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HomeMy WebLinkAboutQuincy Engineering - Insurance Certficate9-1;- 4-0 cne r]I IINr:FNryl ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM1DDlYYYY) 5122/2017 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. T111S 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 poliey(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 Dealey, Renton & Associates P. O. Box 12675 Oakland, CA 946042675 510 465.3090 -TA C T NAME: .._... CY Ferrick Nan c , A, No 510452 -2193 a IL . nferrick @dealeyrenton.com INSURER ($) AFFORDING COVERAGE NAIC # INSURER A: Hartford Casualty Insurance Co. 29424 INSURED Quincy Engineering, Inc. 11017 Cobblerock Drive, Suite 100 Rancho Cordova, CA 95670 ' INSURER 13: Twin City Fire Ins. Co. 29459 INsuRERc: XL Specialty Insurance Co. 37885 INSURER D: Hartford Accident & Ind_ emnity 2.2357 INSURER E: $ 7 000 000 INSURER F: $10,000 r_nvFaet.vc cFwnRCATE 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 CONTRACTOR 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. - -.. L SR TYPE OF INSURANCE - UBR POLICYNUMSER POLICY EFF MJD POLiGY.EXP nlym LIMITS A ' X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X X 57SBWRI1816 0910112016 091011201. EACH OCCURRENCE 5.1000000 - PRE S ELATED oe $ 7 000 000 MED EXP one $10,000 PERSONAL & AOV INJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES PER. POLICY 7 PRO. LOC OTHER GENERAL AGGREGATE s2000000 PRODUCTS •COMP /OP_AGG s2,000,000 S D AurOMOBILELIABILITY ALL OWNED SCHEDULED IR A NY AUTO AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS ' X X 57UEGZC8251 9/01/2016 09/011201 COMBINEDS102 UMM fEa 1 A-20001000 BODILY INJURY (Per person) $ BODILYINJURY(Paraccident) $ PROPERTY DAMAGE dent $ $ A X1 UMSRELLAUAB X EXCESS LIAR OCCUR CLAIMS -MADE 57SBWRI1816 9/0112016 09/01 /2017 EACH OCCURRENCE $5 000 000 AGGREGATE s5:000700 DED I RETENTION 5 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERlEXECUTIVEY7N OFFICERNEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X 57WEGGF5050 0910112016 09/0112017 X InuTF I I(F4H' E.L. EACHACCIOEMr $1000000 E.L DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASES- POLICY LIMIT $1,000,000 C Professional Liability DPR9914253 5/20/2017 05/20/201 $3,000,000 per Claim $3,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mole space Is required) General Liability Policy excludes claims arlsing out of the performance of professional services. 30 Days Notice of Cancellation (10 Days for Non - Payment of Premium). Re: City of Gilroy -San Ysidro Park Bike Path and Lighting Improvement Project - The City of Gilroy, Its officers, officials and employees are named as additional insureds as respects general and auto liability for claims arising from the operations of the named insured. rCDTICIf ATF unI nFD rANrFI I ATIAN City of Gilroy NE THE U EXPIRATION IONH DATE VTHEREOF, DESCRIBED NOTICE )EWILL CBE DELIVERED IN 613 Old Gilroy Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE ®1988 -2014 ACORD CORPORATION. All rights reserved, _._... ._AC.ORD.,'t5..(20141.01.)_ �— pf-a -- The ACORD name and logo are registered marks ofACORO ____ __ ____ _ #520167041M2015776 NMF POUCY NUMBER; 57 SBW RI1816 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ R CAREFULLY. ADDITIONAL INSURED - PERSON- ORGAXI2,ATXON CITY "OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYERS 7351 ROSANNA STREET GILROY, CA 95020 RE: CITY OF GILROY -SAN YSIDRO PARR BM PATH AND LIGHTING IMPROVEMENT PROLMOT f r Form IH 12 00'11 85 T SEQ. NO. 004 printed in U.S.A. Page 001 Expiration Date: 09/01/2017 r.liantfF• 9Rd OUINCENGI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /OD/YYYY) 5/12/2016 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 Dealey, Renton & Associates CONTACT Nancy Ferrick PHONE 510 465 -3090 510 452 -2193 AIC No Extj_ A/C No P. O. Box 12675 Oakland, CA 94604 -2675 E-MAIL ADDRESS: nferrick@dealeyrenton.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hartford Casualty Insurance Co. 29424 510 465 -3090 INSURED INSURER B: Twin City Fire Ins. Co. 29459 Quincy Engineering, Inc. INSURER C: XL Specialty Insurance Co. 37885 11017 Cobblerock Drive, Suite 100 INSURER D, Hartford Accident & Indemnity 22357 Rancho Cordova, CA 95670 INSURER E PREMISES EaEoNccTu ante INSURER F: MED EXP (Any one person) COVFRAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OFF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 ADDL INSR SUHR WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 57SBWRI1816 0910112015 09/0112016 EEAACCHq�OECTCUR��RENCE $1,000,000 CLAIMS -MADE a OCCUR PREMISES EaEoNccTu ante $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X JECT LOC PRODUCTS - COMPIOP AGG $2,000,000 $ OTHER: D AUTOMOBILE LIABILITY X X 57UEGZC8251 9101/2015 09/01/201 ,d EOa accleDtSINGLE LIMIT S1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS IX PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR 57SBWRI1816 9/01/2015 09/01 /201 EACH OCCURRENCE $5000000 AGGREGATE $5,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N OFFICER/MEMBER EXCLUDED? 7N] (Mandatory in NH) NIA X 57WEGGF5050 0910112015 09/01/2016 X l,T,RUT OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below C Professional DPR9804883 5/20/2016 0512012017 $3,000,000 per Claim Liability $3,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is requlred) General Liability Policy excludes claims arising out of the performance of professional services. 30 Days Notice of Cancellation (10 Days for Non - Payment of Premium). Re: City of Gilroy -San Ysidro Park Bike Path and Lighting Improvement Project - The City of Gilroy, its officers, officials and employees are named as additional insureds as respects general and auto liability for claims arising from the operations of the named insured. City of Gilroy 613 Old Gilroy Street Gilroy, CA 95020 ACORD 25 (2014/01) 1 of 1 #S1697732/M1697034 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 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NMF POLICY NUMBER: 57 SBW RI1816 F'� THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON- ORGANIZATION CITY OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYEES 7351 ROSANNA STREET GILROY, CA 95020 RE: CITY OF GILROY -SAN YSIDRO PARK BIKE PATH AND LIGHTING IMPROVEMENT PROJECT Form IH 12 00 11 85 T SEQ. NO. 004 Printed in U.S.A. Page 001 Process Date: 12/02/15 Expiration Date: 09/01/16