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Home My WebLink AboutInsurance Certificate: Univar Solutions USA LLC,4�Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/17/2024 I 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 Aon Risk Services Central, Inc. Phi 1 adel phi a PA Office 100 North 18th Street 15th Floor CONTACT NAME: PHONE (A/C. No. Ext): (866) 283-7122 ,C. No.): 800-363-0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Philadelphia PA 19103 USA INSURED INSURER A: ACE American Insurance Company 22667 Univar Solutions USA LLC 3075 Highland Parkway Suite 200 Downer's Grove IL 60515 USA INSURERB: ACE Fire underwriters Insurance Co. 20702 INSURER C: Indemnity insurance Co of North America 43575 INSURER D: Illinois Union Insurance Company 27960 INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER: 570103619477 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY XSLG EACH OCCURRENCE $3,000,000 CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & conditions DAMAGE TO RENTED PREMISES Ea occurrence)$3,000,000 MED EXP (Any one person) EXCI uded PERSONAL& ADV INJURY $3,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY [—� PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG $3,000,000 OTHER: A AUTOMOBILE LIABILITY ISA H10708436 Commercial Auto 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT Ea accident) S5,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident D X UMBRELLA LIAB X OCCUR XCEG 7380566010 06/01/2023 06/01/2024 EACH OCCURRENCE $4,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $4 , 000 , 000 DED X RETENTION$5,000,000 C B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/ PARTNER/ EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N/A WILR00313443 ADS SCFC70313327 WI 7UM77M 06/01/2023 Wn7=4 06/01/2024 X PER STATUTE I OTH- R E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1 , 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contract to Supply water Treatment Chemicals, Ashland, City of waste water Treatment Plant. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Kari Olson ki 1 90 N. Mountain Road Ashland OR 97520 USA m t` r v rn 0 0 r` 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000014538 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Central, Inc. NAMEDINSURED Univar Solutions USA LLC POLICY NUMBER see Certificate Number: 570103619477 CARRIER See Certificate Number: 570103619477 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES if a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD St BR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATF, (MM/DD/YYYY) LIMITS AUTOMOBILE LIABILITY A MMT H10708540 Truckers Liability 06/01/2023 06/01/2024 combined Single Limi $5,000,000 WORKERS COMPENSATION A N/A wcuc70313364 Excess WC --CA OH OR,WA SIR applies per policy terms 06/01/2023 & condit 06/01/2024 ons ACORD 101 (2008/01) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD