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Method Construction - Insurance Certificate
MFTHA_1 AP In. RC CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD1YYY1f) 12/20/2017 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 408 - 280 -5551 The J. Morey Co., Inc. License #0655907 184 Jackson Street C NTACT Veronica "Roni" Castro PHONE c 408 - 280 -5551 FAX - 280 -1368 A A/C, No E -MAIL ADDRESSa San Jose, CA 95112 0100045859 -1 12/30/2017 Veronica "Ron!" Castro INSURERS AFFORDING COVERAGE NAIC # INSURER A, Kinsale Insurance Company DAMAGES(O RENTED E. INSURED Method Construction, Inc. INSURER B: West American Insurance CO. MED EXP (Any one personi P.O. Box 2702 Gilroy, CA 95021 Midwest Employers Casual Co. INSURER C : Casualty INSURER D: Topa Insurance Company 1'000'000 INSURER E: GENERAL AGGREGATE 2'000'000 INSURER F: $ 2,000,000 CAVFROGF-R CFRTIFICOTF NUMRFR- REVISION NLIMRFR- 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 TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP iMMIDONYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FA] OCCUR X X 0100045859 -1 12/30/2017 12/30/2018 EACH OCCURRENCE 1'000'000 DAMAGES(O RENTED E. 100,000 MED EXP (Any one personi $ 5'000 PERSONAL & ADV INJURY 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X PPCOj -- FI LOC OTHER: GENERAL AGGREGATE 2'000'000 PRODUCTS - COMP /OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS yy p X AUTOS ONLY X AUTOS ONLY X X BAW58197122 08/05/2017 08/05/2018 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY Per person) BODILY INJURY Per accident) Pena cde DAMAGE D UMBRELLA UA13 EXCESS LIAB X OCCUR CLAIMS -MADE XL6607596 -02 12/30/2017 12/3012018 EACH OCCURRENCE 51000'000 X AGGREGATE 5'000'000 DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If es, describe under D P I ON OF OPrIRATIONS o N/A X BNUWC0137622 08/01/2017 08/01/2018 - X PER OTH- E. L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 1'000'000 POLICY 0,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Gilroy, its officials and employees are listed as additional insureds in respect to general liability. Coverage is primary and non- contributory. Waiver of subrogation applies. 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 I f' ACORD 25 (2016/03) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON - CONTRIBUTORY ENDORSEMENT Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100045859-1 12/30/201712:01AM at the Named Insured Method Construction Inc address shown on the Declarations Additional Premium: Return Premium; SO 1 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE ENVIRONMENTAL CONTRACTING AND PROFESSIONAL SERVICES LIABILITY COVERAGE PRODUCTS POLLUTION LIABILITY COVERAGE The insurance provided to Additional Insureds shall be excess with respect to any other valid and collectible insurance available to the Additional Insured unless the written contract specifically requires that this insurance apply on a primary and non - contributory basis, in which case this insurance shall be primary and non - contributory. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CASS003 0717 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION Attached To and Forming Port of polity Effective Dote of Endorsement Named Insured 0100045859 -1 12/30/201712:01AM at the Named Insured Method Construction Inc address shown on the Declarations Additional Premium; Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organizatlon(s): Location(s) of Covered Operations Blanket, as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional: exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CG 20 10 07 04 0 150 Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS Attached To and forming Part of Policy Effective Dote of Endorsement Named insured 0100045859 -1 12/30/201712:01AM at the Named Insured Method Construction Inc address shown on the Declarations Premium: Return Premium: This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional insured Persons or Organization(s) Location and Description of Completed Operatlops Blanket, as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section it — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location desig- nated and described in the schedule of this endorse - ment performed for that additional insured and in- cluded in the "products - completed operations hazard ". ALL OTHER TERMS AND CONDITIONS.OF THE POLICY REMAIN UNCHANGED. CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US- BLANKET Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100045859 -1 12/30/201712:01AM at the Named Insured Method Construction Inc address shown on the Declarations Additional Premium: Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE SECTION IV — CONDITIONS, S. Transfer of Rights of Recovery against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against persons or organizations because of payments we make for injury or damage arising out of "your work" done under a written contract with that person or organization wherein you have agreed to provide this waiver. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS4002 0210 Page 1 of 1