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Home My WebLink AboutSVILC - Insurance Certificate (2018)A07" " CERTIFICATE OF LIABILITY INSURANCE 006/30/201/ 7�) 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 CONTACT RONALD VINCENT C. Ed:925- 334 -3124 FAX No: 866- 669 -8134 PHILADELPHIA INSURANCE COMPANIES MAGUIRE INSURANCE ADDRESS: RONALD.VINCENT PHLY.COM INSURER(S) AFFORDING COVERAGE NAIC # 1277 TREAT BLVD, SUITE 650 INSURER A: PHILADELPHIA INDEMNITY INS CO 18058 WALNUT CREEK, CA 94597 INSURED INSURER B: INSURER C: SILICON VALLEY INDEPENDENT LIVING CENTER INSURER D: PREMISESO(Ea occu D nce) 25 N 14TH ST STE 1000 INSURER E: CLAIMS -MADE FK OCCUR SAN JOSE, CA 95112 -6204 INSURER F: 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MM /DD LIMITS A GENERAL LIABILITY PHPK1680209 6/30/2017 06/30/2018 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESO(Ea occu D nce) $ 100,000 CLAIMS -MADE FK OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 $ POLICY JE� LOC A AUTOMOBILE LIABILITY PHPK1680209 6/30/2017 06/30/2018 (Ea accidel t) SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIRED AUTOS X AUTOSWNED X (Per accident DAMAGE $ A UMBRELLA LIAB X OCCUR PHUB592106 6/30/2017 06/30/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED I X FRE71ENTION $ 10, 000 $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WC STATU- OTH- TORY LIMITS ER ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? ❑ (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ PHPK1680209 6/3012017 06/30/2018 A' EMPLOYEE DISHONESTY $105,000 / $1000 PROFESSIONAL LIABILTY $2,000,000 AGG/ $1,000,000 OCC DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) THE CITY OF GILROY, CITY, ITS OFFICERS, REPRESENTATIVES, AGENTS, AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED IN RESPECTS BEING A FUNDING SOURCE PER THE ATTACHED CG2005 ENDORSEMENT CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF GILROY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HOUSING AND COMM DEVELOPMENT PROGRAM ACCORDANCE WITH THE POLICY PROVISIONS. 7351 ROSANNA STREET GILROY, CA 95020 AUTHORIZED REPRESENTATIVE ATTN: SANDRA NAVA (408)345 -4382 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1680209 COMMERCIAL GENERAL LIABILITY CG 20 05 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CONTROLLING INTEREST This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Person(S) Or Organization(s): THE CITY OF GILROY, CITY, ITS OFFICERS, REPRESENTATIVES, AGENTS, AND EMPLOYEES HOUSING AND COMM DEVELOPMENT PROGRAM 7351 ROSANNA STREET GILROY, CA 950200 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 their liability arising out of: 1. Their financial control of you; or 2. Premises they own, maintain or control while you lease or occupy these premises. 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. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 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 applicable Limits of Declarations. shall not increase the Insurance shown in the CG 20 05 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 7/14/2017 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 CONTACT CL Central NAME: Leavitt Pacific Insurance Brokers, Inc. PHONE (408)288 -6262 FAX (408) 298 -7635 _(Al o E10: (A/C Nol: E -MAIL Broker ADDRESS: License #kOD79674 1330 S Bascom Ave INSURERS AFFORDING COVERAGE NAIC# INSURERA:Re ubl.ic IndemnitV Company of 43753 San Jose CA 95128 INSURED INSURER B: CLAIMS -MADE FI OCCUR INSURER C: Silicon Valley Independent Living Centers INSURER D: 25 N 14th ST STE 1000 INSURER E: $ INSURER F. $ Sari Jose CA 95112 COVERAGES CERTIFICATE NUMBER:17 /18 WC 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 TR TYPE OF INSURANCE ADDL im POLICY NUMBER MMIDD EFF POLICY D LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE FI OCCUR D AGE O RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT � LOC PRODUCTS - COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ 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 $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N }( OTH- STATUTE I I ER _ ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER and t ry In N EXCLUDED? (Mandtory in NH) NIA 16633512 7/1/2017 7/1/2018 $ 11000,000 E.L. DISEASE - EA EMPLOYE If yes, describe under DESCRIPTION OF OPERATIONS below $ 11000,000 E.L. DISEASE - POLICY LIMIT I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * *Evidence of Coverage ** CERTIFICATE HOLDER CANCELLATION City of Gilroy Housing & Development Program 7351 Rosanna St Gilroy, CA 95020 ACORD 25 (2014/01) INS025 (201401) 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 B zcStanden /BISTAN U 1988 -2014 ACORD GURPURATIUN. All rights reserved. The ACORD name and logo are registered marks of ACORD