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Method Construction - Insurance Certificate (2018)
METHCON-01 VCASTRO ACO/�'G)► CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ODIYYYY) 10/1812018 III 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 License # 0655907 CONTACT Veronica Castro NAME: The J. Morey Company, Inc. PHONE FAX 1 184 Jackson St. (A/C, No, Ext): (408) 280-5551 ( (A/c, No): San Jose, CA 95112 ABDRESS: rcastro@jmoreyins.com INSURER(S) AFFORDING COVERAGE NAIC It INSURER A: Kinsale Insurance Companv INSURED INSURER B:Ohio Security Ins. Co. Method Construction, Inc. INSURERC:Topa Insurance Companv Ij P.O. Box 2702 INSURER D: StarNet Insurance Company Gilroy, CA 95021 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSD WVD IMM/DD/YYYYI (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 1 OOO OOO CLAIMS -MADE [X]OCCUR X X 0100046859-1 12/30/2017 EACH OCCURRENCE 12/30/2018 I REM $ �100,0001 PDAGE SETO(Ea occurrence) $ — MED EXP (Any one person) $ 5,0001 -.-..- PERSONAL & ADV INJURY $ 1,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ PRO- GENERAL AGGREGATE $ 2,000,0001 POLICY JECT LOC PRODUCTS-COMP/OPAGG 2,000,000 $ OTHER' B AUTOMOBILE LIABILITY I CO eBINEDtSINGLE LIMIT $ 1,000,0001 X ANY AUTO X X BAS58197122 08/05/2018 08/05/2019 BODILY INJURY (Per person) $ OWNED SCHEDULED _ AUTOS ONLY AUTOS IBODILY INJURY (Peraccident) $ HIRED NON -OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY Peraccident) $ UMBRELLA LIAR I X OCCUR X EXCESS LIAB CLAIMS XL6607596-02 12/30/2017 EACH OCCURRENCE 12/30/2018 5,000,000 $ -MADE AGGREGATE $ 5,000,000 DED I I RETENTION $ 5,000,000 D WORKERS COMPENSATION I X I PER I OTH- STATUTE $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X BNUWC0137522 08/01/2018 ER 08/01/2019 E.L. EACH ACCIDENT $ 1,000,0001 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) 1,000,0001 If yes, describe under E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,0001 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 listed as additional insureds in respect to general liability. Coverage is primary and non- contributory. Waiver of subrogation applies. Project: Gilroy Senior Center, 7371 Hanna Street, Gilroy, Ca 95020 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE M'.^u ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 414wl 2 W1, - WJMr11 1e4TAWT SCHEDULED PERSON OR ORGANIZATION 7ttached To andPolity..._„__.,_...........Et�iiy`ZDatevf En"'d-®rsement Named Insured 0100M859-1 12130/2017 1241AM atthe Named Insured Method Construction Inc tions address shown on the Dedarations Additional Premium: Premium. $0 $0 This endorsement modifies Insurance provided under the following: SCHEDULE Nameof Additional Insured Person(s) or OrganlzMlan(s): I I Location(s) of Covered Operations_,,_ City of Gilroy, its officers, officials and employees A. Section 11 — Who Is An Insured is amended to include B. With respect to the Insurance afforded to these as an additional insured the person(s) or additional Insureds, the following additional exclusions organizationts) shown in the Schedule, but only with apply. respect to liability for "bodily injury", "property This Insurance does not apply to "bodily Injury" or damage" or "personal and advertising injury" caused, "property damage" occurring after: in whole or In part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such work, on the 2. The acts or omissions of those acting on your project (other than service, maintenance or behalf; repairs) to be performed by or on behalf of the in the performance of your ongoing operations for the additional insured(s) at the location of the covered additional Insured(s) at the location(s) designated operations has been completed; or above. 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, Effective Date of Endotseinent Of Policy NernedInsured 0100045859-1 12130/2017 12:01AM at the Named Insured Method Construction Inc 'I address shown an the Declarations Attached To and Forening Part Additional Prernhjm__Iurnum _1RP This endorsement modifies Insurance provided under the following: Nome of Additional Insured Person(s) Location and Description of Completed, Operatio_�_q City of Gilroy, its officers, officials and employees 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" or, "property damage" caused, in whole or in part, by "your work" at the locatlon 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". I � � I IMEMAIMMAI.AbObdrai CC 20 37 07 04 its ISO properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: BNUWC0137522 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed, 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA (Blanket) We have the right to recover our payrnents from anyone liable for an injury covered by this policy. We will not enforce Our rif.'jht against the person of, organi'Litim narned in the Schedule. (This agreement applies only to the extent that YoLi Peff0fin work under a written contract that requires you to ohtain thisagreemont from us,) You must maintain payroll recards mxtjratoy segrogating the remuneration of yotir carjjpjoyoes whikt orlgag(,�d in the; Work described in the Schedule, I he additional prorniurn for this ondorsernent shall let's -1.04020000 % of the Galitornia worhors'componsation promium otherwiso due on such renAlfletati011. Schedule State Description CA Any party Will) WhOM the insured agrees to waive SUbrogafion in a written contract `this endorsement c lianoes the poky to Mik,,h it ui attzi(Jied wid is effecWt e of) Ow, date is,;uod airless otherwise stated, (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement EffcOvo DatoPoky Number BNUWC0137522 NU,: ins wed Name: MePiod Construction, Ines. llmvanc'e Compmlystai+lpl Ifism4fice Coinpmy CQUOtersigned By THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. hermig f;i ctie Doteo....ndorstheNareInsure ure01000458591nd FonPort oP/3vfEene'Named Insured 2:01AIVI hod Construction Inc [address shown on the Declarations �ditlonal Premium, Return Premium; $0 $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 rion-contributory. ALL OTHER `TERMS ANC CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS5003 0717 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ D'CAREFULLY, SCHEDULED PERSON OR ORGANIZATION Attached To and Forming Part ofil-017,-- Fff�ctive Dote of Endorsement Named Insurer) 0100045859-1 1.2/30/2017 12:01AM at the Named Insured Method Construction Inc address shown on the Declarations Additional Premium: Return Premium: This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE —�--�mna||nmu--�nnb)u�O,��mi��nb}' -- �� --��*ns ----- --- | 8|anhe�asm4u|�dbywr�tencontect. T |nfnrmet|onre4uiredtocpmp|�te�his��hedv|e,i(notshownahove/wVU*eshow^intheDec|aradons' � _ A. Section U —VVhu 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 "manmna| and advertising injury" caused, in whole or, in part, by: 1. Your acts or ornissions; or 2. The acts or mnba|om of those acting on your behalf; inthe performance ofyour ongoing operations for the additional insured(s) at the location(s) designated above. 0. With respect to the insurance afforded to these additional insureds, the following additional ou|uoiom apply: This insurance does not apply to "bodily Injury" or "property damage" occurring after: 1. AU 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 inswred(s)atthe location /fthe covered operations has been completed; or 2,That portion of"your work" out nfwhich the injury ordamngearises has been put tuits intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for e principal as e part of the same project. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CGZo007U* (9 ISO Properties, ��2004 Page lof1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Attached To and rorming Part of Policy Effective Date of Endorsement I Named Insured 0100045859-1, 12/30/2017 12:01AM at the Narned Insured 1 Method Construction Inc address shown on the Declarations Additional Premiun`): Return Prernium: $0 011 This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name JAdditional on Location and Description of Completed Operations 'n_I'n-'su'red Berson (s) or Organizati" Rsi Blanket, as required by written contract. Information required to co ete this Schedule, if not shown above, will he shown in the Declarations. Section 11 — Who Is An Insured is arnended 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 "ensured arid in- cluded in the "products -completed operations hazard", ALL OTHERTERMS AND CONDITIONS OF Tll[ POLICY REMAIN UNCHANGED. CC 20 37 07 04 (0 ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Attached ro and Forming Port of Policy 0100045859-1 Additional Premium., $0 Effective Date of Endorsement Nained Insured 12/30/2017 12:01AM at the Named Insured Method Construction Inc addrm�s shown on the Declarations T' Return Premi"u'"n"'")": This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE SECTION IV — CONDITIONS, virransfer of Rights of Recovery against Others to Us is amended by the addition of the following: We waive any right of recovery we, mdy have� against, persons or organizations because of payments we make for injury or damage arising out of "your work" done under as 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 0110 Page 1 of 1