CALTROP - Insurance Certificate (2019)Client #: 25380
TRCCOMPA
ACORD., CERTIFICATE OF LIABILITY INSURANCE
DATE(MM /DD/YYYY)
3/22/2018
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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Greyling Ins. Brokerage /EPIC
3780 Mansell Road, Suite 370
Alpharetta, GA 30022
CONTACT
NAME: Jerry NOyola
PHONE 770- 552 -4225 FAX
A/C, No, Ext : A/C, No :866- 550 -4082
E -MAIL
ADDRESS: jerry.noyola @greyling.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: National Union Fire Ins. co.
19445
5341999
INSURED
CALTROP Corporation a TRC Company
21 Griffin Road North
Windsor, CT 06095
INSURERS: xLSpecialryinsurance co.
37885
INSURER C ; New Hampshire Ins. co.
23841
INSURER Steadfast Insurance Company
:
26387
MED EXP (Any one person)
$25,000
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 18 -19 REVISION NtIMRFR-
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.
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MM /DDY /YYYY
MMIDDY/YYYY
LIMITS
•
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
5341999
D4/01/2018
04/01/2019
EACH OCCURRENCE
$1,000,000
PREMISES E.occurrrence
$500,000
X
MED EXP (Any one person)
$25,000
Contractual Liab.
PERSONAL &ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY � JECOT [XI LOC
I GENERAL AGGREGATE
$2,000,000
GEN'L
PRODUCTS - COMP /OP AGG
$2,000,000
$
OTHER:
•
AUTOMOBILE
LIABILITY
4773667(AOS)
4/01/2018
04101/201
Ee aBINEDtSINGLE LIMIT
$1,000,000
BODILY INJURY (Per person)
$
A
AUTO
4773668 (MA)
04/01/2018
04/01/2019
IANY
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON-OWNED
AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
B
X
UMBRELLA LIAB
X
OCCUR
US00075712LI18A
4/01/2018
04101/201
EACH OCCURRENCE
$9 000 000
AGGREGATE
$9 OOQ 000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION $1O 000
$
C
•
•
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED? N
(Mandatory in NH)
N/A
022298274 AOS
( )
022298275 (CA)
022298276 (ME)
4/01/2018
4/01/2018
4/01/2018
04/01/2019
04/01/201
04/01/201
X E
PTAT TE O RH-
E.L. EACH ACCIDENT
1$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1,000,000
D
Prof. Liab. incl.
PECO19684302
4/01/2018
04/011201
Per Claim $5,000,000
Poll. Liab.
Aggregate $5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Gilroy, its officers, elected or appointed officials, employees, agents & volunteers are named
as Additional Insureds on the above referenced liability policies with the exception of workers compensation
& professional liability where required by written contract. The above referenced liability policies with
the exception of workers compensation & professional liability are primary & non contributory where required
by written contract. Umbrella Follows Form with respects to General, Automobile & Employers Liability
(See Attached Descriptions)
t-IGA I t FIULU
City of Gilroy Public Works Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Nadia Garcia ACCORDANCE WITH THE POLICY PROVISIONS.
7351 Rosanna Street
Gilroy, CA 95020 -0000 AUTHORIZED REPRESENTATIVE
,6'1/14w '
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