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COI - Bud Line Trucking Inc - Expires 2022-06-23BUDLIA ACORN CERTIFICATE OF LIABILITY INSURANCE ID- HE DATE (MM/DDNM) 06/30/2021 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 530-626-2533 ISU Insurance Services Atwood Agency Pacific Street Placerville, CA 95667 Hillary R. Erickson CONTACT Hillary R. Erickson PHONE EXt): 530-626-2533 mac, No :530-622-5221 (800 EMAIL herickson@atwoodins.com ADD ESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A : Canal Insurnace Company 10464 INSURED Bud Line Trucking Inc PO Box 292249 Sacramento, CA 95829 INSURER B : Atain Specialty Insurance Co INSURER C : p State Compensation Ins Fund 35076 INSURER D: Endurance Risk Solutions 43630 INSURER E : Crum & Forster 44520 INSURER F : I !t::J cnVPPAnPA CFRTIFICOTF NUMRER- 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. INSR TYPE OF INSURANCE ADDL SUB ima POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X BWPF0000403ROI 06/2312021 06/23/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 jpeT LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS X AUTOS ONLY X AUTOS Oh X 15581420013 06/23/2021 06/23/2022 COMBINED SINGLE LIMIT (Ea accident)ANY $ 1,000,000 BODILY INJURY Perperson) $ BODILY BODILY INJURY Per accident $ PBOaPcR* DAMAGE $ E UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SE0114012 06/23/2021 06/23/2022 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 DED RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYYIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under IDES RIPTION OF OPERATIONS below N / A 908399721 01101/2021 01/01/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 D Motor Truck Cargo IMU30002473500 01/01/2021 01/01/2022 Cargo 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is named as additional insured on General Liability and Auto Liability. Additional Insured only exists when a written agreement between the named insured and each additional insured requires such status. CITYGIL City of Gilroy 7351 Rosanna St Gilroy, CA 95020 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 R E4i&-4d1W ACORD 25 (2016/03) 01988-2016 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 -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Locations of Covered Operations II persons or organizations as required by written Locations as required by specific, written contract. contract with the insured. A. SECTION II WHO IS AN INSURED is amended to include as an additional insured the persons) or organizations) 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 a 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' or organizations 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 or 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" directly caused by or resulting from the negligence of the "additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: BWPF0000403R01 Named Insured: BUD LINE TRUCKING INC Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 07/2012 with Its permission POLICY NUMBER: 1-558142001-3 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Bud Line Trucking Inc Endorsement Effective Date: 06/23/2021 SCHEDULE Name Of Person(s) Or Organization(s): City of Gilroy 7351 Rosanna St, Gilroy, CA 95020 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1