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Home My WebLink AboutInsurance Certificate: Univar USA Inc ACOROm DAT (MMIDD1 ) CERTIFICATE OF LIABILITY INSURANCE 0 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: H the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. H 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 we certificate holder In lieu of such endoreement(s). c T m PRODUCER CONTAC HIJ�: 9 Aon Risk Services Central, Inc. PHON FAX Philadelphia PA Office W Ne.Eery: (866) 283-7122 A¢He.): (Sal) 953-5390. 9 One Liberty Place ADDRESS, _ 1650 market Street suite 1000 Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAICa INSURED INSURER A, Illinois National Insurance CO 23817 UNIVAR USA INC INSURER B: National Union Fire Ins Co of Pittsburgh 19445 17425 NE Union Hill Road Redmond WA 98052-3375 USA INSURER C: Insurance Company of the State of PA 19429 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570045381958 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. Umits shown ere as requested LTR TYPE OF INSURANCE INSR WD POLICY NUMBER MMDD MIND LIMITS GENERAL LIABLLRP GL EJCHOCCURRENCE $3,000,000 X COMMERCIAL GENERAL LIABILITY SIR applies per policy ter is & condi ions $300,000 PREMISES Ea ovvmnoe CLAIMS-MADE %❑OCCUR MED EXP(Any one Person) $10,000 X SIR:52,000,000 PERSONAL S ADV INJURY $3,000,000 GENERAL AGGREGATE $3,000,000 m GENL AGGREGATE LIMB APPLIES PER: PRODUCTS-COMPIOP AGG E3,000,000 X POLICY PR6 LOC 25 n 8 AUTOMOBILE uAa1LJTY CA 480 890 03/01/2012 03/01/2013 COMBINED SINGLE LIMIT $5,000,000 m Truckers Liability (ADS) B X ANY AUTO CA 4806891 03/01/2012 03/01/2013 BODILY INJURY(Per Person) Z ALL OWNED SCHEDULED Truckers Liability (MA) BODILY INJURY(Per acddenry z B AUTOS AUTOS CA 4806892 03/01/2012 03/01/2013 PROPERTY DAMAGE HIRE D AUTOS ALICE NEO Truckers Liability (VA) Peremdent m ULDIRELLALIAB OCCUR EACH OCCURRENCE U EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION C WORKERS COMPENSATION AND WC001591220 03/01 2012 03/01/2013 WC STATU- OTH' EMPLOYERS'LMBRJTY X TORY LIMBS IE O FIOf�ETORIPMTNEOI�CUT� Y�NIA SIR applies per policy terns & Condi ions EL EACH ACCIDENT $1,000,000 (Mandatory in NM E.L.DISEASE-EA EMPLOYEE $1,000,000 K deamee eeder DESCRIPTION OF OPERATIONS N,bw EL DISEASE-POLICY LIMIT $1,000,000_ �i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(AeacM1 ACORD 101,Atltlltlanel Remarks SPMtlub.11 more space b raeulrod) �- RE: Contract to Supply Water Treatment Chemicals, Ashland, City of waste water Treatment Plant. Mn J�J CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Kari Olson 90 N. Mountain Road Ashland OR 97520 USA 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for UNIVAR USA INC The terms,conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s).This attachment does not contain all terms,conditions,coverages or exclusions contained in the policy. INSURER INSURED UNIVAR USA INC INSURER 17425 NE Union Hill Road Redmond WA 98052-3375 USA INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL Stan POLICYNUMBER/ POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR wVD POLICYDESCRIPTION (MWDDNYYV) (MMIDDXVYY) LIMITS AUTOMOBILE LIABILITY 1 B CA 4806893 3/01/2012 03/01/2013 combined 55,000,000 Commercial Auto (AOS) Single Limi g CA 4806894 3/01/2012 03/01/2013 Comercial Auto (MA) B CA 4806895 3/01/2012 03/01/2013 Commercial Auto (VA) WORKERS COMPENSATION B N/A WC1591222 3/01/2012 03/01/2013 CA, OH, OR & WA SIR applies per policy teams & condit ons A N/A WcO01591223 3/01/2012 03/01/2013 WI ISIR applies per policy to ms & condit ons C N/A W0001591221 3/01/2012 03/01/2013 FL { SIR applies per policy teams & Condit ons A N/A WC001591224 TX SIR applies per policy to ms & condit ons 1 I 1 1 1 i Certificate No 570045381958 I CERTIFICATE OF LIABILITY INSURANCE OATE=812012 YY) 02/28/2012 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: N the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. N 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 a