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HomeMy WebLinkAboutInsurance Certificate: HACH Company AC ® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 06/19/2019 A- 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 MARSH USA INC. NAME: 1050 CONNECTICUT AVENUE,SUITE 700 No,Ext): _ (A/C.No): WASHINGTON,DC 20036-5386 E-MAIL Attn:Danaher.certrequest@marsh.com Fax(212)948-0503 ADDRESS: - INSURER(S)AFFORDING COVERAGE NAIC# CN102997607-ALL.7/1.-19-20. HACH NO INSURER A:ACE American Insurance Company 22667 INSUREDHACH COMPANY INSURER B:ACE Property and Casualty Insurance Company 20699 5600 LINDBERGH DRIVE INSURER c:Indemnity Ins Co Of North America _ 43575 LOVELAND,CO 80539 INSURER D:ACE Fire Underwriters Insurance Company - 20702 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-006426437-03 REVISION NUMBER: 5 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR JNSD.WVD (MM/DD/YYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY HDO G7156860A 07/01/2019 07/01/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE RENTED CLAIMS-MADE X I OCCUR PREMISES O(Ea occurrence) $ _ 2,000,000 X Contractual Liability MED EXP(Any one person) $ 10,000 X Broad Form PD PERSONAL&ADV INJURY $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 PRO LOC PRODUCTS-COMP/OP AGG $ 5,000,000 X POLICY JECT OTHER: COMBINED SINGLE LIMIT $ A AUTOMOBILE LIABILITY ISA H25298512 07/01/2019 07/01/2020 (Ea accident) $ 5,000,000 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) $ ' B X UMBRELLA LIAB X OCCUR X00G71535290 001 07/01/2019 07/01/2020 EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WLR C66037460(AOS) 07/01/2019 '07/01/2020 x I PER I 1OTH- AND EMPLOYERS'LIABILITY STATUTE I ER A Y/N WLR C66037423(CA,MA,AZ) 07/01/2019 07/01/2020 2,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? N N/A SCF C66037381(WI) 07/01/2019 07/01/2020 - (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) THE CITY OF ASHLAND,ITS ELECTED OFFICIALS,OFFICERS&EMPLOYEES ARE ADDITIONAL INSURED FOR GENERAL LIABILITY AND AUTO LIABILITY BUT ONLY AS REQUIRED BY WRITTEN CONTRACT WITH RESPECT TO THE OPERATIONS OF THE NAMED INSURED. GENERAL LIABILITY AND AUTO LIABILITY COVERAGE EVIDENCED HEREIN IS CONSIDERED PRIMARY AND NON- CONTRIBUTORY WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 EAST MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _-1 tom..........>._- -.. .a.-.u_.,.",d.0 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD