HomeMy WebLinkAbout535458 CHEMTRADE CHEMICALS US LLC - INSURANCE CERTIFICATE (2)7 ® DATE (MMIDDNYYY)
AC"Rla CERTIFICATE OF LIABILITY INSURANCE 05/07/2018
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).
CONTACT
PRODUCER NAME:_ --
Marsh USA, Inc. IPHONE FAX
9830 Colonnade Blvd, Suite 400 C No. Ext1: _ A/c Not:
San Antonio, TX 78230 E-MAIL
4DDRESS:
CN 102200184-STND-GAWU L-18-19
INSURED
Chemtrade Holdco US Inc
90 E Halsey Road
Parsippany, NJ 07054
INSURERS AFFORDING COVERAGE NAIC #
RER A: Allianz Global Risks US Insurance Company
RER B Liberty Mutual Insurance Company 23043
RER C : N/A N/A
INSURER E:
INSURER F
uni I nn19n1AAd_nr, RFVISIr)M NI IMRFR• .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.
INSR
LTR
Ty PE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
USL00049318
05/01/2018
05/01/2019
EACH OCCURRENCE
$ 5,000,000
DAMA E TO RENTED
PREMISES Ea occurrence
$ 100,000
CLAIMS -MADE � OCCUR
SIR - $100,000
MED EXP (Any one person)
$ 5,000
X
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO El LOC
X JECT
GENERAL AGGREGATE
$ 5,000,000
PRODUCTS - COMP/OP AGG
$ 5,000,000
g
OTHER
AUTOMOBILE LIABILITY
AS1-B71-072790 068
05/01I2018
05101/2019
COMBINED SINGLE LIMIT
Ea accident
$ 1000 000
BODILY INJURY (Per person)
$
B
X ANY AUTO
AS1-B71-072790-078
05/01/2018
05/01/2019
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
WORKERS COMPENSATION
X PSER OTH-
TATUTE ER
$
B
WA2-B7D-072790-088
05/01/2019
E.LEACH ACCIDENT
.
$ 1,000,000
B
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC2-B71-072790-018
05/01/2018
05/01/2019
E L DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City, its officers, agents and employees included as additional insured (except Workers Compensation) where required by written contract.
CERTIFICATE HULDth
City of Fort Collins
215 North Mason Street
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee
\:l I Aop-.1. ... ..... _. - _.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD