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Home My WebLink AboutHD Supply, Inc. - Insurance Certificate DATE(MM/DD/YYYY) AcoR" CERTIFICATE OF LIABILITY INSURANCE 0310412025 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 CONTACT MARSH USA,LLC. NAME:PHONE FAX TWO ALLIANCE CENTER A/C No Ex1 A/C. /C No 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN1 01 983120-HDS-GAW-25-28 INSURER A: Old Republic Insurance Co 24147 INSURED HD SUPPLY,INC. INSURER B: Liberty Mutual Fire Insurance Company 23035 3400 CUMBERLAND BOULEVARD INSURER C: LM Insurance Corporation 33600 ATLANTA,GA 30339 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-005586239-04 REVISION NUMBER: 5 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. INSRPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER MM/DD/YYY MM/DD/Y Y LIMITS A X COMMERCIAL GENERAL LIABILITY X X MWZY 319000 03/01/2025 03/01/2028 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X� OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Fire Damage(Any One $ 1,000,000 B AUTOMOBILE LIABILITY X X AS2-651-294575-015 03/01/2025 03/01/2026 EOa aBINEDtSINGLE LIMIT $ 5,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident F $ A X UMBRELLA LIAR X OCCUR MWZU 319047 25 03/0112025 03/01/2028 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION WA5-65D-294575-025(AOS) 03/01/2025 03/01/2026 X PER OTH- AND EMPLOYERS'LIABILITY YIN N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 5,000,000 C OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) WC5-651-294575-045(MN,WI) 03101/2025 03/01/2026 E.L.DISEASE-EA EMPLOYEE $ 5,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF FORT COLLINS IS INCLUDED AS ADDITIONAL INSURED IF REQUIRED BY WRITTEN CONTRACT ON THE ABOVE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICIES,BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED. WAIVER OF SUBROGATION IS INCLUDED ON THE ABOVE SHOWN COVERAGES WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY HALL WEST,300 LAPORTE AVE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS,CO 80521 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101983120 LOC#: Atlanta AC"RL> ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA,LLC. HD SUPPLY,INC. 3400CUMBERLAND BOULEVARD POLICY NUMBER ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Umbrella follows form subject to policy terms,conditions,and exclusions. "'HD SUPPLY INSUREDS— HD Supply,Inc. HD Supply Holdings,Inc. HDS Canada Holdings,Inc. HD Supply Canada,Inc. HDS IP Holding,LLC HD Supply Support Services,Inc. HD Supply Facilities Maintenance,LP HD Supply Facilities Maintenance,Ltd HD Supply Management,LLC The Home Depot Pro Redi-Carpet,Inc. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights 1 The ACORD name and logo are registered marks of ACORD 0034-01-00-0003424-0002-0009319 Policy Number AS2-651-2W75-015 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED IF REQUIRED BY CONTRACT—SCHEDULED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to Section II—Covered Autos Liability Coverage: A. Coverage 1. Who Is An Insured d. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage"caused by the conduct of an "insured"described in Paragraphs a. or b. above with regard to the ownership, maintenance or use of a covered "auto". Schedule Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND BY A A WRITTEN CONTRACT OR AGREEMENT TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO". AM 20 06 0614 ®2074 Liberty Mutual Insurance.WI rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission,