Loading...
HomeMy WebLinkAboutCOI - US LBM Holdings, LLC and Affiliates - Expires 2026-10-30Holder Identifier : 7777777707070700077763616065553330773706456215556707453126663406310072640477147231020736045553067451207562451732274112075666371360767740776045373027631207140033570236732077727252025773110777777707000707007 6666666606060600062606466204446200620222426226000206200004060262002062220242600402200622200606004000206002206040262222060022062622402000620020626004200006220004242220620066646062240664440666666606000606006Certificate No :570116210222CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/15/2025 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). 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. PRODUCER Aon Risk Services Central, Inc. MSC# 17385 Aon PO Box 1447 Lincolnshire IL 60069 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED 25674Travelers Property Cas Co of AmericaINSURER A: 25682The Travelers Indemnity Co of CTINSURER B: 25615The Charter Oak Fire Insurance CompanyINSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.):(800) 363-0105 CONTACT NAME: US LBM Holdings LLC & Affiliates LLC DBA Better Built Truss 2077 Convention Center Concourse Suite 125 Atlanta GA 30337 USA COVERAGES CERTIFICATE NUMBER:570116210222 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 POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,500,000 $500,000 $10,000 $2,500,000 $5,000,000 $5,000,000 B 10/30/2025 10/30/2026HC2EGLSA9P531384TCT25 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $7,500,000B10/30/2025 10/30/2026 COMBINED SINGLE LIMIT (Ea accident) HC2E-CAP-9P531335-TCT-25 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $5,000,000 $5,000,000 10/30/2025UMBRELLA LIABA 10/30/2026CUP1X17396525NF RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER PER STATUTEC10/30/2025 10/30/2026 AOS UB3X85704925NCRA 10/30/2025 10/30/2026 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / AN MA, WI WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 UB3X85687625NCT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Gilroy 7351 Rosanna St Gilroy CA 95020 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. COMM RCI L G NERAL IAB LI YE A E L I T T IS ENDORSEMENT CHANGES T E POLICY. PLEASE REA IT CA EF LLYHHD R U . BLANKET ADDITIONAL INSURED – A TOMA IC STA USU T T IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) Thi e dorseme t m dfie i surance prov ded under he f l o ing:s n n o i s n i t o l w COMM RCI L G NERAL IAB LI Y COVERAG PA TE A E L I T E R The fol owing is ad ed told SE TI N II – WHO IS AN (a)C O The Addi ional Insured – Owne s, Le -t r s INSU EDR:see or Contra tors – Scheduled Persos c n or Organizat o endorsem n CG 20 10i n e tAny erson or o ganiza io tha :p r t n t 07 04 o CG 20 10 04 13, the Addi ionalrta.Yo agree in a writ en cont a t o ag ee ent tout r c r r m In ured – Owne s, Le see or Con ra -s r s s t ci clu e as an a ditio al insured on thi Cov ragen d d n s e to s – Com le ed Ope ations endorser p t r -Pa t anr ; d m n CG 20 37 07 04 or CG 20 37 04 13,e tb.Ha not been added a an additio al in ured foss n s r or both o such endo seme ts wi h ei hefr n t t rthe sam proje t by at a hm nt o an en orsee c t c e f d -o ho e ed tio date ; orf t s i n sm n under thi Cov rage Pa t which includee t s e r s (b)Ei her or bot o the fol o ing the Addit h f l w : -such perso or organi at on in the endorsem nt'sn z i e tio al In ured – Owne s, Le sees o Con-n s r s rschedule;tra to s – Scheduled Person Or Organ -c r ii a insured but:s n ,za ion en orsem n CG 20 10, o the Ad-t d e t r a.On y with re pe t to lia ili y fo "bodily injury di ional Insured – Owl s c b t r t ne s, Le see or s s r" or Co tra tors – Com le ed Ope atio s en-n c p t r n"prope ty dam ge that o cur , or fo "perso alr a " c s r n do sem nt CG 20 37, wi hout a edit or e t n i ni ju y caused by an o f n e that is com it ed,n r "f e s m t da e o uch endo sem nt pe i ie ;t f s r e s c f dsubsequent to the signing of that contract or ag ee ent and while that pa t o the cont a t or m r f r c r the person o o gan zat on i an addit onal inr r i i s i -ag ee ent s in e fe t andr m i f c ;sure only i the in ury or dama e i ca sed,d f j g s u b.On y a de cri ed in Paragraph be i whole o in part by al s s b -n r , cts o omssions or i f(1),(2)or (3) y u or you subcont a tor in the pe fo man eo r r c r r clow, whichev r appl e :e i s o "y u work" to whi h the writ en cont act of o r c t r r(1)If the wri ten cont act or ag ee ent speci i a-t r r m f c l ag ee ent ap lie ; or m p s rly require you to prov de addi ional insuredsi t (3)If ne ther aragraphi P (1)nor (2)abov appl e :e i scov rage to tha person or organi ation byetz the se o :u f (a)The perso or o ganizat o is a addin r i n n - tio al i sured only if a d to the ex entn n , n t(a)The Additional Insured – Owners, Les- that the injury o dama e i ca