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Home My WebLink AboutInsurance Certificates Date: 3/8/2013 Time: 11:39 AM To: Page: 02 Client#:654 DOKKEENGI A.CORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(01g/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey,Renton&Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 12675 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland,CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED INSURER A American Automobile Ins.Co. Dokken Engineering Inc. INSURERS National Union Fire Ins Co Pitt 110 Blue Ravine Rd.,Suite 200 INSURERC Hudson Insurance Company Folsom,CA 95630 INSURERD 1 INSURER E. COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDD/YY) DATE(MM/DD/YY) A GENERAL LIABILITY AZC80875810 05/31/12 05/31113 EACH OCCURRENCE $1,000,000 X COMM ERCIAL GENERAL LIAB ILITY FIRE DAMAGE(Any one fire) $1,000,000 CLAIMS MADE I X I OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 _ GENERAL AGGREGATE $2,000,000 GENII AGGREGATE LIM IT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 7 POLICY n PELT n LOC A AUTOMOBILE LIABILITY AZC80875810 05/31/12 05/31/13 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accdent) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) — X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY_ EBUO11030712 05/31/12 05/31/13 EACH OCCURRENCE $5,000,000 OCCUR _CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WZP81003558 05/31/12 05/31/13 X trwocRUITs CER EMPLOYERS'LIABILITY E EACH ACCIDENT $1,000,000 E .DISEASE-EA EMPLOYEE $1,000,000 E DISEASE -POLICY LIMIT $1,000,000 C OTHER Professional AEE7114407 05/31/12 05131/13 52,000,000 per Claim Liability 52,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS General Liability Policy excludes claims arising out of the performance of professional services. Re: Camino Arroyo Bridge Construction and Gap Closure and the Farrell Road Bridge Widening(DE-1450).The City of Gilroy,its officers and employees,is included as Additional Insured for General and Auto Liability. CERTIFICATE HOLDER I ADOITIONAL INSURED,INSURER LETTER: CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Gilroy DATE THEREOF, THE ISSUING INSURER WILL XJU[9tll'r, IMAIL30 DAYS WRITTEN Attn: Henry Servin, P.E. NOTICE TOTHE CERTIFICATE HOLDER NAM EDTO THE LEFT,BJQ(y J(lERXXXXXXkJ(xlJ(,J(J( 7351 Rosanna Street IMMUIEGGICUOGTXXXXXXXIKOCRXIMIXXICXXXONJODUIRMEUXXX4OOKOIXAM Gilroy,CA 95020-6141 WiRI J®EX1aDIDEXx A THO•R •R PRE ENT-//TIV I a[44!11'` (1—'1 ACORD 25-S(7197)1 of 1 #S542349/M494025 NMF 0 ACORD CORPORATION 1988 Insured: Dokken Engineering, Inc. Insurer: American Automobile Ins. Co. Policy Number: AZC80875810 Policy Period: 05/31/12— 05/31/13 EXCERPTS FROM: Fireman's Fund ABC MULTICOVER—AB 91 89 05 99 THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: AMERICAN BUSINESS COVERAGE 2. Blanket Additional Insured Section II —Liability Coverage, Part I. Who Is An Insured, Item 2. is amended to include: 1. Any person or organization that you are required by a written insured contract to include as an insured, subject to all of the following provisions: (1) Coverage is limited to their liability arising out of: (a) the ownership, maintenance or use of that part of the premises, or land owned by, rented to, or leased to you; or (b) your ongoing operations performed for that insured; or (c) that insured's financial control of you; or (d) the maintenance, operation or use by you of equipment leased to you by such person(s) or organization(s) 4. Blanket Waiver of Subrogation Section II—Liability Coverage, Part K. Liability and Medical Payments General Conditions, is amended to include: 6. Transfer or Rights of Recovery Against Others to us and Blanket Waiver of Subrogation b. If required by a written insured contract. we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your operations or your work for that person or organization. 19. Common Policy Conditions (AB 00 09 A 01 87), Part H. Other Insurance, Item 2 is replaced with: 2. Coverage C—Liability If other valid and collectible insurance is available to any insured for a loss we cover under Coverage C of this Coverage Part our obligations are limited as follows: a. The insurance provided under this policy is primary if you are required by a written insured contract to include any person or organization as an insured, but only with respect to that insured's liability arising out of the ownership, maintenance, or use of that part of the premises owned by or rented to you, or your work for that insured by or for you. Any other insurance available to that person or organization is excess and noncontributory with this insurance. EXCERPT FROM: PROPERTY/LIABILITY POLICY --AB 90 00 12 93 II. K. 5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or suit is brought. Date: 3/8/2013 Time: 11:39 AM To: Page: 03 C,.C!:en Engineering Inc. AZC80875810 EXCERPTS FROM: Fireman's Fund ABC MULTICOVER —AB 91 89 08 07 THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: AMERICAN BUSINESS COVERAGE 2. Blanket Additional Insured Section II—Liability Coverage, Part I. Who Is An Insured, Item 2. is amended to include: f. Any person or organization that you are required by a written insured contract to include as an insured, subject to all of the following provisions: (1) Coverage is limited to their liability arising out of: (a) the ownership, maintenance or use of that part of the premises, or land owned by, rented to, or leased to you; or (b) your ongoing operations performed for that insured; or (c) that insured's financial control of you; or (d) the maintenance, operation or use by you of equipment leased to you by such person(s)or organization(s) 4. Blanket Waiver of Subrogation Section II —Liability Coverage, Part K. Liability and Medical Payments General Conditions, is amended to include: 6. Transfer or Rights of Recovery Against Others to us and Blanket Waiver of Subrogation b. If required by a written insured contract, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your operations or your work for that person or organization. 19. Common Policy Conditions (AB 00 09 A 01 87), Part H. Other Insurance, Item 2 is replaced with: 2. Coverage C —Liability If other valid and collectible insurance is available to any insured for a loss we cover under Coverage C of this Coverage Part our obligations are limited as follows: a. The insurance provided under this policy is primary if you are required by a written insured contract to include any person or organization as an insured, but only with respect to that insured's liability arising out of the ownership, maintenance, or use of that part of the premises owned by or rented to you, or your work for that insured by or for you. Any other insurance available to that person or organization is excess and noncontributory with this insurance. EXCERPT FROM: PROPERTY/LIABILITY POLICY --AB 90 00 12 93 II. K. 5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or suit is brought. Client#: 654 DOKKEENGI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE( 12Dm) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey,Renton&Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 12675 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED INSURER A: American Automobile Ins.Co. Dokken Engineering Inc. INSURER B: National Union Fire Ins Co Pittsburg 2365 Iron Point Road,Suite 200 INSURER C: Hudson Insurance Company Folsom,CA 95630 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YYI A GENERAL LIABILITY AZC80875810 05/31/12 05/31/13 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $1,000,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 —1 POLICY 5F1,71: ^ LOC A AUTOMOBILE LIABILITY AZC80875810 05/31/12 05/31/13 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS LIABILITY EBUO11030712 05/31/12 05/31/13 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND .WZP81003558 05/31/12 05/31/13 X I WA --S IOR- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1,000,000 E.L.DISEASE-EA EMPLOYEE $1,000,000 E.L.DISEASE-POLICY LIMIT $1,000,000 C OTHER Professional AEE7114407 05/31/12 05/31/13 $2,000,000 per Claim Liability $2,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS General Liability Policy excludes claims arising out of the performance of professional services. Re: Camino Arroyo Bridge Construction and Gap Closure and the Farrell Road Bridge Widening(DE-1450).The City of Gilroy, its officers and employees, is included as Additional Insured for General and Auto Liability. CERTIFICATE HOLDER ADDITIONALINSURED;INSURER LETTER CANCELLATION Ten Day Notice for Non-Payment of Premium SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Gilroy DATE THEREOF, THE ISSUING INSURER W141IX4eolula TO MAIL 3n DAYS WRITTEN Attn: Don Dey NOTICE TO THE CERTIFICATE H OLDER NAM ED TOTH E LEFT 7351 Rosanna Street maloneecogatoaccutiumuncainoenwaonoconosoneogoseecommancer Gilroy,CA 95020-6141 XietlaneMPOINK AUTHORIZED REPRESENTATIVE I i," , CpcU ACORD 25-S(7/97)1 of 1 #M299262 NMF o ACORD CORPORATION 1988 Client#: 654 DOKKEENGI ACORDT. CERTIFICATE OF LIABILITY INSURANCE (MWD 11 D/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey,Renton&Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 