HomeMy WebLinkAboutInsurance Certificate: Brenntag Pacific
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PROo"ut':ER
Marsh USA Inc.
TWO LOGAN SQUARE
PHILADELPHIA, PA 19103-2797
Attn: PH ILADELPHIA.CERTS@MARSH.COMlFf\X-212-948-0360
DATE (MMfDDfYYYY)
12/21/2009
THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'tNSRJ ADO'l: I POLICY EFFECTIVE I POLlCY' EXPIRATION I
L TRllNSRq TYPE OF INSURANCE POLICY NUMBER OATEtMMlDOlYYYYl DATE (MMlDOIYYYY)
A ~ERAL LIABILITY 0696955 01/01/2010 01101/2011
X I COMMERCIAl GENERAL L1A81L1T'i'
l CLA.IMS MADE 0 OCCUR
CERTIFICATE OF LIABILITY INSURANCE
I INSURERS AFFORDING COVERAGE
I INSURER A: Insurance Company Of The State Of PA
INSURER B: Greenwich Insurance Company
INSURER c: XL Specialty Insurance Company
INSURER D:
/INSURER E'
424780-"ALL-GAW-10-11
INSURED
BRENNTAG PACIFIC, INC.
10747 PATTERSON PLACE
SANTA FE SPRINGS, CA 90670
COVERAGES
LIMITS
B
B
-
-
GENERAL AGG~ATE LIMIT APPLIES PER
Xl POLICY I I j:g ri - LaC
AUTOMOBilE LIABILITY
-
~ ANY AUTO
_ ALL OWNED AUTOS
_ SCHEDULED AUTOS
HIRED AUTOS
-
~ N?N-DWNED AUTOS _
-
EACH OCCURRENCE
~~~~~~~:;~~;~nce\ $
MED EXP(An;: onoperscn) $
$
$
PERSONAL & ADV INJURY
GENERAL AGGREGATE
RAD943713305 (AOS)
RAD943713105 (MA)
01/01/2011
01/01/2011
PRODUCTS - COMPfOP AGG.~
I
COMBINED SINGLE LIMIT 1$
(Eaaccident)
$
01/01/2010
01/01/2010
BODlL Y INJURY
(per person)
-
.1 :
BODILY INJURY
(~er.acddent)
.PROPEf3W DAMAGE.,,:,._. $ '"" ....
(Per accident) ~. -. - "1, r. ~
;-..,.;::: 0':::::.'
.';.:
- - . ~'.. ~
C
C
~RAGE LIABILITY
H ANY AUTO
~XCESS I UMBRELLA LIABILITY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION S
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERlEXECUTlVE Y I N
OFFICER/MEMBER EXCLUDED? 0
IM;,ncia\Ory in NI"i) If yt>:;, de:;cribe under
SPECIAL PROVISIONS below
OTHER
01/01/2011
01/0112011
''C
I .
AUTO ONLY - EA ACCIDENT $
OTHER THAN ~$
AUTO ONLY: AGG 1$
EACH OCCURRENCE 1$
AGGREGATE $
$
$
I,
IX I_WC STATU-J IOTH-
~11OR'UlMIT
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYE $
.L. DISEASE - POLICY LIMIT $
'.,
RWR943509005 (WI)
RWD943509105(AOS)
01/01/2010
01/01/2010
NAIC #
19429
22322
J
2 000 000
1,000,000
10,000
2,000,000
2,000,000
2 000 000
1,000,000
$ --
,
~
.,
:~
~
1 ,000,000 ..~
1,000,000 >
1,000,000
T
DESCRIPTION OF OPERATlONS/LOCATIONSIVEHIClESIEXCLUS10NS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS \
RE: SUPPLYING CHEMICALS TO THE WATER TREATMENT PLANT LOCATED AT: 90 N. MOUNTAIN AVENUE, ASHLAND, OR 97520
THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED, EXCEPT
FOR WORKERS COMPENSATION, WHERE REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER
CLE-002376989-06
CANCELLATION
"',_U "'" ^ .' . ,"A' ",1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCelLED BEFORE THE
,',
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND
UPON THE INSURER,
"ou;rAA~~B~rl~~E~TATIVE
Mary Radaszewski
CITY OF ASHLAND, OR
ATTN: KARl OLSON
90 NORTH MOUNTAIN AVENUE
ASHLAND, OR 97520
ACORD 25 (2009/01)
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