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COI - Two Brothers Cathodic Service - Expires 2023-11-16
®Allstate. yw.w'e mM ram; CUSTOMER NUMBER: 56764 CENTURY PARTNERS INSURANCE AGENCY 13405 FOLSOM ELVD810 FOLSOM, CA 95630 CITY OF GILROY ITS OFFICERS,OFFICIALS AND EMPLOYEES AS ADDITIONAL INSURED 7351 ROSANNA ST GILROY, CA 95020-6141 RUN DATE: 09-02-22 G'3C�C�LOMCDD SEP 2 0 2022 GILROY CITYCLERICS OFFICE BU114-3 100002209020487516530115000070001003 Additional Insured Copy ®Allstate. You're in good hands. M Cl CW A02 10 11 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder. Named Insured: CITY OF GILROY TWO BROTHERS CATHODIC SERVICE ITS OFFICERS, OFFICIALS AND 5361 HILLTOP RD EMPLOYEES AS ADDITIONAL INSURED GARDEN VALLEY CA 95633-9501 7351 ROSANNA ST GILROY, CA USA 950206141 Automobile Uability Insurer Name: Allstate Insurance Company Pol' Number: 048751653 1 -- Any Auto 2 - Owned Autos Only 3 - Owned Priv. Pass. Autos Only 4 -- Owned Autos Other Than Priv. Pass. Autos Only 5 - Owned Autos Subject to No Fault 6 - Owned Autos Subject to a Compulsory UM Law X 17 -- Specifically Described Autos tX 8 - Hired Autos Only X 9 - Nonowned Autos Only Policy Effective Date: 11-16 - 2 0 2 2 1 Policy Expiration Date: 11-16 - 2 0 2 3 Limits of $2, 000, 000 Combined Single Limit (each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description of O rations/Locations/Vehides/Endorsements/S cial Provisions Interested Party Type: Additional Insured - Municipality THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. CENTURY PARTNERS INSURANCE AGENCY Authorized Representative: Date: 09-02-22 Includes copyrighted material of Insurance Services Office, Inc., with its permission CI CW A021011 Allstate Insurance Company Additional Insured Copy Page 1 of 1 Q)Allstate. You're in EoM hands. POLICY NUMBER: 048751653 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: TWO BROTHERS CATHODIC SERVICE Endorsement Effective Date: 11-16 - 2 0 2 2 SCHEDULE Name Of Person(s) Or Organization(s): CITY OF GILROY ITS OFFICERS,OFFICIALS AND EMPLOYEES AS ADDITIONAL INSURED 7351 ROSANNA ST GILROY, CA USA 950206141 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. BIJI14-3 CA20481013 © Insurance Services Office, Inc., 2011 Additional Insured Copy Page 1 of 1