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HomeMy WebLinkAboutHOLCIM PARTICIPATIONS (US) INC - INSURANCE CERTIFICATE (2)AGENCY CUSTOMER ID: 570000035837 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services southwest, Inc. NAMED INSURED HO1Cim Participations (US) Inc. POLICY NUMBER See Certificate Number: 570078400975 CARRIER see certificate Number: 570078400975 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # 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. LNSR LTR TYPE OF LNSI!RA.NCE ADDL IN"SD SC'BR W'Y'D POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE MM/DD/YYYY LIMITS WORKERS COMPENSATION C N/A SCFC65891050 19-20 WC Retro (WI) 10/01/2019 10/01/2020 OTHER B Excess WC wcuc65891098 XS WC (MI,OH,OK,SC,WA) SIR applies per policy to 10/01/2019 ms & conditions 10/01/2020 EL Each Accident $1,000,000 EL Disease - Policy $1,000,000 EL Disease - Ea Empl $1,000,000 ACORD 101 (2009/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD