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HomeMy WebLinkAboutStaples,4C o® CERTIFICATE OF LIABILITY INSURANCE OATDfYYYYJ 211/zazs 5�`9g.-'20 ��2024 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(iss) 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 Lockton Companies NAME: 1185 Avenue of the Americas, Suite 2010 PHONE FAX New York NY 10036 E-MAIL ►uc No). 646-572-7300 ADDRESS: INSURER($ AFFORDING COVERAGE NAIC 0 tNSURERA:ACE American Insurance Com any 22667 _ INSURED Sta lc$, Inc INSURER a :Indemnity Insurance Co of North America 43575 1492159 Attn: Manuel Figueroa INSURER c:ACE Fire Underwriters Insurance Company 20702 500 Staples Drive INSURER D:_Travelers Property Casualty Company ofAmerica 25674 Framingham MA 01702 INSURER E INSURER F : COVFRAGFS Ict CFRTIFIrATF NIIMRFR• InIneSQ7 DFVICIf1W u11HUIRl=O. vvvvvvv 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 TYPE OF INSURANCE INSD WVO SUER POLICY NUMBER MPOLICY �Y� MMI�DIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EJ OCCUR Y Y XSLG47357949 2/1/2024 2+II2U25 EACH OCCURRENCE $ 1,975,000 , PR�IdI5E5 [Ea occurrences l3kM ESLEgL ocuff-- ____ E 975,000 X s XXXXXXX-- SIR S25,000 MED EXP (Any one person) X Contractual Liab s 1,975,000 PERSONAL s ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC GENERAL AGGREGATE PRODUCTS • COMP/OP AGG s 20,000,000 X $ 4.000.000 s OTHER: A AUTOMOBILE LIABILITY y Y 1$A H 10770269 2/I/2024 2 I?202$ COMBINED SINGLE LIMP IT Ea accident $ 5.000 000 _ BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO OWNED AUTOS ONLY AUTOSULED BODILY INJURY (Per accident) $ XXXXXXX HIRED AUTOS ONLY AUTOS ONLOY PER PPe0accidenDAMAGE $ XXXXXXX $XXXXXXX D X UMBRELLA LIAB }{ OCCUR Y N CUP-3W382462-24-HF: 2/1/2024 2fl/2025 EACH OCCURRENCE $ 10060,000 AGGREGATE $ XXXXXXX EXCESS LtAB CLAIMS -MADE DED I X I RETENTION$ 10000 $ XXXXXXX B A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXEGUTIVE Y/N OFFICERrMEMBER EXCLUDED? I NIA Y WLR C55653410 (AOS) WLR C55653872 (OR) SCF C55653471 (WI) 2/1/2024 2/1/2024 2/1/2024 2/1/2025 2/1/2025 2/1/2025 PER OTH- X STATUTE ER E.L. EACH ACCIDENT _ $ ] 000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If s, describe under— DSCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ ] QQQ 0QQ i DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) City of Caldwel I are included as an additional Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Umbrella Liability policies. General Liability and Automobile Liability insurance evidenced herein are Primary and Non-contributory to other insurance maintained by Additional Insured. waiver of Subrogation is granted in accordance with policy provisions of the General Liability, Automobile Liability and Workers Compensation policies as permitted by law. 20305587 City of Caldwell P.O. Box 1 179 Caldwell ID 83606 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 REPRPSC 44JIVE '� t 4 4 ©1988-2015 ACORD CORPORATION.'Al riahts reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD