COI - HHS Construction, LLC - Expires 2023-09-30.acoizo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMDNYYY)
9/30/2023 08/31/2022
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 INSURERS), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 endomement(s).
PRODUCER Lockton Companies CONTACT
444 W. 47th Street, Suite 900 PHONE - -ac .
Kansas City MO 64112-1906 E-MAIL
(816) 960-9000
kctsu@lockton.com INSURERS AFFORDING COVERAGE _ # NAIC
INSURER A: Hartford Fire Insurance Comoanv 19682
INSURED HHS CONSTRUCTION, LLC
1451971 2042 S. GROVE AVE.
ONTARIO CA 91761
[KsYI4;7ge3c6�ygtilltllay-All 1=1Iill J,W4tif1Hf.11K1:L1. :1A9691017111IT, I:I
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 CONTRACTOR 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
TH L S O S AND COI, DITIONS OF SUCH POLICIES LIMITS SHO Y HAVE BEEN REDUCE D CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUB
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
X
COMMERCIAL GENERM- IABILITY
CLAIM 71 OCCURSPREMISES
Y
N
37 ECSOL5825
09/30/202
09/30/2022
EACH OCCURRENCE
$ 1,000,000
IEa
$ 300OOO
MED EXP (Any one erson
$ 10,000
GEN'L
PERSONAL a AOV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER:
POUCYF PEST �LOC
OTHER:
GENERALAGGREGATE
$2000000
PRODUCTS- COMP/OP AGO
$Z000000
S
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
N
N
37UENOL5831
09/30/202
09/3012023
EaaBINEDSINGLELIMIT
$$1000000
X
BODILY INJURY (Per person)
$ XXXXX)(X
X
BODILY INJURY (Per accident)
$ )CXXXXXX
X
rAOPERTY AMAGE
er accldeM
$ XXXXX
XX
$XXXXXXX
B
X
UMBRELLA LIAB
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
N
N
37XHUOL5832
09/30/202
09/30/202
EACH OCCURRENCE
s 10 000 000
AGGREGATE
$10,000000
DED X I RETENTION $ 10,000
S
WORKERS COMPENSATION
AND EMPLOYERS'LIASILITY YIN
ANY PROPRIETOR?ARTNER/EXECUiNE ❑
mFemetorym NHlSEFF CCLUOE09
DESCRIPTION OF OPERATIONS belmv
DESCRIPTION OF
N/A
NOTAPPLICABLE
EL EACH ACCIDENT
$ XXXXX)x
E.L. DISEASE - EA EMPLOYEE
S XXXXXXX
E.L. DISEASE -POLICY LIMIT
S XXXXXXX
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, AddlOonal Remarks Schedule, may be attached If more space Is required)
RE: SERVICE AGREEMENT: FIRE DEPARTMENT PERSONNEL TESTING. CITY OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYEES ARE ADDITIONAL
INSUREDS ON GENERAL LIABILITY, AS REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY.
G3EEC�C ddoD
GILROY CITY CLERK'S OFFICE I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
18803646
CITY OF GILROY, ITS OFFICERS,
OFFICIALS AND EMPLOYEES
7351 ROSANNA STREET
GILROY, CA 95020
AUTHORIZED
-491 /bj w
25
The ACORD name and logo are registered marks of ACORD
reserved
Attachment Code: D568858 Certificate ID: 18803646
POLICY NUMBER: 37 ECSOL5825
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - OPTION I
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Designated Project(s) Or Location(s)
Or Organization(s):
Of Covered Operations:
CITY OF GILROY, ITS OFFICE RS,OFFICIALS AND
All Operations
EMPLOYEES
Information required to completethis Schedule, if not shown above, will be shown in the Declarations.
