HomeMy WebLinkAboutInsurance Certificate: Brenntag Pacific (2)
/~ DATE (MMlDD1YYYY)
ACORiJ CERTIFICATE OF LIABILITY INSURANCE
~ 12/21/2009
PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
Marsh USA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
TWO LOGAN SQUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PHIt.ADELPHIA, PA 19103-2797 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Attn: PHILADELPH IA.CERTS@MARSH.COM/FAX-212-948-0360
424780-.ALL-GAW-10-11 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Insurance Company Of The State Of PA 19429
BRENNTAG PACIFIC, INC.
10747 PATTERSON PLACE INSURER 8: Greenwich Insurance Company 22322
SANTA FE SPRINGS, CA 90670 INSURER c: XL Specialty Insurance Company
INSURER D:
INSURER E: 1
--
COVERAGES
4
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
N01WITHSTANDING 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.
INSR ADD'~ TYPE OF INSURANCE I POLICY NUMBER I POLICY EFFECTNE I POUCY EXPIRATIO,"" I LIMITS
lLTRIINSR~ DATE (MMmOl't'YYYI OATE (MMIDDIYYYY)
A GENERAL LIABILITY 0696955 01/01/2010 01/01/2011 I EACH OCCURRENCE ,$ 2 000 000
~
X I COMMERCIAL GENERAl LIABILITY I DAMAGE TO RENTED $ 1,000,000
PREMISES;'Ea occurrence)
I CLAIMS MADE 0 OCCUR I MED EXP (Any one' person) $ 10,000
- I PERSONAL & ADV INJURY 1$ 2.000,000
- I GENERAl AGGREGATE 1$ 2.000,000
GENERAl AGGREGATE LIMIT APPLIES PERI IPRODUCTS.COM~OPAGG$ 2.000.000
Xl n PRO- n
IX POLICY JECT LOC I I
B AUTOMOBILE LIABILITY RAD943713305 (ADS) 01/01/2010 01/01/2011 1$
- COMBINED SINGLE LIMIT 1.000.000
B J<.. ANY AUTO RAD943713105 (MA) 01/01/2010 01/01/2011 (Eaaccident)
- ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (per person)
-
HIRED AUTOS BODILY INJURY $
-
NON-QWNED AUTOS (per accident)
- - PROPERTY DAMAGE;"", -- -"''"-') "::
-. c< .. .. $'-
- (per accident) _ ~ .-
..
GARAGE LIABILITY - .. AUTO ONLY - EA ACCIDENT $ -
.- R ~NY ;UTO
. OTHER THAN EA ACC $
AUTO ONLY' $
AGG
[JESS' UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE I $
RETENTION $ I.
WORKERS COMPENSATION AND X P;(",?ftT,~, I 10J!!-
EMPLOYERS' LIABILITY RWR943509005 (WI) 01/01/2010 01/01/2011
C .L. EACH ACCIDENT $ 1.000.000
ANY PROPRIETORlPARTNERlEXECUTIVE Y I N RWD9435091 05(AOS) 01/01/2010 01/01/2011
C OFFICERJMEMBER EXCLUDED? 0 $
L DISEASE - EA EMPLOYE 1.000,000
\Mandatory in NH) \l Yels. describe Llnoer p:.L DISEASE. POLICY LIMIT 1$ 1.000.000
SPECIAL PROVISIONS below
OTHER
,
DESCRIPTION OF OPERATlONSfLOCATIONSIVEHICLESfEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
. .-
CERTIFICATE HOLDER
CLE-002377014-09
CANCELLATION
CITY OF ASHLAND
1195 OAK STREET
ASHLAND, OR 97520
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,
Ai1lro1~~~EB~rl~~~ENTATIVE
Mary Radaszewski
ACORD 25 (2009/01)
@1998-2009ACORDCORPORATION.AII Ri9hts Reserved
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