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Insurance Certificate: TRISTAR Insurance Group, Inc.
AC"RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) F2/1/2018 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 NCONTACT AME: Corbee Simoneau_ Arthur J. Gallagher & Co. PHONE Eytl 818-539-1225 (n/c. Nor 818-539-1525 Insurance Brokers of CA, Inc. License #0726293 - - - E-MAIL corbee_simoneau@a com 505 N. Brand Boulevard, Suite 600 DRESS Jg Glendale CA 91203 INSURER(S) AFFORDING COVERAGE NAIC N INSURER A American Guarantee and Liability Ins Co 26247 INSURED TRISINS-03 INSURER B ACE American Insurance Company 22667 TRISTAR Insurance Group, Inc. INSURER c: Zurich American Insurance Com an 16535 100 Oceangate Avenue, Suite 700 INSURER D :Great American E&S Insurance Compaan 37532 Long Beach, CA 90802 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 656233856 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 I,ADDLSUBR POLICY EE POLICY EXP LIMITS LTR INSD WVD' POLICY NUMBER MM/DD/YYYY MM/DD/YYYY C X COMMERCIAL GENERAL LIABILITY CP05543602-05 1/1/2018 1/112019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTEU__ CLAIMS-MADE 'LX OCCUR PREMISES (Ea occurrence) 51,000,000 MED EXP (Anyone person) $10,000 _ Contractual Llab PERSONAL & ADV INJURY $1,000,000 X GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2,000,000 POLICY ~i PE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: E C AUTOMOBILE LIABILITY CP05543602-05 11112018 1/1/2019 Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident)' $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDATJAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ _ Comp. & Coll Ded. $500 A 4 UMBRELLA une X i OCCUR AUC5543479-05 11112018 1!112019 EACH OCCURRENCE $7,000,000 X 1 EXCESS LIAB CLAIMS-MADE_ AGGREGATE !i E7,000,000 DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N, ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L. EACH ACCIDENT $ If OFFICER/MEMBER EXCLUDED - (Mandatory in Nnd ' LE.L. DISEASE - FA E.L. DISEASE -POLICY LIMIT T E $ yes, describe under I I, DESCRIPTION OF OPERATIONS below $ B Crime DON G23670410 006 1/3112018 1/31/2019 :Aggregate $ 10,000,000 D Errors & Omissions TER 317-78-31 1/3112018 1131/2019 !Aggregate $10,000,000 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD