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Home My WebLink AboutInsurance Certificate: Evoqua Water Technologies A►~o o~ CERTIFICATE OF LIABILITY INSURANCE D 01/09/2 17' F 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 have ADDITIONAL INSURED provisions or 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 Willis of Pennsylvania, Inc. CONTACT NAME: c/o 26 Century Blvd PHONE 1-877-945-7378 FAX 1-888-467-2378 P.O. Box 305191 A/C No Ext~ A/C No): E-MAIL certificates@willis.com Nashville, TN 372305191 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Great American E & S Insurance Company 37532 INSURED EWT Holdings III Corp. INSURER B : Travelers Property Casualty Company of America 25674 Evoqua Water Technologies LLC INSURER C: AIG Specialty Insurance Company 26883 1451 E. Nine Mile Road Hazel Park, MI 48030 INSURER D: Berkley Assurance Company 39462 INSURER E : INSURER F : 0VERAG7ES CER T iFiCA T E NUMBER: wi9::aii3o RCViSION 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. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE IN SD WVD POLICY NUMBER I MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 -1 DAMAGE TO REED CLAIMS-MADE I " OCCUR PREM SES (Ea occu ence $ 1 , 000 , 000 A MED EXP (Any one person) $ Y PL 9953269 12/31/2016 12/31/2017 2,000,000 PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY Ll PRO JECT El LOC j PRODUCTS - COMPIOP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED Y TC2JCAP 8B350790-16 12/31/2016 12/31/2017 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ L UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- Per Statute AND EMPLOYERS' LIABILITY YIN STATUTE ER B ANYPROPRIETOR/PARTNER/EXECUTiVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? No N/A TC2J UB 8B35073A-16 7.2/31/2016 12/31/2017 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C Contractors Pollution Liabil?ty eP.0 261540:7 01!15/2 15 01!]5/2018 Per Incident/A gr. $2,000,000 Deductible: $250,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS, AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS AS RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY, IF REQUIRED BY WRITTEN CONTRACT. GENERAL LIABILITY POLICY SHALL BE PRIMARY AND NON-CONTRIBUTORY WITH ANY OTHER INSURANCE IN FORCE FOR OR WHICH MAY BE PURCMSSED BY ADDITIONAL INSUREDS, IF REQUIRED BY WRITTEN CONTRACT. 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, OREGON AUTHORIZED REPRESENTATIVE ATTN: KARI OLSON p 90 N. MOUNTAIN AVENUE ASHLAND OR 97520 Ca 198-3-21015 ACORD CORPORATiiIN". Nii ri-yh s teseived. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 13908886 BATCH: Batch 276737 AGENCY CUSTOMER ID: LOC ACS ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AG"NCY NAMED INSURED Willis of Pennsylvania, Inc. EWT Holdings III Corp. Evoqua Water Technologies LLC POLICY NUMBER 1451 E. Nine Mile Road See Page 1 Hazel Park, MI 48030 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance INSURER AFFORDING COVERAGE: Berkley Assurance Company NAIC#: 39462 POLICY NUMBER: PCAB-5001434-0216 EFF DATE: 12/31/2016 EXP DATE: 12/31/2017 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Contractors Prof. Liab. Occ./Agg.: $2,000,000 CJ SIR Per Claim: $500,000 ACuRu 101 (2008ful) 2008 ACORD CORPGRATi-N. Ail rigirfs reserved. The ACORD name and logo are req~istered marks of ACORD SR ID: 13908886 BATCH: Ba ch 276737 CERT: W1908636