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HomeMy WebLinkAboutFerguson Waterworks - Insurance Certificate (2018)A °® CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 01/11/2 8) 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 endorsement(s). PRODUCER CONTACT Willis of Maryland, Inc. c/o 26 Century Blvd. P. O. Box 305191 PHONE 610- 964 -8700 FAX 610 - 254 -5600 E -MAIL certificates @willis.com A DR Nashville, TN 37230 -5191 INSURER(S)AFFORDING COVERAGE NAIC # INSURERA:National Union Fire Ins. Co. of Pittsburg 19445 -002 5/1/2018 INSURED Ferguson Enterprises, Inc. and Subsidiaries INSURER B: National Union Fire Ins. Co. of Pittsburg 19445 -000 INSURERC:National Union Fire Ins. Co. of Pittsburg 19445 -001 (See Attached Named Insured Schedule) 12500 Jefferson Avenue Newport News, VA 23602 INSURER D: New Hampshire Insurance Company 23841 -001 INSURER E: PpAqMMqq EETTO.RENTED PREMES (r.=a occurence) $ 1,000,000 INSURER F: MED EXP (Any one person) $ 10,000 COVERAGES CERTIFICATE NUMBER: 26044602 REVISION NUMBER:See Remarks 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 DDL SU8 pOLICYNUMBER POLICYEFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y GL 712 -9880 5/1/2017 5/1/2018 EACHOCCURRENCE $ 2,000,000 CLAIMS —MADE X OCCUR PpAqMMqq EETTO.RENTED PREMES (r.=a occurence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 5,000,000 POLICY � PRO JECT X LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y AOS 1921927 5/1/2017 5/1/2018 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY(Per person) $ B X ANYAUTO Y MA 1921928 5/1/2017 5/1/2018 C OWNED SCHEDULED AUTOS ONLY AUTOS Y VA 1921929 5/1/2017 5/1/2018 BODILY INJURY(Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X Self- X Physical Insured Dama e PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLALIAB X OCCUR 12 318 770 5/1/2017 5/1/2018 EACHOCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ D WORKERS COMPENSATION 023102516 /1/2017 5/1/2018 X I PER OTH- FR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 'Mandatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below NIA E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE- POLICY LIMIT Is 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 10/13/2017 WITH ID: 25753733 Store 3340 Workers Compensation Policy #WCO23102516 provides coverage for AL, AR, CO, CT, DC, DE, GA, HI, IA, ID, IN, KS, LA, MD, MI, MN, MO, MS, MT, NE, NM, NV, NY, OK, OR, SC, SD, TN, TX, WV. See Attached for Additional Workers' Compensation Policies. UhK I II-II;A I h HULUtK I;ANL LLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy, its officers, AUTHORIZED REPRESENTATIVE officials and employees 7351 Rosanna Street Gilroy, CA 95020 `e - \ _ ­K- ` . - „ O ACORD 25 (2016103) Cnl l • F1 661 54 Tnl a 2l 42977 cart - - 9. 6044F09. Cc� 19RR -2015 ACORD CORPORATION_ All rights reserved The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: 1 A`°R°® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Ferguson Enterprises, Inc. and Subsidiaries Willis of Maryland, Inc. (See Attached Named Insured Schedule) 12500 Jefferson Avenue POLICY NUMBER Newport News, VA 23602 See First Page CARRIER NAIC CODE EFFECTIVEDATE: See First Page See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Re: Service Agreement: Perform large meter testing for the City Water Service. City of Gilroy, its officers, officials and employees, 7351 Rosanna Street, Gilroy, CA 95020; Service Agreement, Fire Department Personnel Testing, City of Gilroy, its officers, officials and employees are named as an Additional Insured, per tFie attached endorsement. ACORD 101 (2008/01) Coll:5166154 Tpl:2142977 