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HomeMy WebLinkAboutCOI - Clear Channel Outdoor, LLC - Expires 2022-03-31ACURE3 CERTIFICATE OF LIABILITY INSURANCE `�- DATE (MMIDDIYYYY) 03/26/2021 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 MARSH USA Inc. 4400 Comerica Bank Center 1717 Main Street Dallas, TX 75201 CN101851261-GAWU-GAWU-21-22 GAW 1 CONTACT Cathy Crown PHONE (210)C, No): 691-4173(210) 737 3584 (A/C. No. Ext): E-MAILDSS: Cathy.Crown@marsh.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : National Union Fire Insurance Co 19445 INSURED Clear Channel Outdoor, LLC & its subsidiaries 4830 North Loop 1604 W, #111 San Antonio, TX 78249 INSURER B : AIU Insurance Company 19399 INSURER C : N/A NIA INSURER D : Insurance Company of the State of Pennsylvania 19429 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: HOU-003498622-09 REVISION NUMBER: 7 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 ADDL INSD SUER W POUCY NUMBER POUCY EFF IMM/DD/YYYY) POUCY EXPVDLIMITS (MMIDD/YYYYI A X COMMERCIAL GENERAL UABIUTY GL6547077 03131/2021 03/31/2022 EACH OCCURRENCE $ 1,000,000 DRENTED PREM SESAGEO(Ea occurrencej $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 $ A A D AUTOMOBILE X x x - UABIUTY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - _ - SCHEDULED AUTOS NON -OWNED AUTOS ONLY CA7030897 (AOS) CA7030899 (MA) CA7030898 (VA) 03131/2021 03/31/2021 03131/2021 03/31/2022 03/31/2022 03/31/2022 CEOM IINED=) SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N N / A WC016393112 (California) WC016393113 (Florida) Continued On Next Page 03/31/2021 03/31/2021 03/31/2022 03/31/2022 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) REFERENCE: Bus Shelters Certificate Holder is an additional insured for General Liability and Auto Liability, but only to the extent of the liability assumed under written contract. Workers' Compensation coverage is evidenced for employees of the Named Insured only. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 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 ...X.avksosst �+4..A.tG-Ka.A4 e tI - ACORD 25 (2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101851261 LOC #: San Antonio ACQ D ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA Inc. NAMED INSURED Clear Channel Outdoor, LLC & its subsidiaries 4830 North Loop 1604 W, #111 San Antonio, TX 78249 POUCY NUMBER 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 Workers' Compensation Continued: Policy Number: WC016393110 Arizona (AZ), Colorado (CO), Delaware (DE), Georgia (GA), Illinois (IL), Indiana (IN), Kentucky (KY), Maryland (MD), Michigan (Ml), Minnesota (MN), Nebraska (NE), New Mexico (NM), Nevada (NV), New Hampshire (NH), New Jersey (NJ), New York (NY), North Carolina (NC), Oregon (OR), Pennsylvania (PA), South Carolina (SC),Tennessee (TN), Texas (TX), Virginia (VA) Effective Date (MM/DDIYYYY)*: 03/31/2021 Expiration Date (MMIDD/YYYY)•: 03/31/2022 Carrier: AIU Insurance Company Policy Number: WC016393111 Massachusetts (MA), North Dakota (ND), Ohio (OH), Washington (WA), Wisconsin (WI), Wyoming (WY) Effective Date (MMIDDIYYYY)': 03/31/2021 Expiration Date (MM/DD/YYYY)•: 03/31/2022 Carrier: New Hampshire Insurance Company Workers Compensation is evidenced for employees of the Named Insured Only. Certificate Holder included as additional insured on General Liability and Auto Liability, but only with respect to liability that arises out of the acts or omissions of the Named Insured; or, to the extent of the liability assumed by the Named Insured under written contract. The Auto Liability policy is primary, but only with respect to liability that arises out of the acts or omissions of the Named Insured; or, to the extent of the liability assumed by the Named Insured under written contract. The General Liability policy is primary and non-contributory, but only with respect to liability that arises out of the acts or omissions of the Named Insured; or, to the extent of the liability assumed by the Named Insured under written contract. Waiver of subrogation is applicable with respect to General Liability, Auto Liability, and Workers' Compensation policies where required by written contract and subject to policy terms and conditions. In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity (ies) according to the notification schedule shown below. Per the most current schedule maintained by Marsh USA, Inc. and furnished to AIG no less than 45 days prior to the effective date of cancellation. Number of Days Notice of Cancellation: 30. ACORD 101 (2008/01) 0121-01-00-0002397-0002-0005365 © 2008 ACORD CORPORATION. All rights i The ACORD name and logo are registered marks of ACORD Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support our firm's commitment to sustainability, going forward, we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an email address where we can deliver your COI in the future. Please send your response to: USOperations.email@marsh.com and provide the following information so that we can expedite your COl delivery: • Certificate # (Shown below insured Name — e.g.: ABC-123456789-01) • E-Mail for future delivery: For undeliverable email addresses, our system is configured to automatically redirect the Certificate for deliveryvia USPS. Lastly, if you no longer need this COl please respond to USOperations.email (amarsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery. Thank you. US Operations, Marsh USA, Inc.