Form_SCTNID_CTGRY.

XX0316ACORD25_ACORD

<docindex><index>ACORD</index></docindex> BDF_PCA

DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/28/2024
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 CONTACT
NAME: Progressive Commercial Lines Customer and Agent Servicing
TAILORED INS GROUP PHONE FAX
55 W 9000 S, SANDY, UT 84070 (A/C, No, Ext): 1-800-444-4487 (A/C, No):
E-MAIL
ADDRESS: progressivecommercial@email.progressive.com
INSURER(S) AFFORDING COVERAGE NAIC #

INSURER A : Progressive Northern Insurance Company 38628

INSURED
INSURER B :
O S G EXPRESS LLC
410 E WASHINGTON ST INSURER C :
OSCEOLA, IA 50213 INSURER D :

INSURER E :
INSURER F :

COVERAGES CERTIFICATE NUMBER: 138149657118257103D052824T163818 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 IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS

X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000

DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 100,000
MED EXP (Any one person) $ 5,000

A N N 981390013 05/17/2024 05/17/2025

PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
X POLICY JECT LOC
PRODUCTS - COMP/OP AGG $ 2,000,000

OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
ANY AUTO
BODILY INJURY (Per person) $
OWNED SCHEDULED
A AUTOS ONLY X AUTOS N N 981390013 05/17/2024 05/17/2025 BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $

EXCESS LIAB CLAIMS-MADE AGGREGATE $

DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY Y/N STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L. EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
See ACORD 101 for additional coverage details. $

A N N 981390013 05/17/2024 05/17/2025

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
O S G EXPRESS LLC ACCORDANCE WITH THE POLICY PROVISIONS.
410 E WASHINGTON ST
OSCEOLA, IA 50213
AUTHORIZED REPRESENTATIVE

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Form_SCTNID_CTGRY.XX0108ACORD101_ACORD

<docindex><index>ACORD</index></docindex> BDF_PCA

AGENCY CUSTOMER ID:

LOC #:

ADDITIONAL REMARKS SCHEDULE Page 1 of 1

AGENCY NAMED INSURED

TAILORED INS GROUP O S G EXPRESS LLC
POLICY NUMBER
410 E WASHINGTON ST
OSCEOLA, IA 50213
981390013
CARRIER NAIC CODE
Progressive Northern Insurance Company 38628 EFFECTIVE DATE: 05/17/2024

ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance

Additional Coverages
Insurance coverage(s) Limits
……………………………………………………………………………………………………………………………………………………………………………………
Motor Truck Cargo $100,000 w/$2,500 Ded
……………………………………………………………………………………………………………………………………………………………………………………
Uninsured Motorist Bodily Injury $100,000 Combined Single Limit
……………………………………………………………………………………………………………………………………………………………………………………
Underinsured Motorist Bodily Injury $100,000 Combined Single Limit

Description of Location/Vehicles/Special Items

Scheduled autos only
……………………………………………………………………………………………………………………………………………………………………………………
2021 RAM PROMASTER 3500 3C6MRVJG3ME514574
Comprehensive $2,500 Ded
Collision $2,500 Ded

Liability coverage may not apply to all scheduled vehicles.

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD