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HomeMy WebLinkAboutEPC IT Solutions - Insurance CertificateEPCCO -1 OP ID: TT2 CERTIFICATE OF LIABILITY INSURANCE D 1 0/0 512 01 YY) 10/05/2017 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 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 San Jose Insurance Agency Inc. Atlantic - Pacific Ins. Brokers CONTACT NAME Tina Tremain X340 PHONE FAX A/c No Ext 408 -371 -3700 JC No. A DRESS tina@sahjoseins.com 2542 S. Bascom Ave #280 Campbell, CA 95008 San Jose Insurance Agency INSURERS AFFORDING COVERAGE NAIC # INSURER Hanover Insurance Company $ 1,000,00_0 PREMISES Ea occurrence INSURED EPC Computer Solutions, INSURER B Oak River Insurance Company X COMMERCIAL GENERAL LIABILITY 1324 El Camino Real Belmont, CA 94002 INSURERC 970188605 10/01/2017 10/01/2018 INSURER D INSURER E INSURER F: MED EXP (Any one person) $ 10,000 COVERAGES CERTIFICATE NUMBER: 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 INSR LTR TYPE OF INSURANCE POLICY NUMBER MM DDY/YYYY DD/YYYY MML LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00_0 PREMISES Ea occurrence $ 300,000 A X COMMERCIAL GENERAL LIABILITY X 970188605 10/01/2017 10/01/2018 CLAIMS -MADE Fx] OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO AWFD39174600 10/04/2017 10/04/2018 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDENT $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER /EXECUTIVE Y!❑N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N /A EPWC600644 01/02/2017 01/02/2018 X WC STATU- I OTH- I TORY LIMITS ER E L EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000,000 A Professional E &O 970188603 10/01/2017 10/01/2018 PEO 1,000,000 - Ded- - 5,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedulo, If more space Is required) Certificate holder is named as additional insured with repsects to the insured operations CITYGIL City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD EPCCO -1 OP ID: KP '441:7OR°P CERTIFICATE OF LIABILITY INSURANCE �� -75 1105/016 01/05/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE D_ OES 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(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terns 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 endomemen s . - PRODUCER San Jose Insurance Agency Inc. Atlantic-Pacific Ins. Brokers 2542 S. Bascom Ave #280 Campbell, CA 95008 San Jose Insurance Agency CONTACT NAME: PHO N FAX alc NO ADDDRESS: INSURER(S) AFFORDING COVERAGE NAIL P INSURER A: Hanover Insurance Company INSURED EPC Computer Solutions, INSumRs: Hartford Insurance Group. .._ 29424 INSURER C :Oak River Insurance Company _ PREMISES a.ocarrence 1324 EI Camino Real Belmont, CA 94002 INSURER D X INSURER E: 970188603 10/01/2015 INSURER F: MED EXP (Any one person ) $ 10,00 UUV tKAWr --,i 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 CQNDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSSR TYPE OF INSURANCE vivn -- - POLICY.NUMBER POLICY EF MM/D_ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES a.ocarrence $ 300900 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X 970188603 10/01/2015 1010112016 MED EXP (Any one person ) $ 10,00 PERSONAL & ADV INJURY - $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC _-.___ AUTOMOBILE LIABILITY PRODUCTS - COMP/OP AGG $. 2,000,00 COMBINED SINGLE LIMB Ea aeadent $ 1,000,00 BODILY INJURY (Per person) S. B X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED ;HIRED AUTOS AUTOS 67UECAM3472 10/0412015 10/04/2016 BODILY INJURY (Per accident) $ PR PERTY E DAMAGE PE CCID $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ H'CLAJMS-MADE AGGREGATE $ EXCESS LIAS WC STATU- OTH ER $ DED RETENTIONS WORKERS COMPENSATION E.LEACH'.ACCIDENi. $ 1+000.00 C A AND EMPLOYERS` LIABILITY ANY PROPRIETORIPARTNER*- XECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mdndatory7n NH) If yes describe under DESCRIPTION OF.OPERATION below Professional E &O NIA EPWC600644 970188603 01/0212016 10/01/2015 01/02/2017 10/01/2016 E.L. DISEASE,- EA EMPLOYEE $ 11000 +00 E.L. DISEASE - POLICY LIMIT $ 11000,00 PEO 1,000,00 Ded 5,00 _ -- . DESCRIPTION 00 OPERATIONS I LOCATIONS ! VEHICLES (Attach. ACORD 101, AddWOnal Remarks Schedule, N nwe Waco Is nequked) Certificate holder is named as additional insured with repsects to the insured operations City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 CITYGIi_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORISED REPRESENTATIVE San Jose 10uramaA ® 88 -2 O AC CO<3POHATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD • w OBF9701886 • 5701132 ADDMONAL INSURED- OWNEI;G, LESSEES ORORGANIZAMON This endorsement modifies insurance provided under the following: The City of Gilroy, its Officers, 7351 Rosanna Street Offieials and employees Gilroy, CA. 95020 information required to complete this Schedule, if not shown above, will be sho4m In the Declarations. The following is added to Paragraph C. Who Is An I mned in Section 11 - Us6Ur. & Any person(s) or organization(s) shown in the Schedule is also an additional Insured,;but only with respect to liability for bodily ,injury", - property damage" or 'personal and advertising Injury' caused, in whole or in part, by: a. Your ads or omissions; or b. The acts or omissions of those acting on your behalf, In the performance of your ongoing operations for the additional insuied(s) at the location(&) designated above. BP 04 s0 01 06 With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to 'bodily injury' or °property damage' occurring BRer: a. Ali work, including materials, parts or equipment furnished in connection with such work, on the paojea (ether than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the iodation of the covered operations has been completed; or b. That portion of your woW out of which the injury or demage arises has been put to its intended use by any person or organization other than another c niraCtOr or subcontractor engaged in operations a principal as a part d the Copyright, ISO Properties, L inc., 2005 gage 1 of 1 EPCCO -1 OP ID: KP ACV/i O� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/00/YYYY) 09123/2015 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 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 San Jose Insurance Agency Inc. Atlantic - Pacific Ins. Brokers 2542 S. Bascom Ave #280 Campbell, CA 95008 San Jose Insurance Agency CONTACT NAME: PHONE FAX AiC N Ext : A/C No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hanover Insurance Company INSURED EPC Computer Solutions, INSURER B: Hartford. Insurance Group 29424 1324 El Camino Real Belmont, CA 94002 C:Oak River Insurance Company A -INSURER D: X _INSURER INSURER E: 970188603 10101/2015 INSURER F: MED EXP (Any one person) $ 10,00 CnVFRAGFC CFRTIFICATF NIIMRFR- REVISION NUMRFR[. 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE B _ POLICY NUMBER MM/DD Y Y POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ l A00,cO PREMISES Ea occurrence $ 300,00 A X COMMERCIAL GENERAL LIABILITY X 970188603 10101/2015 10/01/2016 MED EXP (Any one person) $ 10,00 CLAIMS -MADE Fx] OCCUR PERSONAL & ADV INJURY $ 000,00 GEN ERAL AGGREGATE $ 2100010_0_._ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG '$ 2,000,00 X - POLICY PRO LOC JECT —1 AUTOMOBILE LIABILITY SINGLE LIMIT COMBINED Ea accident 0 $ 1'Q00'000 BODILY,INJURY (Per person) , $ B X ANY AUTO 57UECAM3472 10/04/2015 10/04/2016 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE PER ACCIDENT)$ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE_ _ $ AGGREGATE $ EXCESS LU1B CLAIMS -MADE DED I RETENTION $ _.. WORKERS CGMPENSATION __ _� WC STATU- DTH= ER C _ LIABIUTY PROPRIETOR/PARTNER/EXECUTIVE ANY PR Y❑ EPWC600644 01/02/2015 01/02/2016 EACH ACCID ACCIDENT $ 1,000,00 OFFCER/MEMBEREXCLUDED? oPRin NOR (.. " _ of 1 N/A — - E.L. EMPLOYEE $ 1,000,00 E.L..DISEASE - POLICY LIMIT $ 1,000,00 If yyes; describe under DESCRIPTION OF OPERATIONS below A Professional E &O 970188603 101014015 10/01/2016 PEO 1,000,00 Ded 5,00 DESCRIPTION OFOPERATIONt I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is named as additional insured with repsects to the insured operations CITYGIL City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. San Jose 0"I 9#8_-201VACbRq C RPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Hanover Insurance Group_ OBF 9701886 5701132 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: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name Of Additional Insured Persons Or Organization(s): Locations Of Covered Operations The City of Gilroy, its Officers, 7351 Rosanna Street Officials and employees Gilroy, CA. 95020 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured in Section II - Liability: 3. Any person(s) or organization(s) shown in the Schedule is also an additional insured,.but only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: a. All 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 location of the covered operations has been completed; or b. 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 other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. BP 04 50 0106 Copyright, ISO Properties, Inc., 2005 Page 1 of 1