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Home My WebLink AboutInsurance Certificate: Brenntag Pacific, Inc.ACC DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F12/2012019 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 Donna Connelly -Marsh USA Inc. Marsh USAInc NAME: PHONE 215 2461282 FAX 1717 Arch Street A/C No): _ Philadelphia. PA 19103-2797 E-MAIL ADDRESS: DOnna.Connelly@marsh.com INSURERISI AFFORDING COVERAGE NAIC # CN101263979-`ALL-GAW-20-21 INSURER A: Insurance Company Of The State Of PA 1943 _ INSUREDBRENNTAGPACIFIC, INC INSURER 9 : ACE American Insurance Company _ 22667 10747 PATTERSON PLACE INSURER C : Indemnity Insurance Cornpany of North America 43575 SANTA FE SPRINGS, CA 90670 INSURER D : ACE Fire Underwriters Insurance Company_20702 INSURER E : INSURER F : rnvcDnr_cc rGaTIGIrATI= Ml IMRFR• rl F-006117481-16 RFVISION NIIMRFR: 12 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDIYYYY) JMM/DD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY GL6634468 01/01/2020 01/01/2021 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE rx-1 OCCUR DAMAGE TO R N E PREMISES Ea occurrence $ 1,000,000 X CONTRACTUAL LIABILITY MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY ❑ PRO ❑ I X JECT $ OTHER: B AUTOMOBILE LIABILITY ISAH25289122 01/01/2020 01/01/2021 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ L UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ B C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A WLRC66041773 (CA & MA) WLRC66041736 (AOS) SCFC66041815(WI) 0110112020 01/0112020 01/0112020 01/01/2021 0110112021 01/01/2021 X I PER OTH- STATUTE ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: SUPPLYING CHEMICALS TO BOTH THE WATER TREATMENT PLANT LOCATED AT: 90 N. MOUNTAIN AVENUE, ASHLAND, OR 97520 AND THE WASTE WATER TREATMENT PLANT LOCATED AT 1195 OAK STREET, ASHLAND, OR 97520. THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS A()DITIONAL INSURED, EXCEPT FOR WORKERS COMPENSATION, WHERE REQUIRED BY WRITTEN CONTRACT. y .� GEK I IFIGA I t HULUtK I.,ANk CLLA I IUN CITY OF ASHLAND. OR ATTN: KARI OLSON 90 NORTH MOUNTAIN AVENUE ASHLAND, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjeen�- U 1988-2U16 AGUKU GUKNUKA I IUN. All rlgnts reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD