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HomeMy WebLinkAboutInsurance Certificate: Zoll Medical Corporation ACORO® DATE(6MM6/DUD,NYYY) 08 CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT 'aa NAME: Aon Risk services South, Inc. PHONE FAX Atlanta GA Office (A/C. No. Ext): (866) 283-7122 <800) 363-0105 3550 Lenox Road NE E-MAIL p Suite 1700 ADDRESS: _ Atlanta GA 30326 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Trans Pacific Ins Co 41238 ZOLL Medical corporation INSURER B: TOkio Marine America Insurance Company 10945 269 Mill Road Chelmsford MA 01824-4105 USA INSURER C: The Travelers Indemnity Co. 25658 INSURER D: Federal Insurance Company 20281 INSURERE: Mitsui Sumitomo Insurance USA Inc. 22551 INSURER F: COVERAGES CERTIFICATE NUMBER: 570071941523 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 ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLL 07/01/2018 671011201~ EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑ OCCUR PREMISE S DAMA ES( E. RENTED occurrence $1,000,000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 N ,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000 2 : a X POLICY ❑PEO ~LOC PRODUCTS - COMP/OPAGG Excluded ;z 0 OTHER: CDr B CA6409761 01 0710112018 07/01/2019 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $1,000,000 Ea accident X ANYAUTO BODILY INJURY ( Per person) Z OWNED SCHEDULED BODILY INJURY (Per accident) N AUTOS ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY (Per accident) _ E Q E X UMBRELLA LIAB X OCCUR EXS5200217 07/01/2018 07/01/2019 EACH OCCURRENCE $25,000,000 U EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED RETENTION C WORKERS COMPENSATION AND UBS3319473 07/01/2018 07/01/2019 X STATUTE OTH EMPLOYERS' LIABILITY IER ANY PROPRIETOR / PARTNER /EXECUTIVE Y❑ E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000 If yes describe under E DESCRIPTION OF OPERATIONS below L. DISEASE-i'ULICr Limit $l, OOO, O00 - D Products Liab 36019266 07/01/2018 07/01/2019 Prod/Comp Ops/Agg $5,000,000 - Retro Date 10/1/2004 Prod/Comp Ops/Occ $5,000,000 Deductible $200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Products Liability - claims made coverage. The City of Ashland is included as Additional Insured in accordance with the policy provisions of General Liability Policy CPP6403426-06. ti 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 AUTHORIZED REPRESENTATIVE Attn: Kariann Olson OIL= 90 N. Mountain Avenue ~Q~tf~, Ashland OR 97520 USA c..~on v ~~st2 4 cJ ~ p✓~ - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000057723 LOC Page _ of _ ADDITIONAL REMARKS SCHEDULE AGENCY NAMEDINSURED Aon Risk Services South, Inc. ZOLL Medical Corporation POLICY NUMBER See certificate Number: 570071941523 CARRIER NAIC CODE See Certificate Number: 570071941523 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 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 POLICY INSR ADDL SUBR EFFECTIVE EXPIRATION LTR TYPE OF INSURANCE INSD WVU POLICY NUMBER LIMITS DATE DATE (MM/DD/1'YYY MM/DD/YY'YY EXCESS LIABILITY D 79882432 07/01/2018 07/01/2019 Aggregate $5,000,000 Ex Products Liab Each $5,000,000 Occurrence ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD