DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 04/01/2022
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.
Holder Identifier : A
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 CONTACT
NAME:
Aon Risk Services Central, Inc. PHONE FAX
(A/C. No. Ext):
(866) 283-7122 (800) 363-0105
Chicago IL Office (A/C. No.):
200 East Randolph E-MAIL
Chicago IL 60601 USA ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A: Zurich American Ins Co 16535
W.W. Grainger, Inc. and its INSURER B: American Zurich Ins Co 40142
subsidiaries, affiliates and divisions
(see attached addendum for Named INSURER C: Illinois Union Insurance Company 27960
Insureds) INSURER D:
100 Grainger Parkway
Lake Forest IL 60045 USA INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570092429816 REVISION NUMBER:
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. Limits shown are as requested
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY GLO554290809 01/01/2022 01/01/2023 EACH OCCURRENCE $10,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR $10,000,000
PREMISES (Ea occurrence)
MED EXP (Any one person) Excluded
PERSONAL & ADV INJURY $10,000,000
570092429816
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000
PRO-
POLICY X LOC PRODUCTS - COMP/OP AGG $10,000,000
JECT
OTHER:
A AUTOMOBILE LIABILITY BAP 5542907 09 01/01/2022 01/01/2023 COMBINED SINGLE LIMIT
$2,000,000
(Ea accident)
BODILY INJURY ( Per person)
Certificate No :
X ANY AUTO
SCHEDULED BODILY INJURY (Per accident)
OWNED
AUTOS
AUTOS ONLY PROPERTY DAMAGE
HIRED AUTOS NON-OWNED
(Per accident)
ONLY AUTOS ONLY
C X UMBRELLA LIAB X OCCUR XEUG27936155007 01/01/2022 01/01/2023 EACH OCCURRENCE $5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION $10,000,000
B WORKERS COMPENSATION AND WC554290409 01/01/2022 01/01/2023 X PER STATUTE OTH
EMPLOYERS' LIABILITY -
Y/N AOS
ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT $1,000,000
A
OFFICER/MEMBER EXCLUDED?
N N/A WC554290509 01/01/2022 01/01/2023
(Mandatory in NH) MA & WI E.L. DISEASE-EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000
A Excess WC EWS554290609 01/01/2022 01/01/2023 EL Each Accident $1,000,000
7777777707070700077761616045571110747517226304466107642005772505102073741755374001210740715332374221007536736472177730077625500621037530722404113052312007677735727156443076727242035772000777777707000707007
7777777707070700073525677115456000723000502427113007774150571375474070623236531364000712223624307311107022327343173100071223362430731100703322634317200007122337352072010077756163351765540777777707000707007
OH EL Disease - Policy $1,000,000
SIR applies per policy terms & conditions EL Disease - Ea Empl $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The Certificate Holder is included as Additional Insured per attached form U-GL-1114-A CW (10/02) with respect to General
Liability policy, where required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
DeKalb County School Board AUTHORIZED REPRESENTATIVE
1701 Mountain Industrial Blvd.
Stone Mountain GA 30083 USA
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 10768055
LOC #:
ADDITIONAL REMARKS SCHEDULE Page _ of _
AGENCY NAMED INSURED
Aon Risk Services Central, Inc. W.W. Grainger, Inc. and its
POLICY NUMBER
See Certificate Number: 570092429816
CARRIER NAIC CODE
See Certificate Number: 570092429816 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
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
ADDITIONAL POLICIES
certificate form for policy limits.
POLICY POLICY
INSR ADDL SUBR POLICY NUMBER LIMITS
EFFECTIVE EXPIRATION
LTR TYPE OF INSURANCE INSD WVD DATE DATE
(MM/DD/YYYY) (MM/DD/YYYY)
OTHER
A EWS115547702 01/01/2022 01/01/2023
WA
SIR applies per policy terms & conditions
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 10768055
LOC #:
ADDITIONAL REMARKS SCHEDULE Page _ of _
AGENCY NAMED INSURED
Aon Risk Services Central, Inc. W.W. Grainger, Inc. and its
POLICY NUMBER
See Certificate Number: 570092429816
CARRIER NAIC CODE
See Certificate Number: 570092429816 EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance
Named Insureds
including Zoro Tools, Inc. and Fabory U.S.A., Ltd.
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Policy Number
GLO
ENDORSEMENT 5542908-09
ZURICH AMERICAN INSURANCE COMPANY
Named Insured W.W. GRAINGER, INC. AND ALL Effective Date: 01-01-22
12:01 A.M., Standard Time
Agent Name AON RISK SERVICES CENTRAL, INC. Agent No. 01784-000
BLANKET ADDITIONAL INSURED
"WHO IS AN INSURED" IS AMENDED TO INCLUDE AS AN INSURED ANY PERSON OR
ORGANIZATION FOR WHOM YOU HAVE AGREED UNDER CONTRACT OR AGREEMENT TO
PROVIDE INSURANCE. HOWEVER, THE INSURANCE PROVIDED SHALL NOT EXCEED
THE SCOPE OF COVERAGE AND/OR LIMITS OF THIS POLICY. NOTWITHSTANDING
THE FOREGOING SENTENCE, IN NO EVENT SHALL THE INSURANCE PROVIDED
EXCEED THE SCOPE OF COVERAGE AND/OR LIMITS REQUIRED BY SAID CONTRACT
OR AGREEMENT.
U-GL-1114-A CW (10/ 02)