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HomeMy WebLinkAboutCOI - American Medical Response, Inc. - Expires 2027-03-31 Cert No. 570118657622� A�Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYYY) 03123.2026 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 Aon Risk Services Central, Inc. Phi 1 adel phi a PA Offi ce 100 North 18th Street 16th Floor Philadelphia PA 19103 USA CONTACT PHON: (NCN E .No. Ext): (1366) 283 7122 (AJX ( CC. No.): 800) 353-0105 E-MAIL ADDRESS: iNSURER(S) AFFORDING COVERAGE NAIC # INSURED American Medical Response Inc 4400 State Hwy 121, Ste.700 Lewisville TX 75056 USA INSURER A: ACE American Insurance Company 22667 INSURERS: Indemnity Insurance Co of North America 43575 INSURER C. ACE Fire Underwriters Insurance CO. 20702 INSURER D: Underwriters at Lloyds 32727 INSURER E: ACE Property & Casualty Insurance Co. 20699 INSURER F: AGE CERTIFICATE NUMBER: 57011 E1657622 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 INSR LTR TYPE OF INSURANCE AUDL INS❑ SUBR WVD POLICY NUMBER POLICY EFF (MMIUDIYYYY) POLICY EXP ({MMIDDIYYYY}} LIMITS A X COMMERCIAL GENERAL LIABILITY XSLG49383034 SIR applies per policy terns 03/31/2026 & condirions 03/31/2027 EACH OCCURRENCE 52,750,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES IEs occurrence) $100,000 MED EXP (Any one person) S10,000 PERSONAL &ACV INJURY 52,750,000 GEN'LAGGREGATE X LIMIT APPLIES PER, POLICY IPRO' LOC JECT OTHER. GENERAL AGGREGATE S5,000,000 PRODUCTS - COMP/OPAGG S2,750,000 SIR $250, 000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED _ S SCHEDULED AUTOS NON -OWNED AUTOS ONLY ISA H11429178 03/31/2026 03/31/2027 COMBINED SINGLE LIMIT (Ea accident) $10,000, 000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) E X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XCQG72514816006 Umb - Auto 03/31/2025 03/31/2027 EACH OCCURRENCE S10,000,000 AGGREGATE S10,000,000 DER X RETENTION $25 0O0 B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR !PARTNER,' EXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory lnNH) f yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N N ! A WLRC72$07157 AOS SCFC72807170 WI 03/31/2026 03/31/2026 03/31/2027 03/31/2027 y IPERSTATUTE „ I OTH- ER E.L. EACH ACCIDENT 51,000,000 E.L. DISEASE -EA EMPLOYEE S1,000,000 E.L. DISEASE -POLICY LIMIT $1, 000 , 000 ❑ E&O - Professional Liability - Excess CSHLC2601663 EX Prof(Claim Made)/Ex GL SIR applies per policy terms 03/31/2026 & conditions 03/31/2027 Per Occ/Agg SIR - Ex Prof SIR - Ex GL S15,000,000 S10,000,000 S10,000,000 DESCRIPTION OF OPERATIONS 1 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. A WAIVER OF SUBROGATION I5 GRANTED IN FAVOR OF CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS OF THE GENERAL LIABILITY POLICY. CERTIFICATE HOLDER CANCELLATION THE CITY OF GILROY ITS OFFICERS AND EMPLOYEES ATTN: CHIEF FOSTER 7351 YOCAA9A STREET GILROY CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES EXPIRATION DATE THEREOF, NOTICE WILL BE POLICY PROVISIONS. BE CANCELLED BEFORE THE DELIVERED IN ACCORDANCE WITH THE AUTHORIZED REPRESENTATIVE r��% Mar /l r �lp,)y �e�� ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Molder Identifier : 570119657622 Certificate No AGENCY CUSTOMER ID: 570000073826 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY Aon Risk Services Central, Inc. POLICY NUMBER See certificate Number: 570118657622 CARRIER see Certificate Number: 570118657622 NAIC CODE NAMED INSURED American Medical Response 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 INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LT12 TYPE OF INSURANCE ADDL INSD SUER MID POLICY NUMBER POLICY EFFECTIVE DATE (MMVODIYYYYI POLICY EXPIRATION DATE (NIM/DD/YYYY) LIMITS WORKERS COMPENSATION A N/A wcuc72807194 OH SIR applies per policy terms 03/31/2026 & conditions 03/31/2027 OTHER D E&O - professional Liability - Excess CSHLC2601663 Ex Prof(Claim Made)/Ex GI SIR applies per policy terms 03/31/2026 & conditions 03/31/2027 sex Mis Per $10,000,000 Sex Mis Agg $10,000,000 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. Ali rights reserved. AGENCY CUSTOMER ID: 570000073826 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services Central, Inc. NAMED INSURED American Medical Response Inc POLICY NUMBER See Certificate Number: 570118657622 CARRIER see certificate Number: 570118657622 NAIC 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 xs GL/E&O Carriers Dale 30.00% Chaucer 6.66% Chubb 16.66% MedPro 10.00% Hamilton 8.18% ACT 28.50% Total: 100.00% ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. Certificate No: 570118657623 SON THE CITY OF GILROY ITS OFFICERS AND EMPLOYEES ATTN: CHIEF FOSTER 7351 ROSSANA STREET GILROY CA 95020 USA Monday, March 23, 2026 To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570118657623) for future renewals: - Visit aon.com{e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. Aon Risk Services 5801 Postal Road PO Box 818037 Cleveland, Ohio 44181-9600 nnnnnn nS nR nnaC.77 M770.F P