Certificate Of Automobile Insurance (For Ridesharing- Ontario)

This Certificate is proof of a contract of insurance between the Named Insured and the Insurer, subject in all respects to the
Ontario Automobile Policy (OAP 1). In return for the premium charged and the statements contained in the Application, the
contract provides the coverage outlined in this Certificate. You only have a particular coverage for a specific automobile if
this Certificate shows a premium for it, or shows the coverage is provided at no cost. All other terms of the Policy remain the
same unless stated otherwise in this Certificate. Your Insurer will provide you with a copy of the Policy if you request it. This Intact Insurance Company,
Certificate is only valid if it is signed by an authorized representative of the Insurer.
Page 1 of 3 (Hereinafter Called The Insurer)

Broker No. Billing Method Policy Number Reason for Issuance

Aon Reed Stenhouse 72564 7J9000184 Renewal
Lessor’s Name and Address
Named Insureds as per Schedule 1 As per Lessor’s Schedule
(For Ridesharing-Ontario)
Attached.

Policy Period D M YR D M YR
To 12:01 a.m. All times are local times at the Named Insured’s primary address shown on this Certificate.
From 12:01 a.m. 01 07 19 01 07 20
DESCRIBED AUTOMOBILES
Auto Model Trade Name/ V.I.N./Serial # of Gross Vehicle
Body Type C.C. Price
No. Year Model Number Cyl Weight Rating
Described Automobiles as defined in Schedule 1 providing transportation services originating in the province of Ontario.
Lienholders (to whom loss may be jointly payable)
As per Lienholders (to whom loss may be jointly payable) Schedule (For Ridesharing-Ontario) Attached.

RATING INFORMATION
Auto Driving Record Vehicle Rate Group Com.
Class At Fault Claims/Convictions Surcharge
No BI
PD/
AB
COLL/ Code ACC.
DCPD
COLL/ COMP/ Territory Co. Use
DCPD AP BEN AP SP

As per IPCF 21B attached.

ACCIDENT
INSURANCE COVERAGES: LIABILITY OPCF 44R
BENEFITS
Auto Liability Bodily Property Damage Direct Compensation - Family Protection Standard Uninsured
Perils
No. Limits Injury Property Damage * Endorsement Benefits Automobile
$2,000,000
*This policy contains a partial
Post
payment of recovery clause
acceptance for property damage if a
Limits are the same as As stated in As stated in
$1,000,000 deductible is specified for
Limit direct compensation - property Liability Section unless Section 4 of Section 5 of
Pre Otherwise specified. Policy. Policy.
damage.
acceptance
period

De-
duc- As per IPCF 21B attached.
tible
Prem
in
Doll. INCL. INCL.
LOSS OR DAMAGE** POLICY CHANGE FORMS &
TOTAL PREMIUM
**This policy contains a partial payment of loss clause. OPTIONAL ACCIDENT BENEFITS
A deductible applies for each claim except as stated in your policy.
PER AUTOMOBILE
TOTAL PER AUTOMOBILE
Excluding Collision or Upset Total Loss See reverse side of document for
Peril Auto All Collision
Compre- Specified or Damage details of Policy Change Forms &
s No. Perils or Upset hensive Perils Optional Increased Accident Benefits.
Premium
$1000 $1000

It is a condition precedent to coverage under this F

De- O
policy for collision and comprehensive coverages that
duc- R
the Rideshare Driver, as defined in the IPCF 6TN, has M
tible
collision and comprehensive coverages on their #
underlying personal owner’s policy for the vehicle As per IPCF 21B attached.
used by the Rideshare Driver.
Prem
As per IPCF 21B
in
attached.
Doll.
Remarks: TOTAL POLICY PREMIUM $
MINIMUM NON-REFUNDABLE PREMIUM $
Please read reverse side for additional information on the rating of your policy. For 24/7 CLAIMS SERVICE
This is your Certificate of Automobile Insurance. Contact your Broker/Agent with any 1-866-470-2335
LHT0118 (06/16) Page 1 of 4
 questions or if you require clarification regarding your coverage choices.

For purposes of the Insurance Companies Act (Canada), this document was issued in
the course of the Insurer’s insurance business in Canada.
AUTHORIZED REPRESENTATIVE

Processed Date:

LHT0118 (06/16) Page 2 of 4

 Broker No. Billing Method Policy Number Reason for Issuance
Aon Reed Stenhouse 72564 7J9000184 Renewal
Named Insured and Primary Address
Named Insureds as per Schedule 1

Policy Period D M YR D M YR
To 12:01 a.m. All times are local times at the Named Insured’s primary address shown on this Certificate.
From 12:01 a.m. 01 07 19 01 07 20

Driver Information
Driver Assignment To Vehicle
Driver Name Principal Secondary Occasional
Territory Description
No.

With limits as stated in Section 4 of Policy, the following Optional Increased Accident Benefits will be listed if purchased: Caregiver, Housekeeping & Home
Maintenance; Medical & Rehabilitation & Attendant Care ($130,000/$1,000,000); Optional Catastrophic Impairment (additional $1,000,000 added to
Standard Benefit or Optional Medical, Rehabilitation & Attendant Care Benefit); Death & Funeral; Dependant Care; Indexation Benefit (Consumer Price
Index). Income Replacement ($600/$800/$1000) will be listed with selected limit if purchased.
Policy Change Forms, Surcharges, Discounts, Other Messages

The premium for Uninsured Automobile is included and accounts for 5% of the Accident Benefits (Standard Benefits) premium indicated.

The premium for Liability - Property Damage is included and accounts for 5% of the Bodily Injury premium indicated.

LHT0118 (06/16) Page 3 of 4

 Broker No. Billing Method Policy Number Reason for Issuance
Aon Reed Stenhouse 72564 7J9000184 Renewal
Named Insured and Primary Address
Named Insureds as per Schedule 1

Policy Period D M YR D M YR
To 12:01 a.m. All times are local times at the Named Insured’s postal address shown on this Certificate.
From 12:01 a.m. 01 07 19 01 07 20

This is a brief explanation of the insurance outlined in this Certificate.

