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HomeMy WebLinkAboutInsurance Certificate: Tristar Insurance Group PRIU„_NxII OOI CERTIFICATE OF LIABILITY INSURANCE O 02/13/2013 02/13 13 ' 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 rv REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. C IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 1-818-539-2300 CONTACT `O r NAMES Arthur J. Gallagher F CO. PHONE tFAX - Insurance Broker. of California, Inc. License #0726293 pUC,NO.EM):_ 505 North Brand Boulevard, Suite 600 E-MAIL - > ADDRESS:-- z. Glendale, CA 91203-3994 INSURER(S)AFFORDING COVERAGE NAIC4 818-539-2300 INSURERA: AMERICAN ZURICH INS CO 40142 INSURED INSURERS: AMERICAN GUAR R LIAB INS- -126247 26 - TRISTAR Insurance Group, Inc. INSURER C : ACBAMER 2N5 CO T 122667 100 Oceangate Avenue, Suite 700 INSURERD: WESTCHESTER FIRE INS CO__-,__ 21121 Long Beach, CA 90802 INSURER F: COVERAGES CERTIFICATE NUMBER: 31989497 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. - AUOUSUBR ILTR. -TYP -POLICY EFF POLICY E%P _I LTRi TYPE OF INSURANCE POLICY NUMBEfl MMIODIYYYYI MMIODIYYYY LIMITS A i GENERAL LIABILITY CP0554360200 01/01/13 01/01/14 _ _ DAMAGE TORREME EWED I g 1, 000, 000 R D _ COMMERCIAL GENERAL LIABILITY PREMISES S ( (Ea occunerce)._ $1,000,000 - CLAIMS-MADE f 1 OCCUR _MED_E%P(Any one person) _ S 10,000 X Incl. Contractual Liab 1,000, 000 PERSONALfl ADV INJURY S GENERAL AGGREGATE- _ f $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPOP AGG $2,000,000 POLICY rI PRO. X LOC I - _GG FC.T A AUTOMOBILE LIABILITY I 'CP0554360200 01/01/1.3 1 Dl /19 COMBINED SINGLE LIMIT I I.(Eaaccodent) __J$1'000'000 _ X _I ANYAUTO i BODILY INJURY (Par person)- S ~ 1 AUTOS AILLOWNED _ SCHEDULED 50DILY INJURY fPer accident), S r-1 F HIRED AUTOS NNON,DWNED f- PROPERTY DAMAGI? X Corry. Ded. X Coll. Ded. i fPer accident)__. _ B UMBRELLA LIAR X OCCUR AUCS54347900 01/01/13 01/01/14; EACHOCCURRENCE i5 7,000,000 j __LAIMS MADE E%tE$$LUB ( AGGREGATE s7 000,000 - - - - -I DEO _RETENTION_ 1_ CS I _ g WORKERS COMPENSATION WCSTATU- OTH- ANDEMPLOYERS'LIABILITY YIN TORY LIMITSLER ANY PROPRIETORIPARTNERIE%ECUTIVE OFFICER/MEMBER NIA E.L. EACH ACCIDENT $ E%CLUDEDi ❑ (Mende.,InNH) I E.L.DISEASE - EA EMPLOYEES _ 11 yes.desOiGeuMer rr DESCRIPTIONOFOPERATIONSbelow EL. DISEASE-POLICY LIMBS Li Crinse s Omi..ione I GG25659223 001 02/07/13, 23670410 001 01/31/13 01/31/141 Limit ofeLiability 50000, 0 0 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAUach ALORD 101, Additional Remade Schedule, 11 more apace Is required) City of Ashland is named additional insured under General Liability as respects their interest in the Operations of the Named Insured. GL Al FORM U-GL-1175-C CN (07/10) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Bari Olson 90 N. Mountain Ave. AUTHORNED REPRESENTATIVE Ashland, OR 97520 J /~ylut+wl y` I USA L V/ CC{(1 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD njuhansing 31989497 P536uuIlYNi3 Arthur J. Gallagher & Co. - 505 North Brand Boulevard, Suite 600 Glendale, CA 91203-3944 Electronic Service Requested E B I X B PO 0 3-DIGIT 975 14856 0.5234 AT 0.381 Ii111~'Ilpplllll'~Il~llrrrl~r~rlr~rrrrr~lr~ll'II~1~~1'II111111' Cityy of Ashland 41 90 N MOUNTAIN AVE. ASHLAND. OR 97520-2014 z W This document was brought to you by Ebix/CertificateaNow and Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. in Glendale, CA.- Any documents forwarded with the certificate request were reviewed for the sole purpose of completing the certificate.- If you have questions regarding the content of this document, please contact - the Producer/Agent listed on the certificate of insurance. - The data included in this notice and in the attached document is confidential to - Ebix/CertificateaNow and Arthur J. Gallagher & Co. Insurance Brokers of California, Inc.- cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by Cer ificatesNOw - www.Confi"Net wm - 877.669.8600