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HomeMy WebLinkAboutPrecision Grade - Insurance Certificate (2019)PRECI -4 OP ID: YR ,4`CORO CERTIFICATE OF LIABILITY INSURANCE DATE (M3 INSR /2018YYY) 0412312018 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 831- 724 -3841 McSherry & Hudson License #0056172 35 Penny Lane, Ste. #6 Watsonville, CA 95076 David Weber CONTACT David Weber PHONE 831- 724 -3841 FAX (A/C, No, Ext): (A/X, No); 831- 724 -7574 E -MAIL -ADDRESS, A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR INSURERS AFFORDING COVERAGE NAIC # INSURER A:James River Ins. Co. 04/2512018 INSURED Precision Grade Inc. 17094 McGuffie Rd. INSURER B ; Liberty Mutual Insurance Co $ 1,000,000 INSURER C ; State Compensation Ins. Fund DAMAGE MIES(Eaoccurrrence ) Salinas, CA 93907 INSURER D ; Topa Insurance Company MED EXP (Any one erson $ 1,000 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NU MBER. 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 ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y `Ami- 00082882 -0 04/2512018 0412512019 EACH OCCURRENCE $ 1,000,000 DAMAGE MIES(Eaoccurrrence ) $ 50,000 MED EXP (Any one erson $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC JECT GENERALAGGREGATE $ 2,000,000 GEN'L - COMP /OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY EOMaBINdEeDiSINGLE LIMIT $ 1,000,000 X ANY AUTO OWNED SCHEDULED BA058647981 04/2512018 04125/2019 BODILY INJURY Per person) $ AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ D X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE XL00200447 -01 0412512018 0412512019 DED I I RETENTION $ $ C WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under NIA 9209210 -18 0412512018 04125/2019 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 below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SERVICE AGREEMENT: CONSTRUCTION SERVICES BY PRECISION GRADE CONTRACTORS ON LAS ANIMAS PARK. CITY OF GILROY ITS OFFICERS, OFFICIALS AND EMPLOYEES ARE NAMED ADDITIONAL INSURED PER YHE ATTACHED ENDORSEMENTS. CERTIFICATE HOLDER CANCFI I ATInN CITYOFG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF GILROY, ITS OFFICERS, ACCORDANCE WITH THE POLICY PROVISIONS. OFFICIALS, AND EMPLOYEES 7351 ROSANNA STREET AUTHORIZED REPRESENTATIVE GILROY, CA 95020 `Ami- ACORD 25 (2016/03) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 00082882 -0 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organ ization s : Locations Of Covered Operations Where required by written contract or written agreement. All operations of the Named Insureds. 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: 00082882 -0 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Location And Description Of Completed Opera - tions Where required by written contract or written All operations of the Named Insureds. agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location desig- nated and described in the schedule of this endorse- ment performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