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COI - Luhdorff & Scalmanini Consulting Engineers, Inc. - Expires 2023-10-14
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 9/28/2022 HUB International Insurance Services Inc. PO Box 255387 Sacramento CA 95865 Carol Dunn 916-480-4182 916-993-7282 carol.dunn@hubinternational.com License#:0757776 Sentinel Insurance Company,Ltd.11000 LUHD&SC-01 Trumbull Insurance Company 27120Luhdorff&Scalmanini Consulting Engineers,Inc. 500 First Street Woodland CA 95695 Travelers Casualty &Surety Company of America 31194 Hartford Insurance Group 914 1443556854 A X 1,000,000 X 1,000,000 10,000 1,000,000 2,000,000 X Y Y 57 SBA BN7796 10/14/2022 10/14/2023 2,000,000 B 1,000,000 X X X Y Y 57 UEC BB8794 10/14/2022 10/14/2023 A X X 3,000,00057SBABN779610/14/2022 10/14/2023 3,000,000 X 10,000 D X Y 57 WEC AM9L32 10/14/2022 10/14/2023 1,000,000 1,000,000 1,000,000 C Professional Liability Includes Pollution Incident Liability 106993020 10/14/2022 10/14/2023 Per Claim Annual Aggregate $2,000,000 $4,000,000 RE:Potable Water Well Number 9 (McCarthy Well),Project No.19-RFP-PW-420. Additional Insured:City of Gilroy,its officers,officials and employees where required by written contract.Policies provide for 30 Days Notice of Cancellation, except 10 Days for Non-payment of Premium. Forms:CA0001 1013,HA9916 0312,SS0008 0405 City of Gilroy,its officers,officials and employees 7351 Rosanna St. Gilroy CA 95020 DocuSign Envelope ID: 0B96DFA2-441F-4E37-9CD9-559EB5DBAB73 32/,&<180%(5 8(& %% DocuSign Envelope ID: 0B96DFA2-441F-4E37-9CD9-559EB5DBAB73 32/,&<180%(5 6%$ %1 DocuSign Envelope ID: 0B96DFA2-441F-4E37-9CD9-559EB5DBAB73