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HomeMy WebLinkAboutFirst Alarm - Insurance Certificate,4coR ®® CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDNYYY) 1 3/29/2017 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 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 endomemen s . PRODUCER InterWest Insurance Services, Inc. License #0601094 330 Tres Pinos Road, Suite A -1 CONrTACr Heidi Buchman, CIC PHONE 916- 609 -8457 FA" 916- 979 -7992 E-MAIL . hbuchman@iwins.com INSURER(S) AFFORDING COVERAGE NAIC # Hollister CA 95023 INSURER A :Philadelphia Ind. Ins. Co. 18058 $1,000,000 INSURED INSURERB :Arch Insurance Company 11150 First Alarm, First Alarm Security & Patrol, Inc. 1111 Estates Drive INSURER C: $20,000 INSURER D E &O INSURER E: $1,000,000 Aptos CA 95003 INSURER F: $2,000,000 PRODUCTS - COMP /OP AGG COVERAGES CERTIFICATE NUMRER. 2139052543 REVISIf)N NUMRER- 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. IL7RR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDfYYYYY POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR BFPD. XCU Y PHPK1516882 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTEU PREMISES Ea occurrence $1,000,000 X MED EXP (Anyone person) $20,000 X E &O PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a Ea LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 $ A AuTOMoaILEitABW7Y X X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY Ix ALTOS ONLY PHPK1516882 7/1/2016 7/1/2017 INFU Eaaccident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ R RT DAMAGE Per accident $ A X UMBRELLA LIAS EXCESS LIAB X OCCUR CLAIMS -MADE PHUB546804 7/1/2016 7/1/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED RETENTION $ $ _.g_:WORKERS.COMP.ENSATION B AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑NIA OFFICE R/MEMBER EXCLUDED4 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below I ZAVVC19415600 ZAWCI9415700 4/1/2017 4/1/2017 4/1/2018 4/1/2018 PER OTH- X STATUTE ER E. L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - _POLICY LIMIT _ $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) Re: All operations performed by Named Insured For Certificate Holder. Additional Insured status applies to requested entities if required by written contract per the attached endorsement(s). City of Gilroy, its officers, officials and employees GCK 1 II'IGA Ir- MULUtK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy, its Officers, officials and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1516982, COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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 Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Blanket Additional Insured As required by written contract As Required by Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations.. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. 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. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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: I. 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 2. 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. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 0413 ,aco CERTIFICATE OF LIABILITY INSURANCE (MM /DD/YYYY) DAT F61281'2016 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 nterWest Insurance Services, Inc. - icense #01301094 330 Tres Pinos Road, Suite A -1 lollister CA 95023 INSURED First Alarm, First Alarm Security & Patrol, Inc. 1111 Estates Drive Aptos CA 95003 NAMr" Heidi Buchman, CIC P " °NE .916- 609 -8457 V. .916- 979 -7992 E;.m I«�. hbuchmanCENwins.com INSURER A: Philadelphia Ind. Ins. Co. INSURER BArch Insurance Company INSURER C : CnVFRAnFR r'FRTIFIr'ATF NIIMRFR• 1630334079 RFVICInKI NIIMRFR- NAIC # 18058 11150 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM /DD MM /DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y PHPK1516882 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 X MED EXP (Any one person) $20,000 BFPD. XCU X E &O PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY F_x� ECT LOC PRODUCTS - COMP /OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY PHPK1516882 7/112016 7/112017 OMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR PHUB546804 7/1/2016 7/1/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ 1 $ B I B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER /EXECUTIVE ZAWC19375300 ZAWC19375200 4/1/2016 4/1/2016 4/1/2017 4/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? F_ N /A E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) tf Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: City Hall Annex Additional Insured status applies to requested entities if required by written contract per the attached endorsement(s). City of Gilroy, its officers, officials and employees CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy, Its officers, officials and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1516882 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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 Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Blanket Additional Insured As required by written contract As Required by Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. 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. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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: 1. 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 2. 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. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413