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Home My WebLink AboutInsurance Certificate: Univar USA Inc (2) A` ° CERTIFICATE OF LIABILITY INSURANCE DATD," " 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 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 '00 Aon Risk Services Central, Inc. NAME: Philadelphia PA Office INC.NN.. EXt: (866) 283-7122 aC No : 800-363-0105 c One Liberty Place E-MAIL p 1650 market Street - ADDRESS: _ Suite 1000 Philadelphia PA 19103 USA INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A National Union Fire Ins CO of Pittsburgh 19445 UNIVAR USA INC INSURER B: New Hampshire Ins CO 23841 17425 NE Union Hill Road Redmond WA 98052-3375 USA INSURER C: Illinois union Insurance Company 27960 INSURER D: eISURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 570053020165 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 INSD MD POLICY NUMBER MPOLICY L" OUCY LAP MlDD MMID LIMITS X COMMERCIAL GENERAL EDIBILITY GL 03/01/2014 03/01/2015 EACH OCCURRENCE $3,000,000 X~occuR SIR applies per policy terns & condi ions $300,000 PREMISES Ea CI-AIMS-MADE X .-112,000,0W NED EXP(Anyone person) EXCluded PERSONAL &ADV INJURY $3,000,000 m GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $3,000,000 N X POLICY ❑ PRO F-] LOC PRODUCTS -COMP/OP AGG $3,000,000 N G OTHER: Or A AUTOMOBILE LIABILITY CA 4806890 03/01/201403/01/2015 COMBINED SINGLE LIMIT $$,000,000 m Truckers Liability (ADS) A X ANY AUTO CA 4806891 03/01/201403/01/2015 BODILY INJURY( Per person) O 2 ALL OWNED SCHEDULED Truckers Liability (MA) BOOILY INJURY (Per evident 0 A AUTOS AUTOS CA 4806892 03/01/2014 03/01/2015 m HIRED AUTOS PROPERTY DAMAGE AUTOS ~EO Truckers Liability (VA) Per amdenl G C O C % UMBRELLA LIAR X OCCUR XCEG27380566001 03/01/2014 03/01/2015 EACH OCCURRENCE $4,000,000 U EXCESS UAB oCCMSMADE AGGREGATE $4,000,000 DED % RETEMION 3500,000 B WORKERS COMPENSATION AND W0001591220 03/01/2014 03/01/2015 X STATUTE 0TH- EMPLOYERS' LIABILITY ANY PROPRIETOR I PARTNER I EXECUTIVE YIN WADS I C1 EL EACH ACCIDENT $1,000,000 A OFFICERIMEMSER EXCLUDEOx Ifl NIA C1591222 03/01/2014 03/01/2015 IMantlatory in NH) CA, OH, OR & WA E. L. DISEASE-EA EMPLOYEE $1,000,000 I(y Ee antler SCRIPTIIPTION OF OPERATIONS below SIR applies per policy ter .5 & condT tors EL. DISEASE-POLICY L'-'!T $1,000,000- DE _ rE¢' DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACOR0101, Atltlitiorul Ramarka ScM1etluM, may M aNCM1etl a narc apace is requlrcd) T RE: Contract to supply water Treatment Chemicals, Ashland, City of waste water Treatment Plant. iF CERTIFICATE HOLDER CANCELLATION Ile- 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 iIL~16C~Ld - pe~sta cXlosa 01988-2014 ACORD CORPORRAT1T100N. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMERID: 570000014538 LOC ® ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Central, Inc. UNIVAR USA INC POLICY NUMBER see Certificate Number: 570053020165 CARRIER NAIC CODE see Certificate Number: 570053020165 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER J ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY MLICT SUHR LTR INSR TYPE OF INSURANCE IAM1'SDOD WVD VD L POLICI'NUMBER EFFECTIVE EEPIRATION LIMITS LT DATE DATE. MM/IIDItTTI' MM/DDIITtT AUTOMOBILE LIABILITY A CA 4806893 03/01/2014 03/01/2015 Combined s5, 000, 000 Commercial Auto (ADS) Single Llmi A CA 4806894 03/01/2014 03/01/2015 Commercial Auto (MA) A CA 4806895 03/01/2014 03/01/2015 Commercial Auto (VA) WORKERS COMPENSATION B N/A W0001591223 03/01/2014 03/01/2015 MA, ND, WI, WY R N/A W0001591221 03/01/2014 03/01/2015 FL , 8 N/A WC012948466 03/01/2014 03/01/2015 IL, KY, NC, NH, UT B N/A 1WC012948467 4 03/01/2015 AK, AZ, GA 8 N/A WC012948468 03/01/2014 03/01/2015 NJ, PA ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD