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HomeMy WebLinkAboutInsurance Certificates ACORQ CERTIFICATE OF LIABILITY INSURANCE 03/16/2006 PRODUCER (510)583-2203 FAX (510)583-2204 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fryar Insurance Services And Risk Management ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 22320 Foothill Blvd. , Ste 130 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hayward, CA 94541 INSURERS AFFORDING COVERAGE NAIC# INSURED Pacific Electric Company INSURER A: Colony Insurance Co 330 Phelan Avenue INSURER B: San Jose, CA 95112 INSURER C: INSURER D: CNGdc 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. IN SR NORL Pp POLICY EXPIRATION RD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDYY) ( nnp Y LIMITS GENERAL LIABILITY GL152447 03/17/2006 03/17/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1,00 000 PRFMISFS(Fa orcurenre) f CLAIMS MADE I X I OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 — —1 POLICY PRO- JECT I LOC AUTOMOBILE UABIUTY 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 UABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'L.IABIUTY TORY LlitiTS FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LQ C�oTIONS I VEHIC ES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIA PROVISIONS RE:First/Chruch Traffic Signal Mod. Project # 04-CDD-126, The City and City's employees, officers, design consultants, elected officials, Constrution Manager, agents, subcontractors are hereby added as addtional insureds insofar as Work done under this contract is concerned. This policy shall be considered primary insurance as respects any other valid & collectible insurance, any other insurance the City be considered excess insurance only. Except for non pay which is 10 days. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Gilroy 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT City Engineer BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 7351 Rosanna Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE �,/ �°jT_q,S�' � WALTER FRYAR/PAT Ai* ACORD 25(2001/08) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL. INSURED -- OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization(Additional Insured): All Persons or Organizations as Required by Written Contract with the Named Insured City of Gilroy City Engineer 7351 Rosanna Street A. SECTION It- HO IS AN INSURED is amended and the following added: The person or organization (called "additional insured") shown in the Schedule is also an insured but only: a. with reaped to indirect liability caused by or resulting from your ongoing operations performed for that"additional insured(s)";and b, when you and the person or organization shown in the Schedule have agreed in writing in a contract or agreement that such person or organization be added as an"additional insured"on your policy. A person's or organization's status as an "additional insured" under this endorsement ends when their contract or agreement with you ends. B. SECTION I—COVERAGES,COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is amended and the following added; This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the "additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work "Bodily injury"or"property damage": (1) occurring after 'your work", including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the"additional insured(s)"at the site of the covered operations has been completed;or (2) occurring after that portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization. Negligence of Additional Insured "Bodily injury" or "property damage" directly arising out of or resulting from the negligence of the "additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U156-0702 Page 1 of 1