Loading...
HomeMy WebLinkAboutSabah International - Insurance Certificate (2019)CERTIFICATE OF LIABILITY INSURANCE r ATE /2/2018) 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 Woodruff-Sawyer & CO. 50 50 California Street, Floor 12 CONTACT NAME: Sindy Lara PHONE FAX A/C No Ext: 415 - 402 -6659 /C -989-99 San Francisco CA 94111 ADD"Ess: slara wsandco.com INSURER (S) AFFORDING COVERAGE NAIC # l 71112019 INSURER A: Tokio Marine Specialty Insurance Company 23850 $ 1,000,000 INSURED SABAINT -01 Sabah International Incorporated 5925 Stoneridge Drive INSURER B: Greenwich Insurance Company 22322 INSURER C; Hartford Fire Insurance Company 19682 INSURER D: Trumbull Insurance Company 27120 Pleasanton, CA 94588 INSURER E: PERSONAL &ADV INJURY INSURER F: AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY OTHER: GUVtKAUtb GtKIIhIGAIE NUMBER: 2051625586 RFZVICInN NIIMRFR• 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 LTR TYPE OF INSURANCE ADDLIISUBR INSD WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y PPK1844441 7/1/2018 l 71112019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 GEN'L MED EXP (Anyone person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ C AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 57UEAFN3854 7/1/2018 7/1/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTYDAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PUB636551 7/1/2018 7/112019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 i I DED I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /Ali 57WEAAB6S9X 711/2018 7/112019 X I STATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional & Pollution Liab. PECO03225408 711/2018 71112019 Per Claim Aggregate SIR $1,000,000 $2,000,000 $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All Services /maintenance work at the Gilroy Police Department, 7301 Hanna Street, Gilroy, CA 95020. City of Gilroy, its officers, officials and employees are additional insured per forms attached. CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials and employees 7351 Rosanna Street 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. REPRESENTATIVE ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PPK1844441 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 Organization(s): Location(s) Of Covered Operations City of Gilroy, its officers, officials and employees All Senrices /maintenance work at the Gilroy Police Department, 7301 Hanna Street, 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: 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 other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 O ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: PPK1844441 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 Organization(s): Location And Description Of Completed Operations City of Gilroy, its officers, officials and employees All Senlices / maintenance work at the Gilroy Police Department, 7301 Hanna Street, Gilroy, CA 95020. 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 in- at the location designated and described in the dude as an additional insured the person(s) or or- schedule of this endorsement performed for that ad- ganization(s) shown in the Schedule, but only with ditional insured and included in the "products -com- respect to liability for "bodily injury" or "property pleted operations hazard ". damage" caused, in whole or in part, by "your work" CG 20 37 07 04 Copyright, ISO Properties, Inc., 2004 Page 1 of 1 UNIFORM