mrtificote holder in lieu of such endorsement(s). PRODUCER CONTACT O ADO Risk services Central, Inc. PHONE (866) 283-7122 FAX (847) 953-5390 m Philadelphia PA office (AIC.NO.En: AIC.No.: y One Liberty Place EM�DRE53: O 1650 market Street = suite 1000 Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A Illinois National Insurance CO 23817 UNIVAR USA INC INSURER B: National Union Fire Ins CO of Pittsburgh 19445 17425 NE Union Hill Road Redmond WA 98052-3375 USA INSURER C: ACE Property & Casualty Insurance Co. 20699 INSURER D: Insurance Company of the State of PA 19429 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570045376674 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. Limits shown are as requested LTR TYPE OF INSURANCE INBR WVD POLICY NUMBER I M OD MMOD LIMITS GENERAL LABILITY GL UJ/UI/ZUIZ EACHOCCURRENCE $3,000,000 X COMMERCIAL GENERAL LABILITY SIR applies per policy terns & condi ions $300,000 PREMISES Eaocarmnce CAMS-MADE El OCCUR MED EXP(Any one person) $10,000 X SIR:$2,000,000 PERSONAL&AM INJURY $3,000.005 I;. GENERALAGGREGATE $3,000,000 G 1-AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $3,000,000 X POLICY PR_ LOC S JECT n B AUTOMOBILE 11ABILrrY CA 4 06890 01 201 03/01/2013 COMBINED SINGLE LIMIT $5,000,000 Truckers Liability (ADS) B X ANY AUTO - CA 4806891 03/01/2012 03/01/2013 BODILY INJURY(Per person) _ ALL OWNED SCHEDULED - Truckers Liability (mA) BODILY INJURY(Per aakenp z B AUTOS AUTOS CA 4806892 03/01/2012 03/01/2013 HIRED AUTOS NONONNED PRO PERTYCAMAGE AUTOS Truckers Liability (VA) Peramtlem C Y e C X ume0.ELU LAB % OCC1M5�lMOE UR XDOG25914922 03/01/2012 03/01/2013 EACH OCCURRENCE $4,000,000 EXCESS LIAR CL4 O SIR applies per policy ter is & Condi ions AGGREGATE 54,000,000 DEO I X RETENTION$500,000 D WORKERS COMPENSATION AND WC001591220 03 0112012 03/01 2013 X TORY LIMBS OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR I PARTNER IEXECIfTNE YIN SIR E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER E%OLUDED, NIA SIR applies per pO11Cy ter is & COndl 1005 (Mandatory in NM EL.DISEASE-EA EMPLOYEE $1,000,000 DES d—beands, DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s1,000,000_ DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(AeacM1 ACORD 101,A441tlanel Remarks Schedule,K more apace V rpuind) I� RE: Bid #2008-101 & Bid 2008-102, SuperflOC N-300 LM; Calcium Hypothlorite; Caustic Soda; Sodium HypochlDrite; SBS; Location: `P- Portland. City of Ashland and all employees are included as Additional Insured on the General Liability and Automobile Liability Policies with respect to written contract. Univar is self-insured for physical damage to their vehicles. i' 2 CERTIFICATE HOLDER CANCELLATION -=�.A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Kari Olson 90 mountain Avenue � �` Ashland 9 OR 97520 USA 61988-2070 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for UNIVAR USA INC The terms,conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s).This attachment does not contain all terms,conditions,coverages or exclusions contained in the policy. INSURER INSURED UNIVAR USA INC INSURER 17425 NE Union Hill Road Redmond WA 98052-3375 USA INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate to=for policy limits. INSR ADDL SUBR POLICY NUMBER/ POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR wVD POLICY DESCRIPTION (MM/DD/Pl'YY) (MM/DD/YYYY) LIMITS AUTOMOBILE LIABILITY B CA 4806893 3/01/2012 03/01/2013 Combined $5,000,000 Commercial Auto (ADS) Single Limi g CA 4806894 3/01/2012 03/01/2013 Commercial Auto (MA) B CA 4806895 3/01/2012 03/01/2013 Commercial Auto (VA) WORKERS COMPENSATION B N/A WC1591222 3/01/2012 03/01/2013 CA, OH, OR & WA SIR applies per policy teims & Condit ons A N/A wc001591223 3/01/2012 03/01/2013 WI SIR applies per policy teims & condit ons D N/A W0001591221 3/01/2012 03/01/2013 FL SIR applies per policy to ms & condit ons A N/A WC001591224 TX SIR applies per policy to ms & condit ons 1 i I I 1 1 1 {' Certificate No: 570045376674 I I rt� I