Liability - Provides coverage for you or other insured persons if someone else is killed or injured or their property is damaged in an automobile incident. It will pay for legitimate
claims against you or other insured persons up to the limit of your coverage, and the cost of settling claims.
Accident Benefits - Your insurance company is obligated to explain details of Accident Benefits coverage to you.
Provides benefits that you and other insured persons are entitled to receive if injured or killed in an automobile accident. These benefits may include: income replacement for
persons who have lost income; payments to non-earners who suffer complete inability to carry on a normal life; payment of medical, rehabilitation and attendant care expenses;
payment of certain other expenses; payment of funeral expenses and payments to survivors of a person who is killed. You may also purchase optional benefits to increase the
standard level of benefits provided in the policy. The optional benefits your insurance company must offer are: income replacement; medical, rehabilitation and attendant care;
optional catastrophic impairment; caregiver, housekeeping and home maintenance; death and funeral; dependant care; and an indexation benefit.
Uninsured Automobile - Provides coverage if you or other insured persons are injured or killed by an uninsured motorist or by a hit-and-run driver. It covers damage to your
automobile and its contents caused by an identified uninsured motorist.
Direct Compensation - Property Damage - Provides coverage in Ontario, under certain conditions, for damage to your automobile and to property it is carrying, when another
motorist is responsible. It is called Direct Compensation because you will collect from us, your insurance company, even though you are not at fault for the accident. There
may be a deductible amount, and this amount is either paid by you toward the cost of repairs or is deducted from the loss settlement. Higher deductibles may reduce your
premium.
Loss or Damage - Provides a selection of optional coverages for your own automobile. Payments cover direct and accidental loss of, or damage to, a described automobile
and its equipment. There is usually a deductible amount indicated for each coverage and this amount is either paid by you toward the cost of repairs or is deducted from the
loss settlement. Higher deductibles may reduce your premium. There are four types of coverages:
Specified Perils: Covers the described automobile against loss or damage caused by certain specific perils. They are fire; theft or attempted theft; lightning; windstorm; hail or
rising water; earthquake; explosion; riot or civil disturbance; falling or forced landing of aircraft or parts of aircraft; or the stranding, sinking, burning, derailment or collision of any
kind of transport in or upon which the described automobile is being transported.
Comprehensive: Covers a described automobile against loss or damage other than those covered by Collision or Upset, including perils listed under Specified Perils, falling or
flying objects, missiles and vandalism.
Collision or Upset: Covers damage when a described automobile is involved in a collision with another object or tips over.
All Perils: Combines the Collision or Upset and Comprehensive coverages.
OPCF No. 23A - Lienholder Protection - 1. Purpose of this Change - 1.1 This change is part of your policy. It protects the lienholder's interest in your
automobile if you have a claim for a loss covered under Section 6: "Direct Compensation - Property Damage" and Section 7 of your policy, "Loss or Damage
Coverages." 2. Joint Payment - If we are settling a claim with you and your automobile is not repaired or the lost or damaged parts are not replaced, we will
jointly pay you and the lienholder for any loss covered under Section 6 of your policy, "Direct Compensation - Property Damage" and Section 7 of your policy,
"Loss or Damage Coverages." 3. Notifying the Lienholder - If any coverage in Section 6 and/or in a subsection of Section 7 of your policy is cancelled, we
must notify the lienholder in writing at least fifteen days before the cancellation. However, this obligation ends on the exp iry date shown on this form. If you
have purchased any coverage under Section 7 but do not cooperate with any reasonable arrangements we make to inspect your automobile, we must notify
the lienholder in writing. The lienholder's rights under the coverage will not be affected except after 15 days following the date of mailing such notice. All
other terms and conditions of your policy remain the same.

THIS CERTIFICATE CONTAINS IMPORTANT INFORMATION ABOUT YOUR AUTOMOBILE INSURANCE.

Warning: The Insurance Act provides that where (a) an Applicant for a contract, (i) gives false particulars of the described automobile to be insured to the prejudice
of the Insurer, or (ii) knowingly misrepresents or fails to disclose in the application any fact required to be stated therein; or (b) the Insured contravenes a term of
the contract or commits a fraud; or (c) the insured wilfully makes a false statement in respect of a claim under the contract, a claim by the Insured, for other than
such statutory accident benefits as are set out in the Statutory Accident Benefits Schedule, is invalid and the right of the Insured to recover indemnity is forfeited.

Warning - Offences
It is an offence under the Insurance Act to knowingly make a false or misleading statement or representation to an Insurer in connection with the person’s
entitlement to a benefit under a contract of insurance, or to wilfully fail to inform the Insurer of a material change in circumstances within 14 days, in connection
with such entitlement. The offence is punishable on conviction by a maximum fine of $250,000 for the first offence and a maximum fine of $500,000 for any
subsequent conviction.
It is an offence under the federal Criminal Code for anyone to knowingly make or use a false document with the intent it be acted on as genuine and the offence is
punishable, on conviction, by a maximum of 10 years imprisonment.
It is an offence under the federal Criminal Code for anyone, by deceit, falsehood or other dishonest act, to defraud or to attempt to defraud an insurance company.
The offence is punishable, on conviction, by a maximum of 14 years imprisonment for cases involving an amount over $5,000 or otherwise a maximum of 2 years
imprisonment.

Cancellation Request (To be filled out and sign in the event of cancellation).
In consideration of the return of unearned premium, to follow if any, this policy is hereby cancelled an surrendered, and the interm and renewal certificate, if any, for same,
acknowledged to be of no effect.

Time ___________ a.m.

___________ p.m. _____________________________ __________________________________ ________________________________

Effective Date of Cancellation Signature of Insured Signature of Lienholder/Mortgagee/Lessor

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