COI - Two Brothers Cathodic Services, Inc. - Expires 2022-02-03TWOBROT-02 ASHORTFS
CERTIFICATE OF LIABILITY INSURANCE
OAT2MMIDDIYYYY)
/3120/2021
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 endorsements .
PRODUCER License # OK07568
CONTACT Alaina Shortes-Bosold
Cumbre Insurance Services, LLC
4065 Mother Lode Drive
Suite A
A ON o, E,n : (530) 558-3959 FAX
No
E-MAIL
DDRESS:alaina@cumbreins.com
Shingle Springs, CA 95682
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Colony Insurance Company
39993
INSURED
INSURER B : National Union Fire Insurance Company of Pittsburgh, Pa.19445
INSURER C :
Two Brothers Cathodic Services, Inc.
INSURER D :
5361 Hilltop Road
Garden Valley, CA 95633
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMRFR- RFVICIC1tU NIIMRFR•
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
TYPE OF INSURANCE
IADDL
SUBRi
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
X
I
!
101 GL000533607
I
21312021
2/3/2022
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED n
PREMISES (Ea
$ 100,000
MED EXP A_n one erson
S 5,000
_
PERSONAL & ADV INJURY
S 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICY n JEtQT I[ ; LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
I $
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRES NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident) S _ __
BODILY INJURY (Per person) $
BODILY INJURY Per accident $
PROPERTY AMAGE
Per accident $
B
X
UMBRELLA LIAR X I OCCUR
EXCESS LIAB CLAIMS -MADE
I
XBS0131345
213/2021
,
2/3/2022
EACH OCCURRENCE
$ 3,000,000
AGGREGATE
$ 3,000,000
DED RETENTION $
$
WRKES AND EMPLOYERS' LIABILITY YIN MPENSATIONI
ANY PROPRIETOR/PARTNER/EXECU I IVE
FFICER/MgMBER EXCLUDED?
Mandatory in NH)
If yes. describe undar
DESCRIPTION OF OPERATIONS below I
N I A
I I
I
TH
STRATUTEI I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE_EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
I
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 named as an additional insured RE: Work performed by the Insured when under contract. 10 days
notice of cancellation for non-payment of premium. 30 days for all others.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy, its officers officials and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
7351 Rosanna Street
Gilroy, CA 95020
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES
OR CONTRACTORS - BLANKET COVERAGE
INCLUDING PRIMARY / NON-CONTRIBUTORY
AND WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s) or Organization(s)
Additional Insured): Locations of Covered Operations:
All persons or organizations as required by a written Locations as required by a written contract or
contract or agreement with the named insured. agreement with the named insured.
A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule for whom you are performing operations when you and such
person or organization have agreed in writing in a contract or agreement that such person or
organization be added as an additional insured on your policy. Such person or organization is an
additional insured only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" caused, in whole or in part, by:
1. your acts or omissions; or
2. the acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s)
designated above.
A person's or organization's status as an additional insured under this endorsement ends when your
operations for that additional insured are completed.
B. With respect to the insurance afforded to these additional insureds, the following additional
exclusions apply:
This insurance does not apply to:
Additional Insured Contractual Liability
"bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages
by reason of the assumption of liability in a contract or agreement.
Finished Operations at Work
"bodily injury" or "property damage" occurring after:
1. all 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 insured(s) at the location of the covered operations has been completed; or
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.
Negligence of Additional Insured
"bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional
insured(s).
U156A-0313 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2
with its permission.
C. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance is
amended and the following added:
The insurance afforded by this Coverage Part for the additional insured required by a written contract
or agreement with the named insured is primary insurance and we will not seek contribution from any
other insurance available to that additional insured.
D. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer Of Rights Of
Recovery Against Others To Us is amended and the following added:
We waive any rights of recovery we may have against any person or organization because of
payments we make for injury or damage resulting from your ongoing operations or "your work" done
under a contract with that person or organization and included in the "products -completed operations
hazard" if:
a. you agreed to such waiver;
b. the waiver is included as part of a written contract or lease; and
c. such written contract or lease was executed prior to any loss to which this insurance applies.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
U156A-0313 Includes copyrighted material of ISO Properties, Inc., Page 2 of 2
with its permission.
COMMERCIAL GENERAL LIABILITY
CG 20 01 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy
provided that:
(1) The additional insured is a Named Insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution
from any other insurance available to the
additional insured.
CG 20 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -
OWNERS, LESSEES OR CONTRACTORS - SCHEDULED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s) or
Organization(s)
(Additional Insured):
Location(s) of Covered Operations:
CITY OF GILROY, ITS OFFICER, OFFICIALS
PER WRITTEN CONTRACT WITH THE
AND EMPLOYEES
NAMED INSURED
A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule for whom you are performing operations when you and such person
or organization have agreed in writing in a contract or agreement that such person or organization be
added as an additional insured on your policy. Such person or organization is an additional insured only
with respect to liability for "bodily injury', It damage" or "personal and advertising injury" caused, in
whole or in part, by:
1 . Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s) designated
above.
A person's or organization's status as an additional insured under this endorsement ends when your
operations for that additional insured are completed.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions
apply:
This insurance does not apply to:
Additional Insured Contractual Liability
"Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by
reason of the assumption of liability in a contract or agreement.
Finished Operations at Work
"Bodily injury" or "property damage" occurring after:
1. All 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 insured(s) at the location of the covered operations has been completed; or
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.
Negligence of Additional Insured
"Bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional
insured(s).
U156-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2
with its permission.