/09/2021
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
<br /> this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Christine Torrance
<br /> NAME:
<br /> USI Insurance Services, LLC PHONE 602 666-4830 F'X 610 537-2283
<br /> (A/C,No,Ext): (A/C,No):
<br /> 2375 E. Camelback Road,Suite 250 A oAaless: christine.torrance@usi.com
<br /> Phoenix,AZ 85016 I INSURER(S)AFFORDING COVERAGE NAIC#
<br /> 877 468-6516 Sentinel Insurance Company Ltd. 11000
<br /> INSURERA: p
<br /> INSURED !INSURER B:Hartford-WC Multiple Issuing Cos 00914
<br /> Matrix Consulting Group, Ltd Twin CityFire Insurance Company 29459
<br /> 1650 S Amphlett Blvd,Suite 213 INSURER C p y
<br /> INSURER D:
<br /> San Mateo, CA 94402-1234 — —
<br /> i INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSRT TYPE OF INSURANCE INSRL WVD POLICY NUMBER (MM/DD//YYYY)'(MM/DD YY Y) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY 59SBAR00849 08/08/2021 08/08/2022 EACH OCCURRENCE $2,000,000
<br /> ,CLAIMS-MADE J OCCUR DAMAGE TO RENTEDPREMISES(Ea occurrence) $1,000,000
<br /> MED EXP(Any one person) $10,000___
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY X JECOT LOC PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> COMBINED SINGLE LIMIT
<br /> A AUTOMOBILE LIABILITY '59SBAR00849 08/08/2021 08/08/2022 (Ea accident) $2,000,000
<br /> ANY AUTO I'I BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED I BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS PROPERTY DAMAGE
<br /> X A T OS ONLY X AUTOS NLYY (Per accident) $
<br /> I $
<br /> A X UMBRELLA LIAB X OCCUR 59SBAR00849 08/08/2021 08/08/2022 EACH OCCURRENCE $3,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000
<br /> X RETENTION$10,000 $
<br /> B WORKERS COMPENSATION 1
<br /> DED 59WECAB6SO4 08/08/2021 08/08/2022 X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE rY�1l E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? I V N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Professional Liab ,59PG0297372 08/08/2021',08/08/2022 $1,000,000/$3,0000
<br /> $5,000 deductible
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> West Virginia University,employees, agents and volunteers are additional insured as it relates to
<br /> general liability&waiver of subrogation applies as it relates to general liability in accordance with
<br /> the terms and conditions of the policies. Umbrella follows form as it relates to additional insured.The
<br /> above coverage is primary and non-contributory where required by written contract.30 day notice of
<br /> cancellation applies, 10 days for non pay.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> West Virginia UniversitySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> PO Box 6024 ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> Morgantown,WV 26506
<br /> AUTHORIZED REPRESENTATIVE
<br /> yt
<br /> ""�� © t9 8-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #533243100/M32921959 BFSZP
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