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HomeMy WebLinkAboutInsurance Certificate: Thatcher Company, Inc. Aco " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/VYYY) 3/23/2018 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 CONTACT NAME: Della R. Zeeh Arthur J. Gallagher Risk Management Services, Inc. PHONE 801-924-1400 FAX 801-924-1441 6967 South River Gate Drive, #200 E-MAIL DRESS- rece tion residio- rou com Salt Lake City UT 84047 P @P 9 P INSURERS AFFORDING COVERAGE NAIC # INSURERA:AIG Specialty Insurance Company 26883 INSURED THATCOM-01 INSURER B: National Union Fire Insurance Company of 19445 Thatcher Company, Inc. INSURERC:New Hampshire Insurance Company 23841 P O Box 27407 Salt Lake City UT 84127 INSURER D: Everest National Insurance Company 10120 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1297171199 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y EG14246248 4/1/2018 4/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE FxIOCCUR PREMISES DAMAGE TOERa ENTED occurrence $300,000 MED EXP (Any one person) $25,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY F-] PRO ❑ LOC PRODUCTS - COMP/OP AGG $2,000,000 JECT OTHER: POLLUTION LEGAL $1,000,000 B AUTOMOBILE LIABILITY Y CA4489610 4/1/2018 4/112019 Ea OMINED accident SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ L I $ A UMBRELLA LIAB X OCCUR EGU14246249 4/1/2018 4/1/2019 EACH OCCURRENCE $6,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED RETENTION $ $ C WORKERS COMPENSATION WC015893603 4/1/2018 4/1/2019 X SPER TATUTE OERH AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 D Motor Truck Cargo IM8CM00012171 4/1/2018 4/1/2019 Cargo 100,000 A Pollution Liability EG14246248 4/1/2018 4/1/2019 Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Verification of insurance subject to the terms and conditions of the policy Named Insured's: Thatcher Company, Inc. Thatcher Group, Inc. Thatcher Transportation, Inc. Thatcher Company of Arizona, Inc. See Attached... 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 ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 USA AUTHORIZED REPRESENTATIVE __Zawq~ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: THATCOM-01 _ LOC A~R,It7►R"a~ ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J. Gallagher Risk Management Services, Inc. Thatcher Company, Inc. P O Box 27407 POLICY NUMBER Salt Lake City UT 84127 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Thatcher Company of California, Inc. Thatcher Company of Montana, Inc. Thatcher Company of Nevada, Inc. Thatcher Company of New York, Inc. Thatcher Chemical of Florida, Inc. Thatcher Pharmaceuticals, Inc. Thatcher Company of North Dakota, Inc. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CA 448-96- 10 COMMERCIAL AUTO CA 20 48 02 99 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 organizationis) 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 /2018 Countersigned By: Named Insured: THATCHER COWANY, INC. (Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): AS REQUIRED PER WRITTEN CONTRACT CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 (If no 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 Who 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 ENDORSEMENT NO. 13 This endorsement, effective 12:01 AM, April 1, 2018 Forms a part of Policy No.: EG 14246248 Issued to: THATCHER COMPANY By: AIG SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGES A. B AND E ADDITIONAL INSURED - DESIGNATED PERSON(S) OR ORGANIZATION(S) ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM Solely as respects Coverages A, B and E, SECTION 11 - WHO IS AN INSURED is amended to include as an insured the person(s) or organization(s) shove) in the Schedule below, but only with respect to bodily injury, property damage, personal and advertising injury, environmental damage or emergency response costs caused in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your work; or B. In connection with your premises owned by or rented to you. SCHEDULE Name of Additional Insured Person(s) or Organization(s): BLANKET WHERE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT I All other terms, conditions, and exclusions shall remain the same. UTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 103366 (9111) PAGE 1 OF 1 C15034 4. Other Insurance Applicable to Coverages A, B and E If other valid and collectible insurance is available to the insured for damages or loss we cover under Coverages A B or E of this Policy, our obligations are limited as follows: a. Primary Insurance s insurance is primary exce==;a.1m.nus below applies. If this insurance is primary, ou ations are not affected unless any of the othes also primary. Then, ws will share with all that other i ranee by the method described in c. beloHowever, regardless of whethepplies, in the event that a written contract or agreement or ermit requires this insurance to be prperson or organization with whom you agreed to insur nd such rson or organization is an ithis policy, we will not seek contributions f y such other insuran to stion. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for your work; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner; or (d) If the damages or loss arises out of the maintenance or use of aircraft, autos or watercraft to the extent not subject to Exclusion g. of Coverage A. (2) Any other insurance available to you covering liability for damages arising out of the premises or operations for which you have been added as an additional insured by attachment of an endorsement When this insurance is excess, we will have no duty under Coverage A, B or E to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends, we veil undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the damages or loss, if any, that exceeds the sum of. (1) The total amount that all such other insurance would pay for the damages or loss in the absence of this insurance; and i (2) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining damages or loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Policy. c. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this 103124 (05/14) Page 30 of 46 C15506 ENDORSEMENT NO. 11 This endorsement, effective 12:01 AM, April 1, 2018 Forms a part of Policy No.: EG 14246248 Issued to: THATCHER COMPANY By: AIG SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM It is hereby agreed that the following is added to SECTION IV. CONDITIONS: In the event that we cancel this Policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this Policy's expiration date; 2. you are under an existing contractual obligation to notify a certificate holder when this Policy is canceled (hereinafter, the "Certificate Holder(s)") and have provided to us, either directly or through your broker of record, the email address of a contact at each such entity; and 3. we received this information after you received notice of cancellation of this Policy and prior to this Policy's cancellation effective date, via an electronic spreadsheet that is acceptable to us, we will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days after you provide such information to us. Proof of our emailing the Advice, using the information provided by you, WWI serve as proof that we have fully satisfied our obligations under this Endorsement. This Endorsement does not affect, in any way, coverage provided under this Policy or the cancellation of this Policy or the effective date thereof, nor shall this Endorsement invest any rights in any entity not insured under this Policy. All otter terms, conditions, and exclusions shall remain the same. / I UTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 109821(9/11) PAGE 1 OF 1 C15040