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HomeMy WebLinkAboutInsurance Certificate: TRISTAR Insurance Group ��® r DATE(MM/DD/YYYY) A C CERTIFICATE OF LIABILITY INSURANCE 1/31/2019 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 NAME: COrbeeSlmoneau Arthur J. Gallagher& Co. PHONE FAX —— Insurance Brokers of CA, Inc. License#0726293 (A,c,No.Extt:818-539-1225 (A/C.No);818-539-1525 505 N. Brand Boulevard, Suite 600 ADDRESS: corbee_simoneau @ajg.com Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Zurich American Insurance Company i 16535 INSURED TRISINS•03 INSURERS:Great American E&S Insurance Company 37532 TRISTAR Insurance Group, Inc. 100 Oceangate Avenue, Suite 700 INSURER C:AIG Specialty Insurance Company 26883 Long Beach, CA 90802 INSURER D:American Zurich Insurance Company 40142 INSURER E:XL Specialty Insurance Company , 37885 INSURER F: COVERAGES CERTIFICATE NUMBER:698604741 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 - ADDL T- SUM I POLICY EFF . POLICY EXP LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER 1(MM!DD/YYYY) (MMIDD/VYYYI LIMITS D X COMMERCIAL GENERAL LIABILITY CPO 5543602-06 , 1/1/2019 1/1/2020 EACH OCCURRENCE T$1,000.000 I CLAIMS-MADE L X OCCUR 1 DAMAGE TO RENTED PREMISES(€a occurrenigf $1,000,000 __ I _MED EXP(A nne person-_$10,000 _ X Contractual Liab PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ' GENERAL AGGREGATE $2,000,000 POLICY �!28T rX 1 LOC _PRODUCTS-COMPrOP AGG t$2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CPO 5543602.06 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT $1,OD0.000 (Ea aaldenU _ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY 1 AUTOS BODILY INJURY(Per accident) $ ---- ------ ---------• HIRED I NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY ;.(Per accident)- -- Comp.&Cot Ded $500 D X UMBRELLA LIAR rx OCCUR AUG 5543479-06 I 1/1/2019 1/1/2020 EACH OCCURRENCE $7,000,000 EXCESS LIAB _ I I CLAIMS-MADE AGGREGATE . $7,000,000 _.Y u DED • RETENTION$ i $ PER OTH- 1N D WORKERS VEERS'LIABILITY _ STATUTE ER AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE 7 N!A l E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 -- — (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ II yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Crime ELU159883-19 1/31/2019 1/31/2020 Aggregate $1,000,000 B Errors&Omissions TER 317-78-31 1/31/2019 1/31/2020 Aggregate $3,000,000 C Cyber 01-133-40-04 1/31/2019 1/31/2020 Aggregate $3,000,000 I , DESCRIPTION OF OPERATIONS i LOCATIONS i VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it 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. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland OR 97520 AUTHORIZED REPRESENTATIVE USA jaiit ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2 of 2 7264 I ��� �'