HomeMy WebLinkAboutInsurance Certificate: Brenntag Pacific Inc A`,°® CERTIFICATE OF LIABILITY INSURANCE OATE12011 YYYY)
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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 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 CONTACT
Marsh USA Inc. NAME:
TWO LQGAN SQUARE PHONE (AIC% No),
PHILADELPHIA PA 191034797 E-MAIL
Ann:PHILADELPHIA.CERTSOMARSH.COWFAX412-9480360 ADDRESS:
INSURERS AFFORDING COVERAGE NAIC If
424780.'ALL-GAW-1 2.13 INSURER A: Insurance Company Of The Slate Of PA 19429
INSURED INSURER B: Greenwich Insurance Comiaarry 22322
10747 P TT PACIFIC,INC.
10747 PATTERSON PLACE I INSURER c: XL Specialty Insurance Company 37885
SANTA FE SPRINGS,CA 90670
INSURER D
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: CLE-003266527-16 REVISION NUMBER:4
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.
INSR ADDL UBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER IMMVDO1YYYY1 (MWDDIYYYYI LIMITS IRSEL
A GENERAL LIABILITY 0696955 01 10112012 01/01/2013 EACH OCCURRENCE $ 1.000.000
DAMA T REN
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 1,000,000
CLAIMS-MADE M OCCUR MED EXP(My one rscn) $ 10.000
PERSONAL B AOV INJURY $ 1.000,000
GENERAL AGGREGATE $ 1000.000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000
JECT
X POLICY PRO- LOC $
B AUTOMOBILE LIABILITY RAD943713307(ADS) 0110112012 01101/2013 COMBINED SINGLE LIMIT 1,000,000
Ea accident)
B X ANY AUTO RAD943713107(MA) 0110112012 01/01/2013 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAM4Ek $
HIRED AUTOS AUTOS Peraccident)
$
UMBRELLA LAB OCCUR EACH OCCURRE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DEp RETENTION $
WORKERS COMPENSATION X WC AND EMPLOYERS'LIAB ILITY G ANY PROPRIETOR/PARTNER/EXECUTIVE Y7N RWR943509007(WI) 01/01/2012 0110112013 EL EACH ACCID $ 1,000,000
D OFFICEWMEMBER EXCLUDED? M N/A RWD943509107(AD$ 0110112012 0110112013 1,000000
(Mandnory in NH) ) E.L.DISEASE-E $
If yes.dewnr under 1,000,D00
DESCRIPTION OF OPERATIONS Win. E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remerke ScheduW,if more apace is required)
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1195 OAK STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND,OR 97520 D F C 2 8 2011 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee
®1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD