COI - Maxim Crane Works, LP - Expires 2022-06-301`�-oRo® CERTIFICATE OF LIABILITY INSURANCE
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OATE(MM/OD/YYYY)
06/23/2021
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 endorsement(s).
PRODUCER
Aon Risk Services Central, Inc.
Pittsburgh PA Office
CONTACT
NAME:
PHONE
(A/C. No. Ext): (866) 283-7122 FAX
No.): (800) 363-0105
EQT Plaza — Suite 2700
625 Liberty Avenue
E-MAIL
ADDRESS:
Pittsburgh PA 15222-3110 USA
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Zurich American Ins Co
16535
Maxim Crane works, LP
7512 Pacific Ave
Pleasant Grove CA 95668 USA
INSURER B: American Zurich Ins Co
40142
INSURER C: National Fire & Marine Ins Co
20079
INSURER D:
INSURER E:
INSURER F:
UUvtHAUtS GEHTIFIGATE NUMBER: 5I0088009581 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
INSH
LTR
ITYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MMIDD/YYYY
MM/DD/YY)Y
LIMITS
X
COMMERCIAL GENERAL LIABILITY
GLO
EACH OCCURRENCE
S5,000,000
CLAIMS MADE a OCCUR
PREMISES Ea occurrence)$100,
000
X
MED EXP (Any one person)
S10, 000
CONTRACTUAL LIABILITY
PERSONAL & ADV INJURY
S5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S12,000,000
POLICY ❑X PRO. ❑ LOC
JECT
PRODUCTS•COMP/OP AGG
$5,000,000
OTHER:
A
AUTOMOBILE LIABILITY
TRK 8979261 21
06/30/202106/30/2022
COMBINED SINGLE LIMIT
(Ea accident)
$2,000,000
BODILY INJURY ( Per person)
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED AUTOS X NON -OWNED
ONLY AUTOS ONLY
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
C
X
UMBRELLA LIAB
OCCUR
42XSF10002209
06/30 2021
06 30 2022
EACH OCCURRENCE
S10,000,000
EXCESS LIAB
H
CLAIMS -MADE
AGGREGATE
$10,000,000
DED RETENTION
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR / PARTNER / EXECUTIVE N
OFFICER/MEMBER EXCLUDED? FN
N 1 A
we 979 142
0 1
06/30/2022
X I PER STATUTE I
OTH-
ER
E.L. EACH ACCIDENT
S1,000,000
E.L. DISEASE -EA EMPLOYEE
$1, 000, 000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L, DISEASE -POLICY LIMIT
S1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Gilroy is included as an Additional Insured for General Liability policy as and to the extent required by written
contract with the Named insured.
CERTIFICATE HOLDER
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS. Na
City Of Gilroy AUTHORIZED REPRESENTATIVE
7351 Rosanna St. -0
Gilroy CA 95020 USA /l Qar
0@1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CANCELLATION
MSC#17755
Aon Risk Services
PO Box 1447
Lincolnshire, IL 60069
MDG2021 00003118 01
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7351 Rosanna St.
Gilroy CA 95020
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