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HomeMy WebLinkAboutCOI - Bureau Veritas, North America, Inc - Expires - 2027-01-01Ate. "t CERTIFICATE OF LIABILITY INSURANCE PAT E(2 M/DO SYYY) 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 Ron Ri sk Services Northeast, Inc. AOn Risk Services Northeast, Inc. NY NY Offi ce One Liberty Plaza 165 Broadway, suite 3201 New York NY 10006 USA CONTACT NAME: PHONE 866-283-7122 FAX 800-363-0105 (AC. No. Ext): INC. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL # INSURED Bureau Veritas North America, Inc. 16800 Greenspoint Park Drive Suite 300s Houston TX 77060 USA INSURER A: AllianZ Global Risks US Insurance Co. 35300 INSURERS: Hartford Fi re Insurance Co. 19682 INSURER C: Trumbull Insurance Company 27120 INSURER D: INSURER E: INSURER F•. COVERAGES CERTIFICATE NUMBER: 570117115529 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 CLAMS. Limits shown are as requested Igor LTR TYPE OF INSURANCE ADDU INSD SUBR WVo POLICY NUMBER POLICY EFF (MMIDDIYYYYL POLICY EXP 1iMMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY usL00159326 01/01/2026- 01/01/2027 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR SIR applies per policy terms & conditions DAMAGE RENTED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) S10,000 PERSONAL& ADV INJURY S2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 , 000 , 000 POLICY X PRp-JEGT I X I LOC PRODUCTS - GDMPlOP AGG $2 , 000 , 000 OTHER: SIR $50,000 B AUTOMOBILE LIABILITY 10 AB 541202 01/01/2026 01/01/2027 COMBINED SINGLE LIMIT (Ea accident S2,000,000 X ANY AUTO AOS BODILY INJURY( Per person) OWNED SCHEDULED BODILY INJURY (Per accident) - AUTOS ONLY HIRED AUTOS ONLY A AUTOS NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accidenl( Comprehensive Deduct $1, 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DEO RETENTION C WORKERS COMPENSATION AND EMPLOYER5'41ABILITY 10WN541200 01/01/2026 01/01/2027 x PER STATUTE OTH- .ER ANY PROPRIETOR! PARTNER! EXECUTIVE Y/N N N 1 A See state Policy Addendum E.L. EACH ACCIDENT S1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatary In NH) EL. DISEASE -EA EMPLOYEE $1, 000 , 000 I1 yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000, 000 A Architects & Engineers Professional USF00248026 Claims Made SIR applies per policy terns 01/01/2026 & condi 01/01/2027 :ions Each Claim Aggregate SIR S10,000,000 510,000,000 8250,00G DESCRIPTION OF OPERATIONS ( LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contract for 18-RFP-CDD-406 for on -call Plan RevieR services. City of Gilroy, its officers, officials and employees are included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & General Liability Coverage policy. CERTIFICATE HOLDER CANCELLATION Haider identifier City of Gilroy, its officers, officials and employees 7351 Rosanna street Gilroy CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 570117115529 Certificate No AUTHORIZED REPRESENTATIVE ✓GAG SSifit.Yt7d6 ,ACeZza✓ 7sd ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID; 570000048582 LOC #: AC' 1z0 Q, ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Bureau Veritas North America, Inc. POLICY NUMBER See Certificate Number: 570117115529 CARRIER see certificate Number: 570117115529 NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES if a po€icy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OR INSURANCE ADDL INSR SUER W VD POLICY NUMBER POLICY EFFECTIVE DATE (MINVI DfYYYY) POLICY EXPIRATION DATE (A1M/DDIYYYY) LIMITS AUTOMOBILE LIABILITY B 1D AB s41202 AOS 01/01/2026 01/01/2027 collision Deductible $1,D00 ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000048582 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. POLICY NUMBER See Certificate Number: 570117115529 CARRIER see Certificate Number: 570117115529 NAIC CODE NAMED INSURED Bureau Veritas North America, Inc. EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability insurance workers compensation/Employers Liability 10wN541200 01/01/26-01/01/27 10WN541200 01/01/26-01/01/27 10WN541200 01/01/26-01/01/27 10wN541200 01/01/26-01/01/27 10WN541200 01/01/26-01/01/27 10WNS41200 01/01/26-01/01/27 10wNs41200 01/01/26-01/01/27 10WNS41200 01/01/26-01/01/27 10WN541200 01/01/26-01/01/27 lOwNS41200 01/01/26-01/01/27 10wN541200 01/01/26-01/01/27 10WNS41200 01/01/26-01/01/27 10wBRS41201 01/01/26-01/01/27 Twin City Fire Insurance Company WI 10wBR541201 01/01/26-01/01/27 sentinel Insurance Company, Limited MA Trumbull Insurance AR,DC,IN,LA,NE,RI,UT Twin City Fire insurance Company FL,ND,OH,WA,WY Hartford Insurance company of the Midwest AK,ID Hartford Casualty Insurance Company Mo,WV Nutmeg Insurance Company CT,IL Hartford Fire Insurance company NH,OR,PA Hartford Accident and Indemnity Company AL,GA,KY,MI,MT,NY,TN,VT Property & Casualty Ins co of Hartford CA,CO,DE,ME, MN,MS,SC Hartford Insurance company of Illinois TX Hartford Insurance company of the southeast KS,MD Hartford Underwriters Insurance Company AZ,HI, NC,N],SD,VA Sentinel insurance Company, Limited IA,NM,NV,OK ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD 02008 ACORD CORPORATION. All rights reserved.