HomeMy WebLinkAboutSharp Business Systems - Insurance Certificate (2018)AC CERTIFICATE OF LIABILITY DATE /2018 /YYYY)
�' INSURANCE ( 071312018
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
Marsh USA Inc. NAME:
Jappan Client Services (A/CPHO, Extl: I (AA/C. Noll:
1166 Avenue of the Americas, 36th Floor E-MAIL
New York, NY 10036 ADDRESS:
Attn: NewYork.Certs@marsh.com Fax: 212-948-0500 INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
Sharp Business Systems
100 Paragon Drive
Montvale, NJ 07645
INSURER A: Sompo America Insurance Company 11126
INSURER B : Mitsui Sumitomo Insurance Company Of America 20362
INSURER C : National Union Fire Insurance Co Of Pittsburgh 19445
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: NYC-009868896-36 REVISION NUMBER: 16
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 'ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WV D POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) I LIMITS
A X COMMERCIAL GENERAL LIABILITY GDL40002GO 10/01/2017 10/01/2018 1 EACH OCCURRENCE $ 1,000,000
CLAIMS -MADE X OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 1,000,000
_
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 1,000,000
X POLICY PRO- ❑ LOC
JECT
PRODUCTS -COMP/OP AGG
$ 3,000,000
OTHER:
$
A AUTOMOBILE LIABILITY
ACV41064MO
10/01/2017 10/01/2018
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X ANY AUTO
I BODILY INJURY (Per person)
$
OWNED SCHEDULED
BODILY INJURY
AUTOS ONLY AUTOS
(Per accident)
$
HIRED NON -OWNED
I PROPERTY DAMAGE
$
AUTOS ONLY AUTOS ONLY
(Per accident)
A X UMBRELLA LIAB X
_ OCCUR
CPU40752AO
10/01/2017 10/01/2018
EACH OCCURRENCE
$ 5,000,000
EXCESS LIAB CLAIMS -MADE
I AGGREGATE
$ 5,000,000
DIED I I RETENTION $
$
B WORKERS COMPENSATION
WCP8530020 (AOS)
U01/2018 06/01/2019
X I PER I 1OTH-
B AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
WCP9110029 ME, ID
( )
06/01/2018 06/01/2019
STATUTE ER
E.L. EACH ACCIDENT
1,000,000
NI NIA
$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
I E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
1,000,000
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
C Errors & Omissions
017081515
08/01/2018 08/01/2019
Limit:
5,000,000
SIR:
150,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF GILROY, ITS OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED (EXCEPT WORKERS' COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER
CITY OF GILROY
7351 ROSANNA STREET
GILROY, CA 95020
CANCELLATION
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
of Marsh USA Inc.
Teresa Gerwycki-Chaves ZJQxWA:- k )AQ7�_- CQ'm�
C 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD
ACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE /YYYY)
��.
/2018
05/30/2018
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
NAME:
Marsh USA Inc.
PHONE FAX
A/C No Ext : A/C No):
Japan Client Services
1166 Avenue of the Americas, 36th Floor
E -MAIL
New York, NY 10036
ADDRESS:
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
Altn: NewYork.Certs @marsh.com Fax: 212- 948 -0500
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A : Som o America Insurance Company
11126
PERSONAL & ADV INJURY
INSURED
Sharp Business Systems
INSURER B: N/A
N/A
INSURER C :
PRODUCTS - COMP /OP AGG
100 Paragon Drive
Montvale, NJ 07645
$
AUTOMOBILE
INSURER D
INSURER E:
INSURER F :
COMBINED SINGLE LIMIT
Ea accident
$
COVERAGES CERTIFICATE NUMBER: NYC - 008950288 -48 RFVISION NIIMRFR• 17
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.
ILTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MMIDD/YYYY
MM /DD /YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
GDL40002CO
10/01/2017
10/01/2018
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY PRO JECT F—] LOC
OTHER:
GENERAL AGGREGATE
$ 1,000,000
PRODUCTS - COMP /OP AGG
$ 3,000,000
$
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRI ETOR /PARTNER /EXECUTIVE
OFFICER /M EMBER EXCLUDED? r7
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
STATUTE I iER
E. L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Gilroy is included as additional insured where required by written contract.
CERTIFICATE HOLDER CANCFLI_ATION
City of Gilroy
7351 Rosanna St.
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
of Marsh USA Inc.
Teresa Gerwycki- Chaves i_ C O'C'mcp
@ 1988 -2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
ACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE 05130//2018 2018 IYYYY)
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
Marsh USA Inc.
Japan Client Services
CONTACT
NAME:
PHONE �X
(A/C. No Ext : A/C No):
E -MAIL
ADDRESS:
1166 Avenue of the Americas, 36th Floor
New York, NY 10036
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE XI OCCUR
Attn: NewYork.Certs @marsh.com Fax: 212- 948 -0500
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Som o America Insurance Company
11126
$ 1,000,000
INSURED
Sharp Business Systems
INSURER B : Mitsui Sumitomo Insurance Company Of America
20362
INSURER C : National Union Fire Insurance Co Of Pittsburgh
19445
100 Paragon Drive
Montvale, NJ 07645
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: NYC - 009868896 -32 REVISION NUMBER: 16
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
INSD
SUER
POLICY NUMBER
MM /DD/YYYY
MMLDD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE XI OCCUR
GDL40002CO
10/01/2017
10/01/2018
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 1,000,000
PRO-
POLICY I
F ❑ LOC
JECT X
PRODUCTS - COMP /OP AGG
$ 3,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
ACV41064MO
10/01/2017
10/01/2018
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
X
UMBRELLA LIAB
X
OCCUR
CPU40752AO
10/01/2017
10/01/2018
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR /PARTNER/EXECUTIVE
OFFICER /MEMBER EXCLUDED? �
(Mandatory in NH)
NIA
WCP8530020(ADS)
WCP9110029 ( ) ME, ID
06/01/2018
06/01/2019
06/01/2019
X I PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C
Errors & Omissions
017716881
08/01/2017
08/01/2018
Limit:
5,000,000
SIR:
150,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF GILROY, ITS OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED (EXCEPT WORKERS' COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER CANCELLATION
CITY OF GILROY
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
7351 ROSANNA STREET
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
GILROY, CA 95020
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Teresa Gerwycki- Chaves C0 c, „
@ 1988 -2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD