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Home My WebLink AboutInsurance Certificate: Univar USA AC~S CERTIFICATE OF LIABILITY INSURANCE I DATECMM/DD/YYYY) ~- 02/25/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Aon Risk services Central, lnc. philadelphia PA Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS One Liberty place CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE 1650 Market Street COVERAGE AFFORDED BY THE POLICIES BELOW. suite 1000 Ph~lla~~llihia PA 19103 USA FAX- (8471 953-5390 INSURERS AFFORDING COVERAGE NAIC# PHO'<. 866 83-7122 I:\'SURED INSURER A: chartis specialty Insurance company 26883 UNIVAR USA INC INSURER B: Insurance company of the State of PA 19429 17425 NE union Hill Road Redmond WA 98052-3375 USA INSURER c: National union Fire Ins Co of pittsburgh 19445 INSURER D: Illinois National Insurance Co 23817 INSURER E: ACE property & Casualty Insurance Co. 20699 COVERAGES ~ ~ '" ." = ~ ... ~ ~ .. :!l Q SIR applles per terms and cond,tlons of the polley = THE POLICIES OF INSURANCE LISTED BEWW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CGNDmON OF ANY CONTRACT OR OTIIER DOCUMENT WITH RESPECT TO WHICH TIllS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED I~SR ADD' LTR I~SRE n'PE OF I:'\ISURA.~CE POLICY :'\lUMBER POLICY EFFECTIVE POLICY EXPIRATIO;'\l LIMITS InATE{M~IIDDfYYYY DATE(MMIDDfYYY'", C r~.~ GL2802979 03/01/2010 03/01/2011 EACH OCCURRENCE $3,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO REl-o'TED $300,000 , CLAIMS MADE [!] OCCUR . PREMISES (Ea occurrence) MED EXP (Anv one person I ... X SIR: $2,000,000 PERSONAL & AnY INJURY 13,000,000 N OJ '" GENERAL AGGREGATE 13,000,000 .... OJ GEN'L AGGREGATE LIMIT APPLIES PER: .... $3.000,000 m PRODUCTS-COMWOPAGG 0 0 POLICY D ;:;?; 0 LOC 0 .... ~ C AUTOMOBILE LIABILITY CA 4806890 03/01/2010 03/01/2011 .. COMBINED SJI\GLE LIMIT Q X ANY AUTO Truckers liability (ADS" (Eaaccidcnl) 15,000,000 Z C - CA 4806891 03/01/2010 03/01/2011 $ ALL Ov,.""'ED AlITOS Truckers liability (MA) .. BODILY INJURY u C - SCHEDULED AUTOS CA 4806892 03/01/2010 03/01/2011 (Perpel>On) '" - Truckers liability (VA) ." ~ HIRED AlITOS .. BODILY INJURY U - NON OWNED AUTOS . (Per accident) - PROPERTY DAMAGE - (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT R ANY AUTO OTHER THAN EAACC AUTOONLY: AGG E EXCESS f UMBRELLA LIABILITY XOOG24903953 03/01/2010 Vj/U1/'UH EACH OCCURRENCE ", uuu, UUU ~ OCCUR D CLAIMS MADE AGGREGATE 14,000,000 , 80EDUCTIBLE - RETENTION 1500,000 B WC X I~,;,v ~;~:::;-I I~~H. WORKERS COMPESSATIO;'ol A;'oID AOS EMPLOYERS' LIABILITY rJ 03/01/2011 E.L. EACH ACCIDENT $1,000,000 == C wC1591222 03/01/2010 ANY PROPRIETOR I PARTNER I EXECUTIVE CA, OH, OR & WA $1,OOO,OOOj;i: OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE 0 (MandatoryinNH) WC1591223 03/01/2010 03/01l20i1 " ifves, describe under SPECIAL PROVISIONS below WI E.L. DISEASE-POLICY LIMIT $1,000,001 OTIIER , !i'C- DESCRIPTION OF OPERATIONSfLOCA TIONS!\'EHICLESlEXCLUSIONS ADDED BY ENDORSEMENTfSPECIAL PROVISIONS I RE: Bid #2008-101 & Bid 2008-102, Su~erfloc N-300 LMW; calcium Hypochlorite; Caustic soda; sodium H~pochlorite; SBS; Location: portland. Cit~ of As land and all employees are included as Additional Insured on t e General liability and Automobile liabi ity policies with respect to written contract. univar is self-insured for physical CERTIFICATE HOLDER CANCELLATION ~ City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION . Attn: Kari olson DATE THEREOF, THE ISSUiNG INSURER WlLL ENDEAVOR TO MAlL 90 N. Mountain Avenue 30 DAYS WRITTEN NOTICE TO THE CERTIACATE HOLDER NAMED TO THE LEFT, Ashland OR 97520 USA BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 6iTV FtEOORDER . AUTHORIZED REPRESENTATIVE ~ ~.9"____ ~/--?:. . .._ , I - ACORD 25 (2009/01) <1:>1988-2009 ACORD CORPORATION. All rights reserve~_ The ACORD name and logo are registered marks of ACORD . Attachment to ACORD Certificate for UNIVAK USA INC The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer{s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. !;'\lSURED UNIVAR USA INC 17425 NE Union Hill Road Redmond WA 98052-3375 -USA INSURER . 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. ADD'L POLICY :oiUMBER POLICY POLICY I:"o'SR I;'IlSRO TYPE OF I:'IlSURA:'IlCE POLICY DESCRlPTIO:'ll EFFECTIVE EXPIRATIO;ll LIMITS LTO DATE DATE AUTOMOBILE lIABILITY CA 4806893 P3/01/2010 03/01/2011 Combined IS,OOO,OO( C Comme rei a 1 Auto (ADS) single L;m; CA 4806894 b3/01/2010 03/01/2011 C Commercial Auto (MA) . CA 4806895 . b3/01/2010 03/01/2011 C Commercial Auto (VA) WORKERS COMPENSATION wc1591221 03/01/2010 03/01/2011 B FL wCl591224 03/01/2010 03/01/2011 0 TX DESCRIPTION OF OPERA llONSILQCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS damage to their vehicles. Certificate No : 570037879824 ~