12675 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland,CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED INSURER A: Travelers Property Casualty Co of Am Dokken Engineering Inc. INSURER B: St.Paul Fire&Marine Ins.Co. 2365 Iron Point Road,Suite 200 INSURER C: American Automobile Ins.Co. Folsom,CA 95630 INSURER D: Hudson Insurance Company INSURER E: Travelers Indemnity Co.of Connectic COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY N LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DDT/YY) LIMITS A GENERAL LIABILITY 6801613L360 05/31/11 05/31/12 EACH OCCURRENCE $1,000,000 X COMM ERCIAL GENERAL LIPBILITY FIRE DAMAGE(Any one fire) $1,000,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEM_AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 7 POLICY X JERI LOC E AUTOMOBILE LIABILITY BA1616L429 05/31/11 05/31/12 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S1,000,000 X ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS LIABILITY QK06503410 05/31/11 05/31/12 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION AND WZP80993537 05/31/11 05/31/12 X WC STATUS OTH- EMPLOYERS'LIABILITY TORY LIMITS ER E.L.EACH ACCIDENT $1,000,000 E.L.DISEASE-EA EMPLOYEE $1,000,000 E.L.DISEASE-POLICY LIMIT $1,000,000 D OTHER Professional AEE7114406 05/31/11 05/31/12 $2,000,000 per Claim Liability $2,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS General Liability Policy excludes claims arising out of the performance of professional services. RECEIVEC Re:Camino Arroyo&Farrel Avenue Bridges(DE-1450). City of Gilroy is included as Additional Insured to General Liability per policy form MAY 1 7 2011 wording. ENGINEERING. CERTIFICATE HOLDER ADOmONAL INSURED;INSURER LETTER: _ CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Gilroy DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_DAYS WRITTEN Attn Don Day,City Traffic Engr NOTICE TOTHE CERTIFICATE HOLDER NAMED TO TH E LEFT,BUT FAILURE TODOSOSHALL 7351 Rosanna Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE R,ITS AGENTS OR Gilroy,CA 95020 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE I ir l CPcLL ACORD 25-S(7/97)1 of 1 #M283421 NMF 0 ACORD CORPORATION 1988 Client#: 654 DOKKEENGI ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE( M/ Dm) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 12675 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED INSURER A: Travelers Property Casualty Co of Am Dokken Engineering Inc. INSURER B: American Automobile Ins.Co. 2365 Iron Point Road, Suite 200 INSURER C: Hudson Insurance Company Folsom, CA 95630 INSURER D: Travelers Indemnity Co.of Connectic 1 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE IMM/DD/YYI DATE(MM/DD/YY) A GENERAL LIABILITY 6801613L360 05/31/10 05/31/11 EACH OCCURRENCE $1,000,000 I X COMM ERCIAL GENERAL LIAB ILITY FIRE DAMAGE(Any one fire) $1,000,000 1 CLAIMS MADE i X I OCCUR I ED EXP(Any one person) $5 CLC • I Wv' PERSONAL&ADV INJURY $1,000,000 ■ GENERAL AGGREGATE $2,000,000 GEM_AGGREGATE LIM ITAPPLIES PER: PRODUCTS -COMP/OP AGG $2,000,000 POLICY X PRO OLICY LOC JECT D AUTOMOBILE LIABILITY I BA1616L429 05/31/10 05/31/11 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 lil ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ — AUTO ONLY: AGG $ A EXCESS LIABILITY CUP6268Y532 05/31/10 05/31/11 EACH OCCURRENCE $5,000,000 X OCCUR I _ � CLAIMS MADE AGGREGATE $5,000,000 $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WZP80982794 05/31/10 05/31/11 X ORY LIM TS i 0TH- EMPLOYERS'LIABILITY E. $1,000,000 A L.EACH ACCIDENT E.L.DISEASE-EA EMPLOYEE $1,000,000 E.L.DISEASE -POLICY LIMIT $1,000,000 C OTHER Professional 1AEE7114405 05/31/10 05/31/11 $2,000,000 per Claim Liability $2,000,000 Annl Aggr. DESCRIPTION OF OPERATION S/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS General Liability Policy excludes claims arising out of the performance of professional services. Re: Camino Arroyo& Farrel Avenue Bridges (DE-1450). City of Gilroy is 1 included as Additional Insured to General Liability per policy form wording. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURERLETTER: CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Gilroy DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn Don Day, City Traffic Engr NOTICE TOTHE CERTIFICATE HOLDER NAM ED TO THE LEFT,BUT FAILURE TODOSOSHALL 7351 Rosanna Street IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURE R,ITS AGENTS OR Gilroy, CA 95020 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ' :*i674/1/1—' ) CPC Li ACORD 25-S(7/97)1 of 1 #M267984 NMF O ACORD CORPORATION 1988