The URL can be used to link to this page

Tiburon Subcontractor - Coplogic (2021)DDN A CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/12/31 /2019 ) 019 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 NAME: Aon Risk Services Northeast, Inc. PHONE (866) 283-7122 I FAX (800) 363-0105 Boston MA office (A/C. No. Ext): (A/C. No.): 53 State Street I E-MAIL suite 2201 ADDRESS: Boston MA 02109 USA I INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Zurich American Ins CO 16535 Copl ogi c, a RELX Inc Company I 231 Market Place INSURER B: ACE American Insurance Company 22667 Suite 520 I INSURER C: Zurich Insurance Plc AA1780059 San Ramon CA 94583 USA IINSURERD: XL Insurance Company SE AA1121547 INSURERE: Lloyd's syndicate No. 2623 AA1128623 Ij INSURER F: COVERAGES CERTIFICATE NUMBER: 570079966265 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. Limits shown are as requested INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYYk �MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY OGLG46663160 1/01/202 1/01/2021 EACH OCCURRENCE $1 , 000 , 000 DAMAGE TO RENTED $1, OOO, OOO CLAIMS -MADE X❑ OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) $5 , 000 PERSONAL & ADV INJURY $1, 000 , 000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO JECT � LOC (PRODUCTS - COMP/OPAGG $2,000,000 OTHER: I Host Liquor Liab $ 5 , 000 , 000 A AUTOMOBILE LIABILITY 8376848 21 01/01/2020 01/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 5 , 000 , 000 X ANY AUTO BODILY INJURY ( Per person) OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED PROPERTY DAMAGE ONLY H AUTOS ONLY (Per accident) X Collision Ded $1,000 X Comp Ded $1,000 C UMBRELLALIAB X OCCUR X EXCESS LIAR CLAIMS -MADE DED I IRETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? N N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E E&O-PL-Primary GBCGP2001519 01/01/2020 12/31/2020 J EACH OCCURRENCE $5 , 000 , 000 AGGREGATE $5,000,000 837684521 01/01/2020 01/01/2021I X I PER STATUTE I JOTH-I ER CD N co CD rn rn CD r L0 0 Z d m O tv U E.L. EACH ACCIDENT $1 , 000 , 000 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 E.L. DISEASE -POLICY LIMIT $1, 000 , 000 -_ FSCE2000015 01/01/2020 12/31/2020 Aggregate Limit $3,000,000 — SIR applies per policy terns & conditions .4L .r3 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)-� Cityof Gilroy is added as additional insured on the General Liability subject to the Mi Y y 7 policy limitations, conditions and =_._1 exclusions. .Fr__ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE r� POLICY PROVISIONS. City of Gilroy AUTHORIZED REPRESENTATIVE • F j 7351 Rosanna Street C = Gilroy CA 95020 USA 0111-' Ill ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: A ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED ADD Risk Services Northeast, Inc. Coplogic, a RELX Inc Company POLICY NUMBER See Certificate Number: 570079966265 CARRIER I NAIC CODE See Certificate Number: 570079966265 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER I INSURER Page _ of _ INSURER I ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL SUER LTR TYPE OF INSURANCE INSD WVD OTHER D E&O-PL-XS POLICY POLICY POLICY NUMBER EFFECTIVE EXPIRATION LIMIITS DATE DATE (M4M/DD/YYYY) OIM/DD/YYYY) FSCE2000059 01/01/2020 12/31/2020 Aggregate $10,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: .4� ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services Northeast, Inc. Coi)logic, a RELX Inc Comr)anv POLICY NUMBER See Certificate Number: 570079966265 CARRIER NAIC CODE see certificate Number: 570079966265 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Companies Affording coverage LINE OF BUSINESS DESCRIPTION POLICY NUMBER POLICY POLICY COMPANY NAIC PRIMARY PERCENTAGE EFFECTIVE EXPIRATION (YIN) OF DATE DATE FLAG RISK (MM/DD/Y YY Y) (MM/DD/YYYY) (workers Compensation 837684521 1/1/2020 1/1/2021 Zurich American Ins co 16535 Y 100 Business Auto Coverage 8376848 21 1/1/2020 1/1/2021 Zurich American Ins Co 16535 Y 100 E&O - Professional FSCE2000015 1/1/2020 12/31/2020 Lloyd's syndicate No. 2623 AA1128( Y 82 Liability - Primary E&O - Professional FSCE2000015 1/1/2020 12/31/2020 Lloyd's Syndicate No. 623 AA1126( N 18 Liability - Primary E&O - Professional FSCE2000059 1/1/2020 12/31/2020 XL Insurance Company SE AA11211 Y 100 Liability - Excess Excess Liability GBCGP2001519 1/1/2020 12/31/2020 Zurich Insurance Plc AA1780( Y 100 Coverage General Liability OGLG46663160 1/1/2020 1/1/2021 ACE American insurance Company 22667 Y 100 Coverage The Subscribing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co -subscribing insurer who for any reason does not satisfy all or part of its obligations. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD