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HomeMy WebLinkAboutInsurance Certificate: TRISTAR Insurance Group (5) DATE (MM/DD/YYYY) A~QR° CERTIFICATE OF LIABILITY INSURANCE 12/21/2017 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 endorsements . PRODUCER CONTACT NAME: COrbee Slmoneau Arthur J. Gallagher 8, Co. PHONE 818-539-1225 FAX 818-539-1525 Insurance Brokers of CA, Inc. License #0726293 (ALC. No. Exu:- _ lac o _ E-MAIL corbee_simoneau@ajg.com 505 N. Brand Boulevard, Suite 600 ADDRESS: Glendale CA 91203 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :American Guarantee and Liability Ins Co i 26247 INSURED TRISINS-03 INSURER B ACE American Insurance Company 22667 TRISTAR Insurance Group, Inc. INSURER c :Zurich American Insurance Company 16535 100 Oceangate Avenue, Suite 700 Long Beach, CA 90802 INSURER D :Great American E&S Insurance Core 37532 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 2060582527 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. INSFI TYPE OF INSURANCE ADUL SUBR° - - - POLICY EFF POLICY EXP r LIMITS LTR INSD WVD POLICY NUMBER MMlDD/YYYY MbVDDIYYYY C X COMMERCIAL GENERAL LIABILITY CP05543602.05 1/112018 1/1/2019 EACH OCCURRENCE $1,000,000 -DAMAGE S a CLAIMS-MADE X OCCUR PREMISE oNccu ~nce$1,000,000 MED EXP (Any one person) $10,000 $1,00_0,000 X ContraCtll21-Liab ~PERSON_AL&ADVINJURY GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2,000,000 POLICY JECOT- X LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: ' C AUTOMOBILE LIABILITY CP05543602-05 1/1/2018 1/1/2019 (ECOMBINED SINGLE LIMIT aacr:ident) - $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) j $ AUTOS ONLY AUTOS 1 HIRED r NON-OWNED I ( ~fiOPERT46AMAG~ - X AUTOS ONLY X AUTOS ONLY (Per accident] $ Comp. & Coll Ded. $500 A UMBRELLA LIAB X i OCCUR AUC5543479.05 1/1/2018 1/1/2019 EACH OCCURRENCE $7,000,000 X 1 EXCESS LIAB CLAIMS-MADE AGGREGATE $7,000,000 DED RETENTION $ WORKERS COMPENSATION STATUTE ~R AND EMPLOYERS' LIABILITY - - ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N N /A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - _EA EMPLOYE_ $ If yyes. descrbe under, - E E.L. DISEASE -POLICY LIMIT $ D SGRIPTION OF OPERATIONS below B Crime DON G23670410 005 1131!2017 1131/2018 ,Aggregate $ 10,000,000 D Errors & Omissions TER 317-74-31 1/31/2017 1/31/2018 Aggregate $10,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Ashland is named additional insured under General Liability as respects their interest in the operations of the Named Insured. 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 90 N. Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 USA AUTHORIZED REPRESENTATIVE of ii ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD it I I i I 00-6184 2 of 2 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 50S N. Brand Boulevard, Suite 600 Glendale, CA 91203 II II 6184 1 MB 0.420 CITY OF ASHLAND 00 6184 90 N MOUNTAIN AVE ASHLAND, OR 97520-2014 I I I I I r~ II i 00-6184 1 of 2