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Overhead Door Co. - Insurance Certificate (2019)ACC>R a CERTIFICATE OF LIABILITY INSURANCE I DA6/MMIDDN Y) 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 certlflcate holder Is an ADDITIONAL INSURED, the policy(les) must 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 'usn"' Candi Bacteria NAME: Leavitt Central Coast Insuzance Services, Inc. I HONE PHI, (831) 424-6404 (NC. Nol: I8a11424-014p License #OG39781 It-MAI-L candi-renteria@leavitt.com ADDRESS. 950 East Blanco Rd, Suite 103 INSURERS) AFFORDING COVERAGE NAIC q Salinas CA 93901 INSURER A: Houston Specialty Insurance Company a12936 INSURED INSURER B: California Automobile Insurance Compare} 38342 Overhead Door Co. of Santa Clara Valley Inc. INSURER C: Insurance Company of the West 27847 INSURER D: Fireman Fund Insurance Company a21873 733 Sanborn Place (INSURER E: Salinas CA 93901 LINSURERF: COVERAGES CERTIFICATE NUMBER:18-19 MASTER-SANTA CLARA 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 PAI ) CLAIMS. INSR ADDL Sues POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INAn wen POLICY NUMBER IMMIDDIYYYYI IMMjIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE � OCCUR no ecal for residential MM2264 $0 deductible GENT AGGREGATE LIMIT APPLIES PER: POLICY [X] jEOT TOO OTHER: AUTOMOBILE LIABILITY B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-0WNED X HIREDAUTOS X AUTOS X sl'ow COMP X $1,000 COLL UMBRELLA LIAB X OCCUR A X EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER E(CLUDED? ❑ NIA C (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below D EQUIPMENT FLOATER M040000049314 MMN50269 WPL504876200 SM93045905 EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occunence) $ 11/1/2018 31/1/2019 MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMPIOPAGG $ COMBINED SINGLE LIMI I $ (Ea accldent) BODILY INJURY (Per person) $ 11/1/2018 11/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ fPer amMentl $ I EACH OCCURRENCE $ I AGGREGATE $ 11/1/2018 11/1/2019 I $ X I STATUTE I I ERH I El EACH ACCIDENT $ 6/6/2019 6/6/2020 I EL DISEASE - EA EMPLOYEE $ E L. DISEASE -POLICY LIMIT $ 11/1/203B 11/1/2019 Rented4.nosetllLeaaed DED DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACvRD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Gilroy, its officers and employees are included as Additional Insureds per the attached endorsement form CERTIFICATE HOLDER City of Gilroy Attn: Rick Brandini 7351 Rosanna Street Gilroy, CA 95020 ACORD 25 (2014/01) INS025 (201401) CANCELLATION 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000I I I 5,000,000I 5,000,000 1,000,000 11000,000 1,000,000 $25,000 41,000 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 Francis Svedas/CARENT a, © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON / ORG WHEN REQUIRED BY WRITTEN CONTRACT 3 %of the total California Workers' Compensation premium Schedule Job Description ALL CA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/06/2019 Policy No. WPL 5048762 00 Endorsement No. Insured OVERHEAD DOOR COMPANY INC Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST p Countersigned By �n nrrJ 1C1 ro,in n_ WC 99 06 34 (Ed. 8-00) INSURED