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Jones Hall - Insurance Certificates (2018)
AICO'RO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) v 03/30/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nenette Murata NAME: Calender- Robinson Company, Inc. PHONE (415) 978 -3800 FAX (415) 978 -3825 A/C No Ext : A /C, No 0267063 ADDRESS: nmurata@calrob.com 233 Sansome St. Ste 508 EACH OCCURRENCE $ 2,000,000 INSURER(S) AFFORDING COVERAGE NAIC # San Francisco CA 94104 INSURER A: Sentinel Insurance Co., LTD 11000 INSURED INSURER B : Republic Indemnity Co ofAmerica 22179 Jones Hall, a Professional Law Corporation INSURER C: 475 Sansome Street INSURER D: Suite 1700 INSURER E: A San Francisco CA 94111 INSURER F: 57SBANK7611 COVERAGES CERTIFICATE NUMBER: 2018 -2019 WC Renewal 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADUL1SUBR INSD WVD POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE $ 2,000,000 ffA_MAr.E TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY- $ 2,000,000 A Y 57SBANK7611 10/01/2017 10/01/2018 GEN'LAGGREGATE LIMITAPPLIES PER: X POLICY JECT PRO ❑ LGC GENERAL_AGGREGATE $ 4,000,000 PRODUCTS- COMP /OP AGG $ 4,000,000 $ OTHER: I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 57SBANK7611 10/01/2017 10/01/2018 BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE 57SBANK7611 10/01/2017 10/01/2018 AGGREGATE $ 1,000,000 DED X1 RETENTION $ 10,000 $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ N/A 168749 -13 04/01/2018 04/01/2019 X STATUTE EORH AND E.L. E EACH ACCIDENT $ ,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLIC`! LIMIT J 3 1,000,000 EMPLOYEE BENEFITS EACH CLAIM: $2,000,000 A 57SBANK7611 10/01/2017 10/01/2018 AGGREGATE: $4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy, its officers, officials and employees are named as additional insureds on the general liability policy but only with respect to liability arising out of the named insured's operations or premises owned by or rented to the named insured with respect to formation of a landscape maintenance community facilities district. Note: 10 day notice of cancellation applies for non - payment of premium I JUN ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Teresa Mack AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy CA 95020 �„�,/, ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Named Insured: Jones Hall, A Professional Law Corporation Policy Number: 57SBANK7611 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED Additional Insureds When Required By Written Contract, Written Agreement Or Permit 6. Additional Insureds When Required By Written Contract, Written Agreement or Permit The person(s) or organization(s) identified in Paragraphs a through f below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other party or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products- completed operations hazard ", but only if: (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products- completed operations hazard ". (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily Injury ", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawing specifications; or (b) Supervisory, inspection, architectural or engineering activities Form SS 00 08 04 05 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 03/30/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nenette Murata X NAME: Calender- Robinson Company, Inc. PHONE., No (415) 978 -3800 FAX, (415) 978 -3825 Ext : No : 0267063 E -MAIL nmurata @calrob.com ADDRESS: 233 Sansome St. Ste 508 DAMAGE RE TED PREMISES Ea occurrence $ 1,000,000 INSURER(S) AFFORDING COVERAGE NAIC # San Francisco CA 94104 INSURERA: Sentinel Insurance Co., LTD 11000 INSURED INSURER B: Republic Indemnity Co ofAmerica 22179 Jones Hall, a Professional Law Corporation INSURER C: 475 Sansome Street INSURER D: $ 2,000,000 Suite 1700 INSURER E: San Francisco CA 94111 INSURER F: 10/01/2018 COVERAGES CERTIFICATE NUMBER: 2018 -2019 WC Renewal 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. INSR LTR TYPE OF INSURANCE ADUL15UHR INSD WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE RE TED PREMISES Ea occurrence $ 1,000,000 —PREMISES MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 2,000,000 A Y 57SBANK7611 10/01/2017 10/01/2018 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY 1 PRO ❑ JECT LOC PRODUCTS $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 57SBANK7611 10/01/2017 10/01/2018 BODILY INJURY (Per accident) $ X HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESSLIIAB CLAIMS -MADE 57SBANK7611 10/01/2017 10/01/2018 AGGREGATE $ 1,000,000 u DED RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA 168749 -13 04/01/2018 04/01/2019 �/ /� STATUTE EORH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1.000,000 EMPLOYEE BENEFITS EACH CLAIM: $2,000,000 A 57SBANK7611 10/01/2017 10/01/2018 AGGREGATE: $4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Covered Loc. Deer Park CFD City of Gilroy is named as additional insured as per the attached endorsement - NOTE: 10 day notice of cancellation for non - payment of premium GANGELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Sandra A. Meditch, P.E. AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy CA 95020 @ 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Named Insured: Jones Hall, A Professional Law Corporation Policy Number: 57SBANK7611 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED Additional Insureds When Required By Written Contract, Written Agreement Or Permit 6. Additional Insureds When Required By Written Contract, Written Agreement or Permit The person(s) or organization(s) identified in Paragraphs a through f below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other party or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products- completed operations hazard ", but only if: (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products- completed operations hazard ". (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily Injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawing specifications; or (b) Supervisory, inspection, architectural or engineering activities Form SS 00 08 04 05