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HomeMy WebLinkAboutInsurance Certificate: Thatcher Company THATCOM-01 ESTATHIS ,AC''C~RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6!1612017 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 fSSUING INSURER(S), AUTHORIZED REPRESENTATIVE 0R PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: tf 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 endorsements). PRODUCER NAMEACT Deila R. Zeeh, CPCU, CIC The Presidio Group, InC. PHONE 801 290-3181 Alc No ; 6967 South River Gate Drive, #200 AIC No Ext): ( ~ Salt lake City, UT 84047 AoDRess: dzeeh@presidio-group.com INSURER(Si AFFORDING COVERAGE NAIC # _ _ INSURERA:AIG Specialty Insur. Co. 126883 INSURED INSURER B :Nat'l Union Fire Ins. Co. PA _ '~~19445 Thatcher Company, Inc. eta! see named insureds attached INSURER C ;New Hampshire Insurance Ca. 1,23841 _ PO Box 27407 INSURER D :Everest National Insurance Co X10120 Salt lake City, UT 84104-3724 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDYIY1fYY MMIDDYIYYYY i LIMITS LTR IN D WVD A X COMMERCIAL GENERAL LIABILITY j EACH OCCURRENCE $ 1,000,000 DAM E T ELATED CLAIMS-MADE ~ OCCUR X EG23060782 0410112017 0410112018 PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) ~ $ _ 25,000 PERSONAL & ADV INJURY 1 r000~~~Q - I, GEN'L AGGREGATE LIMIT APPLIES PER: ~ ~ j GENERAL AGGREGATE I $ 2,000,000 X POLICY ~ PRO ~ LOC i PRODUCTS - COMPIOP AGG ~ $ 2,000,000 JECT OTHER. POLLUTION LEGAL ~ $ 1,000,000 AUTOMOBILE LIABILITY ~ I ~ ~ COMBINED SINGLE LIMIT ; $ 1,000,000 ~Ea accident) ~ B x ANY AUTO ~ X CA4489610 ~ 04101/2017 0410112018 'BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS ( I j BODILY INJURY (Per accident) ~ $ NON-OWNED ( l PROPERTY DAMAGE HIRED AUTOS AUTOS i I i Per accident $ ~ $ UMBRELLA LIAR X OCCUR ~ EACH H OCCURRENCE I~ $ 6,000,000 A X ~ EXCESS LIAB 000,000 CLAIMS-MADE j EGU23060878 0410112017 ~ 0410112018 I AGGREGATE $ _ s~^ - i $ DED RETENTION $ WORKERS COMPENSATION ~ PER ~ OTH- ~ ~ ~x STATUTE ~ ER AND EMPLOYERS LIABILITY ~ ! C ANY PROPRIETORIPARTNERIEXECUTIVE YIN IWC015893603 ~ 04101/2017 0410112018 ' E.L. EACH ACCIDENT ` $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ N I A I I (Mandatory in NH) ~ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under ~ i DESCRIPTION OF OPERATIONS below ~ ; E.L. DISEASE -POLICY LIMIT i $ 1,000,000 A Pollution Liability ;EG23060782 0410112017 0410112018 jLimit 1,000,000 D Motor Truck Cargo ;IM8CM00012171 ~ 0410112017 0410112018 CARGO 100,000 DESCRIPTION OF OPERATIONS !LOCATIONS /VEHICLES (ACORD 1Q1, Additional Remarks Schedule, may be attached if more space is required! Verification of insurance subject to the terms and conditions of the policy. City of Ashland, Oregon, and its elected officials, officers and employees are Additional Insured with respect to General Liability and Auto Liability. Coverage is primary and non-contributory as long as no other insurance applies. 30 day notice of cancellation applies except for non-payment of premium which is 10 days notice. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ~~Gi ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CA 448-96-10 COMMERCIAL AUTO CA 20480299 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person{s} or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 04 / 01 / 2 0l 6 Countersigned By: i Named Insured: THATC~IER COMPANY {Authorized Representative} SCHEDULE Name of Person{s~ or Organization{s}: Per Written Contract and or Agreement CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 (If na entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to the endorsement. Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the UUha Is An Insured Provision contained in Section II of the Coverage Form. Page 2 of 2 Copyright, Insurance Services Office, Inc., 1998 CA 20 48 02 99