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HomeMy WebLinkAboutInsurance Certificate: Suburban Propane L.P. AL DATE /YYYY) �..�" CERTIFICATE OF LIABILITY INSURANCE os/27/2023no23 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,LLC. NAME: 445 SOUTH STREET (NCNNo.Ext/: FAX No): MORRISTOWN,NJ 07960-6454 E-MAIL Attn:Morristown.CertRequest@marsh.com Fax:212.948.0979 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B:LM Insurance Corporation 33600 SUBURBAN PROPANE L.P. 240 ROUTE 10 WEST INSURER C:N/A N/A PO BOX 206 INSURER D: WHIPPANY,NJ 07981 INSURER E: INSURER F: COVERAGES . CERTIFICATE NUMBER: NYC-010267283-14 REVISION NUMBER: 1 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 SUER POLICY EFF POLICY EXP/YLIMITS LTR INSD WVD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY) A X -COMMERCIAL GENERAL LIABILITY TB2-631-507975-083 10/01/2023 10/01/2024 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES Ea occur ence) $ 250,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X JEC LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY AS2-631-507975-073 10/01/2023 10/01/2024 COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ X OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS _ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WA5-63D-507975-093(AOS) 10/01/2023 10/01/2024 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N WC5-631-507975-113(WI) 10/01/2023 10/01/2024 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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,OREGON,ITS OFFICERS,AGENTS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO GENERAL LIABILITY COVERAGE AS SHOWN HEREIN AND SOLELY IN THE EVENT THIS STATUS IS REQUIRED BY WRITTEN CONTRACT BETWEEN SUBURBAN PROPANE LP OR ITS SUBSIDIARIES OR AFFILIATES AND CERTIFICATE HOLDER AND ONLY WITH RESPECT TO SUBURBAN PROPANE'S SOLE NEGLIGENCE. 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 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 0003382 SP 0356 -C01-P03383-I CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND,OR 97520 4 0356-01-000003382-0001-0007437 r ` SO Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability,going forward,we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: --Certificate#(Shown below Insured Name—e.g.,ABC-123456789-01) --E-Mail for future delivery For your convenience, If we do not receive your response,we will conclude that you no longerrequire proof of insurance from the named insured and will remove you from our records. - Thank you, US Operations, Marsh USA, LLC A bbU ii,K: s vY Marsh 1f,tenn rt 0356-01-00-0003382-0002-0007438 •