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HomeMy WebLinkAboutInsurance Certificate: Tristar Ins. Group Inc AC D® CERTIFICATE OF LIABILITY INSURANCE UATE(MM/°°/YVYV) , 12/29/2022 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(les)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: Cert Requests • Arthur J.Gallagher&Co. Insurance Brokers of CA. PHONE 500 N. Brand'Boulevard (A/C,No.Ext): (A/C,No): Suite 100 • ADDRESS: certrequests@ajg.com Glendale,CA 91203 INSURER(S)AFFORDING COVERAGE NAIC if INSURER A;Zurich American Insurance Company 16535 INSURED TRISINS-03 •B:Great American E&S Insurance Company 37532 TRISTAR Insurance Group, Inc. INSURER c:XL Specialty Insurance Company 37885 100 Oceangate Avenue,Suite 700 Long Beach,CA 90802 ' INSURER D:Endurance.American Specialty Ins Co• 41718 INSURER E:American Guarantee and Liability Ins Co 26247 INSURER'F:American Zurich Insurance Company 40142 COVERAGES CERTIFICATE NUMBER:316334963. 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. _ IL q TYPE OF INSURANCE 'DDL SUBR - ' - POLICY EFF POLICY EXP LIMITS. INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) F X COMMERCIAL GENERAL LIABILITY Y CP0554360210 1/1/2023 1/1/2024 EACH OCCURRENCE $1,000,000A RENED CLAIMS-MADE X OCCUR - PREMISES(Ea occur ence) $1,000,000 .MED EXP(Any one person) $10,000 X Contractual Llab - PERSONAL&ADV INJURY $1,000,000 — GE 'L AGGREGATE LIMIT APPLIES PER: •GENERAL AGGREGATE- $2,000,000 - POLICY PROT X LOC PRODUCTS.-COMP/OP AGG $2,000,000 JEC OTHER: $ A AUTOMOBILE LIABILITY Y CP0554360210 1/1/2023 ' 1/1/2024 , COMBINED SINGLE LIMIT $1,000,000 (Ea eccldenty X ANY AUTO -BODILY INJURY(Per person). $ - — OWNED SCHEDULED• AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ Comp.&Coll Oed. $1,000 E X UMBRELLA LIAB X OCCUR AUC554347909 1/1/2023 1/1/2024 EACH OCCURRENCE $4,000,000' EXCESS LIAB. CLAIMS-MADE AGGREGATE' $4,000,000 DED RETENTION$ $ WORKERS COMPENSATION - PER OTH- AND EMPLOYERS'LIABILITY STATUTE. . ER ANYPROPRIETOR/PARTNERIEXECUTIVE Y!N N/A • E,L.EACH ACCIDENT $ OFFICERRIMEMBEREXCLUDED7 (Mandatory in NH) E;L,DISEASE EA EMPLOYEE $ - If yes,describe under . ' • DESCRIPTION OF OPERATIONS below - • E.L.DISEASE-POLICY LIMIT, $ C Crime/Fidelity - -- ELU180894-22 - 1/31/2022 - 1/31/2023 Aggregate 2,000,00,0. B .Errors&Omissions. TER 2861642 1/31/2022 1/31/2023 Aggregate. 2,000,000 D Cyber PRV30003483201 1/31/2022 1/31/2023 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) City of Ashland is named additional insured under General Liability and Automobile 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 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 k0§14/444/ ©1988-201.5 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher&Co. Insurance Brokers of CA.,Inc: 500 N. Brand Boulevard,Suite 100 Glendale CA 91203 MDG2022 00003285 01 IIuIIui'IIIilIiIuIluiiii.IIIIIIl,IIIInI'ulil'IriIUI.Iiii.I�„I riR City of Ashland 90 N. Mountain Ave. Ashland, OR 97520 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the.future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG,com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S.,Mail delivery 3.• Insured Code: TRISINS-03 4. This Certificate Number: 316334963 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacypolicy found at https:// www.ajg.com/us/privacy-policy/. Sc' a. Your "volunteer workers" only while performing dutiesrelated to the conduct of your business, or,your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers(if you area limited liability company), but only for acts within the scope of their employmentby you or while performing duties related to the conduct of your business. However, none of these"employees"or'Volunteer workers"are insureds for: (1) "Bodily injury"or"personal and advertising injury": (a) To you, to your partners or members(if you are a partnership or joint venture), to your members(if you are a limited liability company),to a co;"employee"white in the course of his or her employment or performing duties related to the conduct of your business, or to your other"volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or 'Volunteer worker" as a consequence of Paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who musto muPic damages because of the injury described in Paragraphs(1)(a) or,(b)above;or (d) Arising out of his or her providing or failing to provide professional health care services. However: Paragraphs(1)(a) and (1)(d) do not apply to your"employees" or"volunteer workers",who