DOC112125-11212025122613.pdf

The documents comprise an insurance certificate, an affirmation and disclosure form, an Ohio Bureau of Workers' Compensation certificate, and a state auditor search results page. The primary entities involved are York Electric, Inc., located in Dayton, Ohio, and Marsh McLennan Agency LLC as the insurance producer. The insurance certificate is issued for the Ohio Department of Rehabilitation & Correction, with Selective Insurance Company providing coverage. The Workers' Compensation certificate is issued by the Ohio Bureau of Workers' Compensation for York Electric, Inc.

The insurance coverage includes commercial general liability, automobile liability, umbrella liability, and workers' compensation, with policy periods effective from 9/2/2025 to 9/2/2026. The general liability coverage includes $1,000,000 per occurrence, $3,000,000 aggregate limits, and various other specified protections. The affirmation and disclosure form confirms that the contractor (York Electric, Inc.) will perform services at 530 E. 2nd Street in Dayton, Ohio, with no subcontractors listed. The Workers' Compensation certificate covers the period from 07/01/2025 to 07/01/2026, with policy number 00197432, and includes a required posting about rebutting presumptions related to work-related injuries.