The URL can be used to link to this page

COI - American Wind Transport Group, LLC - Expires 2024-08-01ACD eb �f. CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 DATE (MM'DD/YYYY) 03/21/2023 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 ri • hts to the certificate holder in lieu of such endorsement(s). PRODUCER Willis Towers Watson Midwest, Inc. c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA INSURED American Transport, Inc.; ATI Trucking, LLC; American Wind Transport Group, LLC 200 Airside Drive, Suite 260 Moon Township, PA 15108 COVERAGES CERTIFICATE NUMBER: W28389858 CONTACT NAME: Willis Towers Watson Certificate Center PHONE , 1-877-945-7378 . FAX No: 1-888-467-2378 .I E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE INSURERA: RLI Insurance Company INSURERS: Lexington Insurance Company INSURER C : NAIC 13056 19437 INSURER D : INSURER E : INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR ADDL;SUBR ' POLICY EFF LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM'DDIYYYY) THE INSURED OR OTHER DESCRIBED PAID CLAIMS POLICY EXP (MMMDDIYYYY) NAMED ABOVE FOR THE DOCUMENT WITH RESPECT HEREIN IS SUBJECT TO POLICY PERIOD TO WHICH THIS ALL THE TERMS. LIMITS X COMMERCIAL GENERAL LIABILITY ' EACH OCCURRENCE $ 1,000, 000 X CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISEStEa occurrence)_ $ A , MED EXP (Any one person) $ 5, 000 Y LGL0012094 04/01/2023 08/01/2024 PERSONAL &ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000, 000 X , POLICY . PRO- , j LOC PRODUCTS - COMP/OP AGG i S 1, 000, 000 OTHER: $ AUTOMOBILEUABILITY COMBINED SINGLE LIMIT $ 1,000, 000 _ accident)-- _ _LEa --_ -- �— BODILY INJURY (Per person) $ X ANY AUTO A XOWNED ; AUTOS ONLY SCHEDULED Y LFT0013314 04/01/2023 AUTOS 08/01/2024': BODILY INJURY (Per accident) $ HIRED X AUTOS ONLY X NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR —^ EACH OCCURRENCE $ EXCESS LIAB I j CLAIMS -MADE AGGREGATE $ DED T RETENTIONS $ WORKERS COMPENSATION PER I OTH• AND EMPLOYERS' LIABILITY Y / N STATUTE ER `` E.L. EACH ACCIDENT $ ANYPROPRIETORIPARTNER/EXECUTIVE OFFICEW'MEMBEREXCLUDED? NIA — (Mandatory In NH) IE.L. DISEASE - EA EMPLOYEE $ II yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT $ B Motor Truck cargo 51567017 08/01/2022 08/01/2023 Limit: $100,000 Other deductibles may apply as Deductible: $5,000 per policy terms and conditions DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Tariff rules and regulations limit carrier's liability to a max of $1.50/lb for each article transported, or $0.10/1b for shipments of used or reconditioned goods. If value in excess of these limits is declared, see tariff rules and regulations for complete procedures to which shipper is subject. it is agreed that the carrier's liability on any shipments tendered by a certificate holder is limited to an amount not to exceed the limit listed above. Higher limits are available upon request and are effective upon confirmation in writing from the corporate headquarters of the motor carrier. Drivers or agents have no authority to amend wording or limits. CERTIFICATE HOLDER City of Gilroy Rosanna St Gilroy, CA 95020 R EgFRU F E APR 1 0 2023 GILROY CITY CLERK'S OFFICE CANCELLATION 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 ACORD 25 (2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD sa ID: 23861171 BATWn: 2900904 2 of 3 11030 TLTT98£Z : QI 11S 1,06006Z:HaI S 8S868£8ZM :.L1133 The ACORD name and logo are registered marks of ACORD (Lo/soot) Lot. a ioov •paniasaa si461a IId •NOU.V8Od1:IOO a1:10o1/ soot car M• r• n CD CD CD r• Q. O 0 C a 0 � x n o r• r cra Ct W 0 n 0 W O 0 0 0 M. Cr O M a o G .* . . 0 a w 0 a 0 0 F" N 0 0 h{ 0 01 Fi ro 0 c► aa 0 0 at ph F- r W W f.' r• K a O. n 0 g. W R 1< a 0 :a38Wf1N WI:1Od N M FORM TITLE: Certificate of Liability Insurance THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, S)IUVIN3 I IvNOWaav CD a 0 33 ro m a 0 F+ O e m r N 0 0 ro ph W 0 r d3erinN A3I1od Willis Towers Watson Midwest, Inc. C) m z t abed SOS :31V0 3A1103dd3 x oo h 0D c o rm 0 W trxi -' C ro na m m r- ro .o A r o F.• 0 0 K O M a r• 7 4a r r 0 a a a D 0 v v_ 0 z Tr m cn ♦ V I C) m v C r m CO Co CD N 0 N :al >:I3WOISf10 AON3DV Policy Number: LFT0013314 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: TRUCKERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM GENERAL LIABILITY COVERAGE FORM EXCESS INDEMNITY COVERAGE FORM MOTOR TRUCK CARGO COVERAGE FORM COMMERCIAL EXCESS LIABILITY POLICY MOTOR CARRIER COVERAGE FORM The provisions of the Coverage Form apply unless modified by this endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 04/01/2023 Named Insured: American Transport, Inc.; ATI Trucking, LLC; American Wind Transport Group, LLC Additional Insured shall include any organization where shown on a Certificate of Insurance or to whom the Named Insured is obligated by virtue of a written contract or agreement to provide insurance but only as respects the operations of the Named Insured. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. TRS 601 (11/06) Page 1 of 1 3 of 3 11030 Policy Number: LGL0012094 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL. INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: TRUCKERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM GENERAL LIABILITY COVERAGE FORM EXCESS INDEMNITY COVERAGE FORM MOTOR TRUCK CARGO COVERAGE FORM COMMERCIAL EXCESS LIABILITY POLICY MOTOR CARRIER COVERAGE FORM The provisions of the Coverage Form apply unless modified by this endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 04/01/2023 Named Insured: American Transport, Inc.; ATI Trucking, LLC; American Wind Transport Group, LLC Additional Insured shall include any organization where shown on a Certificate of Insurance or to whom the Named Insured is obligated by virtue of a written contract or agreement to provide insurance but only as respects the operations of the Named Insured. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. TRS 601 (11/06) Page 1 of 1