Cert: 26044602 © 2008AGORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGE SCHEDULE COVERAGE LIMITS POLICY TYPE: Workers' Compensation & Employers Per Statute Liability- ME E.L. Each Accident: $2,000,000 CARRIER: New Hampshire Insurance Company E.L. Disease - Policy Limit: $2,000,000 POLICY TERM: 05/01/2017 - 05/0112018 E.L. Disease -Each Employee: $2,000,000 POLICY NUMBER: WCO23102515 POLICY TYPE: Workers' Compensation & Employers Liability Per Statute - CA E.L. Each Accident: $2,000,000 CARRIER: American Home Assurance Company E.L. Disease - Policy Limit: $2,000,000 POLICY TERM: 05/01/2017 - 05/01/2018 E.L. Disease -Each Employee: $2,000,000 POLICY NUMBER: WCO23102514 POLICY TYPE: Workers' Compensation & Employers Liability Per Statute - FL E.L. Each Accident: $2,000,000 CARRIER: Illinois National Insurance Company E.L. Disease - Policy Limit: $2,000,000 POLICY TERM: 05/01/2017 - 05/01/2018 E.L. Disease -Each Employee: $2,000,000 POLICY NUMBER: WCO23102513 POLICY TYPE: Workers' Compensation & Employers Liability Per Statute - MA & WI E.L. Each Accident: $2,000,000 CARRIER: New Hampshire Insurance Company E.L. Disease - Policy Limit: $2,000,000 POLICY TERM: 05/01/2017 - 05/01/2018 E.L. Disease -Each Employee: $2,000,000 POLICY NUMBER: WCO23102518 POLICY TYPE: Workers' Compensation & Employers Liability Per Statute - AK ,AZ,IL,KY,NC,NH,NJ,PA,UT,VA,VT E.L. Each Accident: $2,000,000 CARRIER: New Hampshire Insurance Company E.L. Disease - Policy Limit: $2,000,000 POLICY TERM: 05/01/2017 - 05/01/2018 E.L. Disease -Each Employee: $2,000,000 POLICY NUMBER: WCO23102517 Ferguson Enterprises, Inc. and Subsidiaries. List of Named Insureds Air Cold Supply Air Cold Supply/Webb Distributors Alamo Pipe & Supply Alaska Pipe & Supply Andrews Lighting Gallery, Inc. (dba Andrews Lighting & Hardware Gallery) Arkansas Supply, Inc. Ar -Jay Building Products, Inc. (dba The Ar -Jay Center) Atlantic American Fire Equipment Company Arkansas Supply The Bath + Beyond Bruce - Rogers Company Build.com, Inc. Builders Appliance Center, LLC CAL - STEAM, a Wolseley Company Camellia Valley Supply Castle Supply Company, Inc. CastleNorth Central Pipe & Supply CFP Chadwick City Lights Design Showroom Clawfoot Supply, LLC Clayton Group, Inc. Clayton International, LLC Cline Contract Sales Colgan Cabinets Colgan Distributors Crow Company Custom Lighting Incorporated Custom Hardware and Accessories, Inc. D & C Plumbing & Heating Supply Davis & Warshow, Inc. Davidson Electric Wholesale Supply The Davidson Corporation, a Delaware Corporation The Davidson Group Companies, Inc Davidson Group Leasing Davidson Pipe Company Inc., a New York Corporation Davidson Pipe Supply Company, Inc. Davies Water Dealernet, LLC dba Dealemet Decorative Product Source, Inc. E & J Plumbing & Heating Supply Co. Economy Plumbing and Heating Supply Co. Energy & Process Corporation Equarius, Inc. dba Equarius Waterworks, Meter & Automation Group Factory Direct Appliance Ferguson Bath Kitchen and Lighting Gallery Ferguson Enterprises IV, Inc. Ferguson Enterprises of Montana, Inc. Ferguson Enterprises of Virginia, Inc. Ferguson Enterprises V, Inc. Ferguson Enterprises, Inc. Ferguson Enterprises, Inc. dba WPCC Forwarding Ferguson Enterprises, Inc. A Corp of Virginia Ferguson Enterprises .NY — Metro, Inc. Ferguson Fire & Fabrication, Inc. Ferguson Fire & Fabrication, Inc. (fka Action Fire Fab & Supply, Inc.) Ferguson Fire & Fabrication, Inc. (fka Sierra Craft, Inc.) Ferguson Full Service Supply Ferguson Heating & Cooling Ferguson Holdings, Inc. Ferguson Hospitality Sales Ferguson Industrial Plastics and Pump Division Ferguson Integrated Systems Division, Inc. Ferguson Intermountain Piping Ferguson International Ferguson Process Services Ferguson Valve & Automation Ferguson Waterworks Ferguson Waterworks - Midwest Pipe Ferguson Waterworks - Municipal Pipe Ferguson Waterworks - Red Hed Ferguson Waterworks EPPCO Ferguson Waterworks International Frischkorn, Inc. Gabriel Scientific & Machine, LLC Galleria Bath & Kitchen Showplace Gilmour Supply Company, Inc. Global HVAC Distributors, Inc. Ferguson Enterprises, Inc. dba Groeniger & Company Ferguson Enterprises, Inc. and Subsidiaries. List of Named Insureds Gulf Refrigeration Supply High Country Plumbing Supply Home Equipment Company, Inc. HM Wallace, Inc. HP Products Corporation HP Logistics, Inc. Indiana Plumbing Supply Co., Inc. Industrial Hub of the Carolinas J &G Products J.D. Daddario Company Joseph G. Pollard Co., Inc. Kandall Fabricating Karl's Appliances, A Ferguson Enterprise Lane Piping Co. Lawrence Plumbing Supply Co. Lighting Unlimited, LLC Lincoln Products Linwood Pipe and Supply Living Direct, Inc. Louisiana Utilities Supply Company Louisiana Chemical Pipe, Valve & Fitting, Inc. dba Wolseley Industrial Group LUSCO Lyon Conklin & Co., Inc. Mastercraft Cabinets Matera Paper Company, Inc. McFarland Supply Co., Inc. Michigan Meter Technology Michigan Pipe &Valve - Flint, Inc. Michigan Pipe &Valve- Lansing, Inc. Monotube Pile Corporation Northern Water Works Supply, Inc. Onda -Lay Pipe and Rental, Inc. Page's Appliances Palermo Supply Park Supply PCS Industries d/b /a HP Products Corp. Pipe Products Plumbing Decor Plumb Source Powell Pipe & Supply Company Power Equipment Direct Inc. P.V. Sullivan Supply Co., Inc. R Supply Company Ramapo Wholesalers Record Supply Company Redlon & Johnson Reese Kitchen, Bath & Lighting Gallery RenWes Sales S.G. Supply Company S.G. Supply Company dba SG Supply Co., a Ferguson Enterprise Sierra Craft, Inc. Signature Hardware Ship -Pac, Inc. d/b /a HP Products Corp. SOS Sales Specialty Pipe & Tube, Inc. Specialty Pipe & Tube of Texas, Inc. Stock Loan Services LLC Summer & Dunbar Supply North Central Group Tarpon Wholesale Supplies T & A Valve Industries, Inc. The Parnell -Martin Companies LLC The Plumbers Warehouse The Plumbing Source Inc. The Stock Market Tubeco Fabrication, Inc. Underground Pipe & Valve Inc. United Automatic Water Works Supplies Webb Distributors Western Air Systems and Controls, Inc. Westfield Lighting Wholesale Group, Inc. WIA of California, Inc. Wolseley Industrial Group Wolseley Industrial Plastics Wolseley Investments Acquisitions, Inc. Wolseley Investments, Inc. Wolseley NA Construction Services, LLC Wolseley North America, Inc. Wolseley North American Consulting, LLC Wolseley North American Services, Inc. WPCC Forwarding POLICY NUMBER: 712 -9880 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): CITY OF GILROY, IT OFFICERS, OFFICIALS AND EMLOYEES, ROSANNA ST., GILROY, CA 95020 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 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. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ENDORSEMENT This endorsement, effective 12:01 A.M. 05/01/2017 forms a part of policy No. GL 712 -9880 issued to Wolseley Investments, Inc. by National Union Fire Insurance Company Of Pittsburgh, Pa THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II - WHO IS AN INSURED, is amended to include as an additional insured: Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: . The coverage and /or limits of this policy, or The coverage and /or limits required by said contract or agreement. 61712 (12/06) Authorized Representative or Countersignature (in States Where Applicable) Page 1 of 1