sed by,r g s usee o Cont actors – (Form B) en orses r r d - a t or omi sions o y u o y u subcon-c s s f o r o rm n G 20 10 11 85; ore t C tra to in the pe fo ma ce o "y ur workc r r r n f o "(b)Ei her or bot o the fol o ing the Addit h f l w : -to whi h the wri ten co tra t o agree-c t n c rtio al In ured – Owne s, Le sees o Con-n s r s r m nt applie ; ande stra to s – Scheduled Person Or Organ -c r i (b)Su h pe son o organiza io does notc r r t nzation endorsement CG 20 10 10 01, or qual fy a an addi ional insured with rei s t -the Addit onal Insured – Owne s, Le seeir s s spe t to the independent acts or om s-c ior Co tra tors – Com leted Ope ationsn c p r sio s o uch erson or organizationn f s p .endo sem nt G 20 37 0 01;r e C 1 The insurance prov ded to such addi ional i sured isit nthe person o o gan zat on i an addit onal inr r i i s i - subje t o he fo lowing p ov sion :c t t l r i ssure only if the inju y or dama e ari e outdr g s s o "y u work" to whi h the writ en cont act of o r c t r r a.If the Lim t o Insurance o thi Cov rage Parti s f f s eag ee ent ap lie ;r m p s shown i the De larat on ex eed the mnim mn c i s c i u (2)If the wri ten cont act or ag ee ent speci i a-t r r m f c l l mt req ired by the wri ten co t act o agree-i i s u t n r r ly require you to prov de addi ional insuredsi t m n , the i surance prov ded to the addit o al i -e t n i i n n cov rage to tha person or organi ation byetz sure wi l be lim ted to such mnim m requi edd l i i u r the se o :u f l mt . For the purpo es o de erm ni g whethei i s s f t i n r CG 6 04 02 19D © 2017 T e Travelers Indemnity Company. All rights rehserved.Pa e 1 o 2g f POLICY NUMBER: HC2E-GLSA-9P531384-TCT-25 COMM RCI L G NERA L IAB LI YEAELIT th s lim tation , th e mi im m lim ts requi ed i a claimiinuirn . T o t he ex ent po sible suchts, by t he written co tra t or agreem nt wi l b e con-no ice should inncelt cl de:u si e ed to incl de the m nim m lim t o an y U mdruiuisf-(a)How,when and where t he "o cur en ecrc"brel a or Ex ess lia il ty cov rag e requi ed f o th elcbierr or o fe se took la e;f n p caddiionalinsuredbythat written cont a t otrcr (b)The nam s and add e se o any inj rederssfuageeentThiprovsionwilnot increa e th erm.s i l s pe sons an witne s e ;andrdsslmtoinurance escribed in Sect oniisfsdi III –Lim tis (c)The natur e and loc a ion o any injury otf rOfIsurancen.dama e a i i g ou t o th e "o cur en e ogrsnfcrc"rb.The in uran e pro v ded to such a dit onal insur edscidi o fe se.f ndoenotapplytos:(2)If a claim is ma e o "su i "i broug ht agai stdrtsn(1)Any "bod i y inju y ,"property dam ge olr"a "r the ad it onal nsureddii:"pe sonal injury arising out o the pro v d ng,r "f i i (a)Im e ia ely re ord th e o th emdtcfor fai ure to prov de, any pr o e sional archilifs-cla m or "suit an the date re eiv d; andi"d c etetual, e gineer ng or surv yin s e v ce ,c r n i e g r i s i clu ing:n d (b)No i y us a s oon a pra ticable an seetfsscd to i that we re eiv wri ten not ce o th etcetif(a)The pr epar i g, approv ng,or f a l ng t oniii cla m or "suit a soon ai"s sprepae o approv ,ma s, shop draw-r r e p i g , opin on , rep o ts, surv ys, fiel o -n s i s r e d r (3)Im ed ately s end us copie o a l legal p amisfl- de s or chang e o de s, o the prep ari g,pe s re eiv d in r r r r n r c e c o ne tion wi h the claim onct r approv n , o f ai ing t o prepar e or ap-"sui ", coope ate wi h us i g r l t r t in th e in v stigat onei prov , dr awings and sp e i i a ion ; and o the claim o deecfctsfrfens e agai stn the "suit , and othe wi e com ly with all pol cy"r s p i()b Su er v so y,in pe t on, archi ect ral opirscitu r condi ion .t sengineerinatvte.g c i i i s (4)T e der th e d e en e and ind em i y o anynfsntf(2)Any "bodily inj ry or "property dam geu"a " cla m or "su i "to any prov der o o her ins ur-i t i f tcaused by "work a d included in t he"n an e whi h wou d c ov r such addit onal i -c c l e i n"produ ts-om leted ope ation hazard"unccprs- le s the wri ten c on ra t or ag ee ent spe if -sure f o a s t t c r m c i d r loss we cov r. H owev r, this c o -e e n cal y requir e you t o pr ov de such cov ragelsie di ion does no a fe t wheth e the insuranc ettfcr fo th at addit o al in ured during the pol cyrinsi prov ded t o such addi ional insured is prim ryita pe iodr.to o her i suran e av ila le t o such ad it onaltncabdi i sured whi h c ov rs t hat pers on o organizancer -c.The addit o al ins ur ed m st com ly with the i n u p tio a a nam d in ur ed a descri ed in Pa -n s e s s b rlowing utie :d s ag aphr 4., Ot er In uranc e o Se tionhs,f c IV –(1)G v us written no ice a s oon a pra tica leietsscb Co m rcial Gener al Lia il ty on dit on .m e b i C i soa"o cur en e or an o fe se which mayfncrc"f n Pa e 2 o 2gf ©2017 T e Travelers Indemnity Company.All rights rehserved.CG 6 04 02 19D fol- your or settlement practicable. specifics applies result