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HomeMy WebLinkAboutInsurance Certificate: Newco, Inc. dba Cascade Columbus Distr. Co. DATE(MM/DD/YYYY) ACCORD® EVIDENCE OF PROPERTY INSURANCE 10/31/2023 • THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED'REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. • AGENCY PHONE COMPANY (NC,No.Ext:425-586-1011 _ her Risk Management Services,LLC Hanover Insurance Companies • Arthur J.Gallagher 9 8403 Colesville Rd • 777 108th Avenue NE,Suite 200 Silver Spring,.MD 20910 Bellevue,WA 98004 License#:BR-724491 (AICC.No):425-451-3716 ADDRess:kelsey spaniel@ajg.com CODE: SUB CODE: AGENCY CUSTOMER ID#: - • - ' INSURED LOAN NUMBER POLICY NUMBER Newco,Inc.,dba Cascade Columbia Distribution Company RQ2-H818390-02 • 6900 Fox Ave.S EFFECTIVE DATE EXPIRATION DATE Seattle WA 98108S CONTINUED UNTIL 10/31/2023 10/31)2024 TERMINATED IF CHECKED • THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION • • • 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGEINFORMATION PERILS INSURED BASIC BROAD SPECIAL . • COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Business Personal Property 5,050,000 10,000 • • REMARKS(Including Special Conditions) Regarding current project and contract,The City of Ashland is listed as an additional insured for General Liability and Automobile Liability • CANCELLATION S ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • ADDITIONAL INTEREST NAME AND ADDRESS ADDITIONAL INSURED LENDERS LOSS PAYABLE I I LOSS PAYEE • MORTGAGEE • LOAN# City of Ashland 20 E Main • Ashland,OR 97520 AUTHORIZED REPRESENTATIVE USA21., ACORD 27(2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • • ENDORSEMENT This endorsement, effective 12:01 A.M. 10/31/2022 • forms.a part of Policy No. 1.84-12-5.58 issued to NEWCO, INC. DBA CASCADE COLUMBIA DISTRIBUTION COMPANY by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: • BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: • BLANKET WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. . I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage; 1'. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated . to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising but of use of a covered • "auto". However,the insurance provided will:not exceed the lesser-of: (1) The coverage and/or limits of this policy, or . • (2) The coverage and/or limits required by said contract or agreement., • AUTHORIZED REPRESENTATIVE 87950 (9/14) Includes copyrighted material of Insurance Services Office, Inc.with its permission. Page 1 of 1 • • • • POLICY NUMBER: 184-12-558 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on theinception date of the policy unless another date is indicated below. Named Insured: NEWCO, INC. DBA CASCADE COLUMBIA DISTRIBUTION COMPANY • Endorsement Effective Date: 10/31/2022 • SCHEDULE Name(s) Of Person(s) Or Organization(s): BLANKET WHERE REQUIRED BY WRITTEN CONTRACTORAGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the,Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not'apply to the • person(s) or organization(s) shown in the.Schedule, - • . but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a , contract with that person or organization. ( • • ' • CA 04 44 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 • ❑ ENDORSEMENT NO.12 This endorsement,effective 12:01 AM, 10/31/2022 Forms a part of Policy No: 14260808-01 Issued to: Newco,Inc. DBA Cascade Columbia Distribution Company By:AIG Specialty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED VENDORS ENDORSEMENT—PRIMARY AND NON-CONTRIBUTORY This endorsement modifiesinsurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM l SCHEDULE Name of Person(s)or Organization(s)(Vendor): Where required by written contract when such contract was signed and executed prior to the sale,distribution,handling or transfer of your product Your Products: All products sold,handled or distributed by the insured Solely as respects Coverages A, E-1, E-2 and E-3,if applicable,SECTION II -WHO IS AN INSURED is amended to include as an insured any person(s) or organization(s) (referred to herein as the "vendor") shown in the Schedule above, but only with respect to bodily injury, property damage, environmental damage, or emergency response costs arising out of your products shown in the Schedule above which are distributed or sold in the regular course of the vendor's business,subject to all of the terms and conditions of this Policy and the additional following exclusions,terms and conditions: 1. The insurance afforded the vendor does not apply to: a. Bodilyinjury, property damage, environmental damage, or emergency response costs for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement.This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in your product made intentionally by the vendor; d. Repackaging,except when unpacked solely for the purpose of inspection,demonstration,testing,or-the substitution of parts under instructions from the manufacturer,and then repackaged in the original container; e. Any failure to make such inspections, adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of your product; f. Demonstration, installation; servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of your product; 103388(10/09) 5 PAGE 1 OF 2 CI4401 ENDORSEMENT NO.12 CONTINUED • • g. Your product which,after distribution or sale by you, has been labeled or relabeled,or used as a container, part or ingredient of any other thing or substance, by or for the vendor;or h. Bodily injury, property damage, environmental damage or emergency response costs 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 not apply to: (1) The exceptions contained in Sub-paragraphs,d.orf.above;or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of your product. • 2. This insurance does not apply to any products you have acquired from a vendor, or any ingredient, part or container,entering into,accompanying or containing such products. 3. Solely with respect to the coverage afforded to the vendor pursuant to this Endorsement, SECTION IV- CONDITIONS,paragraph 4.Other Insurance is deleted in its entirety and replaced with the following: 4. Other Insurance This insurance is primary and non-contributory,and our obligations are not affected by any other insurance carried by such vendor whether primary,excess,contingent,or on any other basis. • All other terms,conditions,and exclusions shall remain the same ' UTH IZ f RESEN . TIVE Or countersignature(where required by law) 103388(10/09) Page 2 of 2 CI4401 ENDORSEMENT NO.5 This endorsement,effective 12:01 AM,10/31/2022 Forms a part of Policy No:14260808-01. J Issued to:Newco,Inc.DBA Cascade Columbia Distribution Company By:AIG Specialty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM It is hereby agreed as follows: SECTION IV—CONDITIONS; Paragraph 7.Transfer of Rights of Recovery Against Others to Us—Applicable to Coverages A,B, C and E is amended by the addition of the following at the end of such subparagraph: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make under Coverage A, B, C and E for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule below. SCHEDULE Name of Person or Organization: Blanket where required by written contract or agreement All other terms,conditions,and exclusions shall remain the same. t, UTH IZE EPRESEN ATIVE • Or countersignature(where required by law) 94283(3/07) PAGE 1 OF-1 CI3021