|
356429-FNSOL
<br /> AC R DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 2/20/2018
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME' Risk Managgmenl Deportment
<br /> Commercial Lines-(305)443-4886 Pf{ONE ^
<br /> W.(305176 1605 305)441-0813
<br /> USI Insurance Services National, Inc. ADDRESS: StericycleCerts@wellsfargo.com _
<br /> 2601 South Bayshore Drive,Suite 1600 INSURERJSJ AFFOADM COVERAGE NAIL#
<br /> Coconut Grove,FL 33133 1 I ISURERA: Lexington Insurance Company 19437
<br /> INSURED INSURER B: Greenwich Insurance Company 22322
<br /> Stericycle Environmental Solutions, Inc. INSURERC: XL Insurance America,Inc. 24554
<br /> A subsidiary of Stericycle, Inc. INSURER D: XL Specialty Insurance Company 37885
<br /> 28161 N Keith Drive 1NSURERE:
<br /> Lake Forest,IL 60045 SURE F:
<br /> COVERAGES CERTIFICATE NUMBER: 12676582 REVISION NUMBER: See below
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> 1 SR I TYPE.LTROF INSURANCE DDL R POLICY EFF POLICY EXP LIMITS
<br /> POLICY NUMBER ~DIYYYY MMIADr1'YYV
<br /> A X COMMERCIAL GENERAL LIABILITY X EG 1932356 06/01/2017 06/01/2018 EACHOCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR PREMISES Ea oc
<br /> I -. I currence S 300,000
<br /> MED EXP(Any one person) S 25,000
<br /> PERSONAL&ADV INJURY S 1,000,000
<br /> rlGEN'L AGGRE�G--ATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000
<br /> POLICY IJECTLOC PRODUCTS-COMPIOP AGG $ 2,000,000
<br /> OTHER $
<br /> B AUTOMOBILE LIABILITY RAD9437833(AOS) 06/01/2017 06/01/2018 =SINGLE LIMIT 5 5,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNEDSCHEDULED Physical Damage- BODILY INJURY(Per accident) S
<br /> e-
<br /> AUTOS ONLY AUTOS y 9
<br /> HIRED NON-OWNED Self Insured PRAPER�YI]AMAGE $
<br /> AUTOS ONLY AUTOS ONLY
<br /> $
<br /> UMBRELLALUIB OCCUR EACH OCCURRENCE S
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S
<br /> DED I RETENTION $
<br /> WORKERS COMPENSATION 06/01/2017 06/01/2018 x STATLIT ER
<br /> C AND EMPLOYERS'LIABILITY YfN RWD9435489(AOS)
<br /> ANYPROPRIETOR7PARTNERIEXECUTIVE RW R9435490 AK&WI 06/01/2017 06/01/2018 EL.EACH ACCIDENT $ 1,000,000
<br /> D OFFICERfMEMBEREXCLUDED? C NIA ( )
<br /> (Mandatary In NHI E.L.DISEASE-EA EMPLOYE S 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Lodi,its elected and appointed Boards,Commissions,Officers,Agents,Volunteers,and Employees are included as Additional Insured for General
<br /> Liability,as required by written contract subject to policy terms,conditions and exclusions. Coverage is provided on a Primary Non-Contributory basis,with
<br /> respect to General Liability,to extent required by the terms of the executed contract. General Liability includes severability clause,subject to policy terms,
<br /> conditions and exclusions.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Lodi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 221 W.Pine St.
<br /> Lodi,CA 95240 AUTHORIZED REPRESENTATIVE
<br /> The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) r �0 14
<br />
|