are not employed by you or volunteering for youas health care professionals, for"bodily injury"arising out of "Good Samaritan Acts"while the"employee"or'Volunteer worker" is performing duties related to the conduct of your business. "Good Samaritan Acts" means any assistance of a medical nature rendered or provided in an emergency situation for which no remuneration is demanded or received. Paragraphs (1)(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in rank, with respect to "bodily injury" to co-"employees". As used in this provision, "employees" designated as a supervisor or higher in rank means only "employees"who are authorized by you to exercise direct or indirect supervision or control over"employees"or'Volunteer workers"and the manner in which work is performed. (Add' one nsur-•a ssees o remises 0 `°tion —" 0 S 'n nsur--• is menses to Inc use as an d•eitional insure• any person or organization w o (leases or rents a part of the premises you own or manage who you are required to add as an additional insured) (on this policy under a written_contract or written agreement, but only with respect to liability arising,out of your) owners ip, maintenance or repair o a part o t e premises w is is not-reserve• or t a exc usive use' or occupancy o sue person or organize Ion or any;of er'enant or essee. (However,`;the insurance afforded to such additional insured:) Q (Only applies to the extent permitted by law;and) (Wiilinot be broader.thanlthat which you are required by the written contract or writtenagreement toprovide) or suc a„ Itiona1 insure ;an (Ends when the person or organization ceases_to lease or rent premises from you.) respect o e insurance a;or•e• o t .e a••itiona insures unbar t is en•orsement, t e o owing s a••e•''to (Section III—Limits Of Insurance:) e mos we wl pay on •e a o e a••I Iona insure• is t e amount o insurance: (a. Required bythe written 'contract_or,written agreement referenced in Subparagraph D.1.-above (of this) endorsement,or (b.: Available under the applicable Limits`of Insurance shown in the Declarations;) o (Whichever)is less.) IS 'aragrap s a not increase t e app Ica•e units'o nsurance s own in t e sec arations (Additional-Insured—Vendors) Q e a owing c ange app ies 1 tis Overage 'art provi•es insurance to you or "•o• v injury" an. property (damage"included in the"products-completed.operations hazard":) is U-GL-1330-C CW(04/13) Page 2 of 12 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. ection :;-Who Is An Insured,is amended,to include as an additional insured"any person or.organization) referred to th ou•Bout this,Pares raph E. as vendor who ou.have agreed in a written,contract or Written ag'reemen; prior to oss, to name as,an additional insured, but only with respect to"bodily;iniury" or "property) (damage" arising out of,`your.products'" which are distributed',or,sold in the regular course of the vendor's] (business.).: owever;: ein surance eller e to suc ven or: ) (Only apples'to the extent permitted by law;and) lE, (Will not,be broader than,;that which you are required by the wrritten-contract or written agreement to provide) (for such`vendor.) 2) (With respect'fa the insurance_afforded toIhese vendors;the follovuing.additional-exclusions apply;) .0 e insurance a or•e• t e ven•or•oes not • oz" DI)' 'Madly injury",or_"property damage"-for which the vendor is obligated to pay damages by reason of the) • assumption o' Iasi ity-in a contract or agreemen . Is exc usion ices n0 appy 0 a.ii or .anlages (that the vendor would have in the absence of the contract or agreement;) (()j) (Any express warranty unauthorized by your ((3)) (Any ph sical or'c emical chane in the •roduct made`ih�tentionall b the vendor ((4)) Reaacka•ins ' exce•t when uneac ed solei for the •ur•ose of'iris section "demonstration testis• or e su•stitut on o parts un•er.instruc ions rom e menu ac urer,an. en repac ages in e origins container;) ((5)) (Any failure to ma a suc ins•ec ions a• ustmen s tes s or servicin• as a ven•or as at ree. to ma e orT norma y undertakes to make in t e usua course o •usiness, in connec ion wi e'•is`ri.u ion or (sale of the products;) ( (Demonstration, ins a ation, servicing or weir opera ions, excep suc operations per orme• a e wen ors prer_ni es,4in connection with the sale:of the product;) QM 'r0•ucts w C , er •istri•ut on or sae •y you, ave seen as:e• or rea•ee• or uses as a container , par,or ingre lent o any o er t' mg orsu•s ance •y or.or t e von•or:;or • qgD `C'Rodily injury".or "property damage"arising out of the sole negligence of the vendor for its own acts or) (omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does) a e excep.