A. With respect to those person(s) or
organization(s)shown in the Schedule above when
you have
agreed in a written contract or written agreement
to provide insurance such as is afforded under this
policy to them, Subparagraph f., Any Other
Party, under the Additi ona I Insureds When
Required By Written Contract, Written
Agreement Or Permit Paragraph of Section II —Who Is
An Insured is replaced with the fol I owi ng:
f. Any Other Party
Any other person or organization who is not
an insured under Paragraphs a. through e.
above, but only with respect to liability for
"bodily injury", "property damage" or "personal
and advertising injury" caused, in whole or in
part, by your acts or omissions or the acts or
omissions of those acting on your behalf:
(1) In the performance of your ongoing
operations for such additional insured at
the project(s) or location(s) designated in
the Schedule; 2) In connection with your premises
owned by or rented to you and shown i n the Schedule;
or
(3) In connection with "your work" for the additional
insured at the project(s) or
location(s) designated in the Schedule
and included within the "products completed
operations hazard", but only if:(a) The written
contract or written
agreement requires you to provide
such coverageto such additional
insured at the project(s) or location(s)
designated in the Schedule; and
(b) This Coverage Part provides
coverage for "bodily injury" or
"property da mage" i ncl uded within the
"products -completed operations
hazard".
The insurance afforded to the additional insured
shown in the Schedule applies:
(1) Only if the "bodily injury" or "property
damage" occurs, or the "personal and advertising
injury" offense is committed:
(a) Duri ng the pol icy peri od; a nd
(b) Subsequentto the execution of such
written contract or written agreement;
and
Attachment Code: D568858 Certificate I D : 18803646
(c) Prior to the expiration of the period of
time that the written contractor written
agreement requires such insurance
be provided to the additions! insured.
(2) Only to the extent permitted by law; and
(3) Wi I I not be broader than that which you
are required by the written contract or
written agreement to provide for such
additional insured.
With respect to the insurance afforded to the
person(s) or organization(s) that are additional
insureds under this endorsement, the
following additional exclusion applies:
This insurance does not apply to "bodily
injury", "property damage" or "personal and
advertising injury" arising out of the rendering
of, or the failure to render, any professional
architectural, engineering or surveying
servi ces, i ncl udi ng:
(1) The prepa ri ng, a pprovi ng, or fa i I i ng to
prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders,
change orders, designs or specifications; or
(2) Supervisory, inspection, architectural or
engi neeri ng activities.
The limits of i nsura nce that apply to the additional
insured shown in the Schedule are described in the
Limits Of Insurance section.
How this i ns u ra nce a ppl i es when other insurance is
available to the additional insured is described in
the
Other Insurance Condition in Section IV -Commercial
General Liability Conditions, except as
otherwise amended below.
B. With respect to insurance provided to the
person(s) or organization(s) that are additional
insureds under this endorsement, the When You
Add Others As An Additional Insured To This
Insurance subparagraph, under the Other
Insurance Condition of Section IV —Commercial
General Liability Conditions is replaced with the
fol I owi ng:
When You Add Others As An Additional
Insured To This Insurance
(a) Primary Insurance When Required By
Contract
This insurance is primary if you have agreed
in a written contract or written agreement that
this insurance be primary. If other insurance
is also primary, we will share with all that
other insurance by the method described in
Paragraph (c) below. This i ns ura nce does not
apply to other insurance to which the
additional insured in the Schedule has been
added as an additional insured.
(b) Primary And Non-Contri butory To Other
Insurance When Required By Contract
This insurance is primary to and will not seek
contribution from any other insurance
available to an additional insured under your
pol i cy provi ded that:
(i) The additional insured in the Schedule is
a Named Insured under such other
insurance; and
(i i) You have agreed in a written contract or
written agreement that this insurance
would be primary and would not seek
contribution from any other insurance
available to the additional insured inthe
Schedule.
(c) Method Of Sharing
If all of the other insurance permits
contri buti on by equa I sha res, we wi I I fol I ow
this method also. Under this approach, each
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none of
the I oss rema i ns, whi chever comes fi rst.
If any of the other i nsurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable I i mit of insurance to the total
applicable limits of insurance of all insurers.
Al I other terms and conditions i n the pol icy remain
unchanged.
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