Loading...
Maggiora Bros. Drilling - Insurance Certificate (2021)MAGGIBROI AC RO o® CERTIFICATE OF LIABILITY INSURANCE DATE/ 12/2727/2019 Y) 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: Commercial Lines - (628) 201-9001 PHONE FAX (A)C No. Ext): (A/C. No): 610.537.2393 US] Insurance Services LLC - CA Lic#: OD08408 I E-MAILADDRECertRequests@usi.com 201 Mission St, 11th Floor I INSURER(S) AFFORDING COVERAGE NAIC # San Francisco, CA 94105 I INSURERA: Continental Insurance Company 35289 INSURED INSURERB: Continental Casualty Company 20443 Maggiora Bros. Drilling Inc. I INSURERC: Cypress Insurance Company 10855 595 Airport Boulevard I INSURER D I INSURER E : Watsonville, CA 95076 INSURER F COVERAGES CERTIFICATE NUMBER: 14732261 REVISION NUMBER: See below 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 ADDL SUER I POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MMIDDYYY) (MMIDDIYYYY) I TYPE OF INSURANCE /Y LIMITS A X COMMERCIAL GENERAL LIABILITY X 4015556058 CLAIMS -MADE � OCCUR X BI/PD Ded: S5,000 X I XCU Included GEN'L AGGREGATE LIMIT APPLIES PER: PRO - X� POLICY ECT LOC OTHER: B AUTOMOBILE LIABILITY X 4016912684 X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR �—{ 4016912670 EXCESS LIAB CLAIMS -MADE DED I X I RETENTIONS 10,000 C WORKERS COMPENSATION MAWC127987 AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTI V E OFFICER/M EMBER EXCLUDED? ❑ N I A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 1 /1 /2020 1 /1 /2021 1 /1 /2020 1 /1 /2021 EACH OCCURRENCE DAMAGE 10 RENT ED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMPIOP AGG S 1,000,000 S 100,000 S 15,000 5 1,000,000 S 2,000,000 S 2,000,000 S COMBINED SINGLE LIMIT (Ea accident) S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ 01/01/2020 01/01/20211 EACHOCCURRENCE S 5,000,000 I AGGREGATE S 5,000,000 1/1/2020 1/1/2021 X I STATUTE I PER ERH E.L. EACH ACCIDENT $ 1,000.000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SCA23500D (Ed. 10/11),CNA75079XX (1-15) The City of Gilroy, its officers, and employees is named as additional insured as respects general liability and automobile liability per endorsements attached. CERTIFICATE HOLDER CANCELLATION City Of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 613 Old Gilroy St. ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE I The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 11111111 II (III 1E 11111 II II 11111 l 11 III 1111 11� 'CYB01 A27/003262/02/07/0/0/0/0' POLICY PLUMBER: 4016912684 CNA SCA 23 500D (Ed. 10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED COVERAGE ENDORSEMENT - BA PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILTY COVERAGE A. Who Is An Insured The following Is added to Section 11, Paragraph A.1., Who Is An.lnsured: 1. a. Any Incorporated entity of which the Named Insured owns a majority of the voting stock on the date of Inception of this Coverage Form; provided that, b. The insurance afforded by this provision A.I. does not apply to any such entity that Is an "Insured" under any other liability "policy" providing "auto" coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest, The Insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of Its Inception date, whichever is earlier. b. Does not apply to: (1) "Bodily injury" or "property damage" caused by an "accident" that occurred before you acquired or formed the organization; or (2) Any such organization that is an "Insured" under any other liability "policy" providing "auto" coverage. 3. Any person or organization that you are obligated to provide Insurance where required by a written contract or agreement is an insured, but only with respect to legal responsibility for acts or omissions of a person for whom Liability Coverage is afforded under this policy. 4. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement In that "employee's" name, with your permission, while performing duties related to the conduct of your business. "Policy," as used in this provision A. Who Is An Insured, Includes those policies that were In force on the Inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Ball Bonds and Loss of Earnings Section II, Paragraphs A.2.a.(2) and A.2.a.(4) are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is Increased from $2,000 to $5,000, and 2. In a.(4), the limit for the loss of earnings is increased from $250 to $600 a day. C. Fellow Employee Section 11, paragraph 13.5 does not apply. Such coverage as is afforded by this provision G. is excess over any other collectible Insurance. If. PHYSICAL DAMAGE COVERAGE A. Towing Section 111. Paragraph A.2., is revised to include Light Trucks up to 10,000 pounds Q.V.W. B. Glass Breakage — Hitting A Bird Or Animal -- Falling Objects Or Missiles The following Is added to Section III, Paragraph A.3.: With respect to any covered "auto," any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, In a manner acceptable to us, rather than replaced. C. Transportation Expenses Section III, Paragraph AA.a. is revised, with respect to transportation expense Incurred by you, to provide: a. $60 per day, in lieu of $20; subject to b. $1,800 maximum, in lieu of $600, D. Loss of Use Expenses Section III, Paragraph A.4.b. Is revised, with respect to loss of use expenses incurred by you, to provide: a. $1,000 maximum, in lieu of $600, E. Personal Property The following is added to Section i1I, Paragraph A.4. SCA 23 500D Copyright, CNA corporation, loon. Page 1 of 3 (Ed. 10/11) Includes copyrighted material of the Insurance SoMoes office mod with Its pormissien. 'CYB01 A27/0032fi2/n3/07/0/e/0/e' CNA c. We will pay up to $500 for loss to Personal Property which is; (1) Owned by an "insured"; and (2) In or on the covered "auto." This coverage applies only In the event of a total theft of your covered "auto." This Insurance Is excess over any other collectible insurance and no deductible applies. F. Rental Reimbursement The following is added to Section III, Paragraph A.4.. d. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto," Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto." No deductibles apply to this coverage. 1. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto"; or, (b) 15 days. 2. Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or, (b) $25 per day subject to a maximum of $375. 3. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 4. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension. SCA 23 500D (Ed. 10(11) a. Any covered "auto" you lease, hire, rent or borrow without a driver; and b. Any covered "auto" hired or rented by your "employee" without a driver, under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. c. The most we will pay for any one "accident" or "loss" Is the actual cash value, cost of repair, cost of replacement or $75,000 whichever is less minus a $500 deductible for each covered auto. No deductible applies to "loss" caused by fire or lightning. d. The physical damage coverage as is provided by this provision will be limited to the types of physical damage coverage(s) provided on your owned "autos." e. such physical damage coverage for hired "autos" will; (1) Include loss of use, provided it is the consequence of an "accident" for which the Named Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern. (2) Such coverage as Is provided by this provision G.e.(1) will be subject to a limit of $750 per "accident." H. Airbag Coverage The following Is added to Section III, Paragraph B.3. The accidental discharge of an airbag shall not be considered mechanical breakdown. G. Hired "Autos" The following is added to Section ill. Paragraph A.. J. 5. Hired "Autos" If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired Autos, then Physical Damage coverage is extended to; Electronic Equipment Section III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following: c. Physical Damage Coverage on a covered "auto" also applies to "loss" to any permanently Installed electronic equipment including Its antennas and other accessories d. A $100 per occurrence deductible applies to the coverage provided by this provision. ',diminution in value The following Is added to Section ill, Paragraph 8.6. Subject to the following, the "diminution in value" exclusion does not apply to: SCA 23 500D Copyright, CNA Corporation, 2000. Page 2 of 3 (Ed. 10/11) lnoludos oopyrighled material of the Insurance Services office used with Its pemisslon. •cvso � nz�iooszsvoarmroioroio CNA a. Any covered "auto" of the private passenger type you lease, hire, rent or borrow, without a driver for a period of 30 days or less, while performing duties related to the conduct of your business; and b. Any covered "auto" of the private passenger type hired or rented by your "employee" without a driver for a period of 30 days or less, under a contract In that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. c. Such coverage as is provided by this provision is limited to a "dlminutlon In value" loss arising directly out of accidental damage and not as a result of the failure to make repairs; faulty or incomplete maintenance or repairs; or the installation of substandard parts. d. The most we will pay for "loss" to a covered "auto" in any one accident is the lesser of: (1) $5,000; or (2) 20% of the "auto's" actual cash value (ACV) Ill. Drive Other Car Coverage Executive Officers The following is added to Sections II and III: 1. Any "auto" you don't own, hire or borrow Is a covered "auto" for Liability Coverage while being used by, and for Physical Damage Coverage while In the care, custody or control of, any of your "executive officers," except: a. An "auto" owned by that "executive officer" or a member of that person's household; or b. An "auto" used by that "executive officer" while working in a business of selling, servicing, repairing or parking "autos." Such Liability and/or Physical Damage Coverage as is afforded by this provision will be: (1) Equal to the greatest of those coverages afforded any covered "auto"; and (2) Excess over any other collectible Insurance. 2. For purposes of this provision, "executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar SCA 23 500D (Ed. 10/11) governing document, and, while a resident of the same household, includes that person's spouse. Such "executive officers" are "insureds" while using a covered "auto" described In this provision. IV. BUSINESS AUTO CONDITIONS A. Duties In The Event Of Accident, Claim, Suit Or Loss The following is added to Section IV, Paragraph A,2.a. (4) Your "employees" may know of an "accident" or "loss," This will not mean that you have such knowledge, unless such "accident" or "loss" Is known to you or If you are not an individual, to any of your executive officers or partners or your Insurance manager. The following is added to Section IV, Paragraph A.2.b. (6) Your "employees" may know of documents received concerning a claim or "suit." This will not mean that you have such knowledge, unless receipt of such documents Is known to you or If you are not an Individual, to any of your executive officers or partners or your Insurance manager. B. Concealment, Misrepresentation or Fraud The following is added to Section IV, Paragraph B.2. Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. C. Policy Period, Coverage Territory Section IV, Paragraphs 7.(5).(a). is revised to provide: a. 45 days of coverage in lieu of 30 days V. DEFINITIONS Section V. Paragraph C. is deleted and replaced by the fallowing; "Bodily Injury" means bodily Injury, sickness or disease sustained by a person, including mental anguish, mental Injury or death resulting from any of these SCA 23 500D CopyAght, CNA Corporation, 2000. (Ed. 1Oil 1) Includes copyrlphled materlel of the Insuranoe Services Office used with its permission. Page 3 of 3 'CYB01A27/003262/05/07/0/0/0/0' CAM CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: The WHO 1S AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this coverage part, including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. unless paragraph B. below applies, 1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the acts or omissions by or on behalf of the Named Insured and in the performance of such Named Insureds ongoing operations as specified in such written contract; or 2. bodily injury or property damage caused in whole or in part by your work and included in the products - completed operations hazard, and only if a, the written contract requires the Named Insured to provide the additional insured such coverage; and b. this coverage part provides such coverage. B. bodily injury, property damage, or personal and advertising injury arising out of your work described in such written contract, but only if. 1. this coverage part provides coverage for bodily injury or property damage included within the products completed operations hazard; and 2. the written contract specifically requires the Named Insured to provide additional insured coverage under the 11-85 or 10-01 edition of CG2010 or the 10-01 edition of CG2037. 11. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written CNA75079XX (1-15) Policy No: 4015556058 Page 1 of 2 Endorsement No: CONTINENTAL INSURANCE COMPANY Effective Date: 1 / 1 / 20 Insured Name: MAGGIORA BROS . DRILLING INC. Copyright CNA All Rights ReservedIIIIII III Illl�yIII lIgll materialed Insurance S siIcthis permission. IP 11illl IIIII llIIIIIIIllII IIIIIll I iOffice -CYB01A27/0032.0 1111 /0.V CAM CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effector becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated Ini said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (1-15) Policy No: 4015556058 Paae 2 of 2 Endorsement No: CONTINENTAL INSURANCE COMPANY Effective Date: 1/1/20 Insured Name: 1 AGGIOPA BROS. DRILLING INC. copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. ' C Y B O t A27/003262/07/07/0/0/0/0'