„lons Contalne•fin u•tares rat s (J or '. . • tic msec ions a• us men s, es s or.'servicin• as .e ven•or as a•ree• o ma e or norma un•erta esto ma e in t e usua course o_ •us ness, in connec on wi e •Is ri U Ion.Orsae 0 (fhe products,] is insurance •oes.not,appy to any insures person or organize ion, rom w om you ave acquire• such) ro uc s,or any ingredient par or con ainer,entering in o,accompanying or con wining suc pros ucts. (This insurance does notapply to any of'your products"for which coverage is excluded under this Coverage) • (3 (With respect to the insurance afforded to the vendor under this Paragraph E.,the following is added to Section III) (-Limits OFf insurance) (The most will pay-on behalf of the vendor is the amount of insurance:) CD '-quire• •y` t e wrl en' contract or written agreemen '.reerence• in u•para_grap a•ove o is (endorsement):;or)" g (word.e'un•er t eapp ices a emits o nsurance s own in a -c ara ions, .. (whichever],Is less) (This Paragraph E.shalll;not'lncrease the'applicable Limits of Insurance shown in the Declarations,) • (AddItional'InsuredtMana±hers Lessors or Govern nentahEnti , U-GL=1330-C CW(04/13) Page 3 of 12 Includes copyrighted material of Insurance Services Office,Inc.,with its permission, • • • eCti0111 — TT 0 s n nsu is arnense• to Inc u•e as an insures any persOn.4,or ontanization w o 's a (manager, lessor or governmental entity who you are required to add,rallan additional insure, on this "olio un.er (a writte contract, written agreement or perrnif; qpiact to liability fOr '..bodily injury","'property) •amage_or •ersona an• a•yertising njury'caus-• in w oe or in par•, (Yogr acts,or omissions;ol) • e acts or om ssions ot os e acting on your le a •an. - • - (resulting_directly from') •(I) Pperations performed by you or on yourbehalf for Which the..state-or political subdivision has Ise-bed a) • 43errnit;) • I tiers ip main enance;•occupancy or'use.o premises •v you:,or • , • • • 0 , enance, operation gr use .y you o equipment ease• to yo .of suc person or organization. , • "qwever,t e insurance a or•e• to suc a.eitonal Insured) (Only,applies to the extent permitted by law;and) * (D Yli mat •- •roa•er t an t at w to you are require. •y t e written contract agreement to provide) (for such additional insureC (2. This ProVision does not apply:) • (Urilds-ilhe Written contract or written-agreement has been exeCtited, or the permit has been issued, prior to) (thertodily injury", "properti,damage" or offense that caused pesopal and • JJ o any person or organization Inc u.e. as an insure. unser -aregraph 3.of Settion.11—Who Is An'Insured;) • craTailyie§T517:Ari&615hTient 11 e occurrence or o ense to cs •lace after theaqUiprnerit lease expires;) J (To any) ((IT or other interests from whom land has been leased by you;or) ((2) Managers or lessors pf premise , it) (ja) The''occurrence',,or offense takes place after the expiratioffof the lease Of'yoU cease to be a tenant in) (that premises;) ((b) The 'bodily Injury," "property damage"or "personal andjaci -ig injury'arises Out of the'structural) a teratlis, new construction or demolition operations 0767-,orme• •y or on •e a o t e m.• a•-r or (lessdr; or) • • c e premises are exc use. unterthliWYEIjt. ' Z) (With respect to the insurance the additional insureds underithiS Paragraph:F.,the following is added to) (Section flu— -01 ---ts Insurance) - e most we wi pay on se a o t e a••itiona insure. ist e amounof insurance) ReqUirecl by the written:contract or written agreement-referenced in SOParagraph F.1. above of this (endorsement); pr) • We-Wallas e un•er e app ica•e imi s o nsurance s own in t e D,ecara ions, (whichever is less) • (I his Paragraph F.shall not increase the applicable Limits of Insurance.shbtnin in thepaclarations.) • G Damage to Premises Rented or Occupied by You ' 1. The last paragraph under Paragraph 2.•Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c: through n. do not apply to damage by "specific perils" to premises while rented to you or • • temporarily occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Section III—Limits Of Insurance. • • 2. Paragraph 6. of Section III Limits Of Insurance is replaced by the following: • • U-GL-1330-C CW(04/13) , Page 4 of.12 Includes copyrighted material of Insurance Services Office,Inc.,with its permission.