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HomeMy WebLinkAboutDu-All Safety - Insurance Certificate (2019)ACo " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) `—_ I 10/31/2018 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 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 I CONTACT NAME: Leanna Stellman TLB Insurance Services (PHONE (925)395-2600 (FAX (925) 287-0710 (A/C. No. Ext): (A/C. Nol: E-MAIL CA License #OB82095 IADDRESS: leanna-stellman@leavitt.com 3000 Oak Road, Suite 210 I INSURER(S) AFFORDING COVERAGE NAIC# Walnut Creek CA 94597 m INSURERA:Associated Indenity Corporation 21865 INSURED INSURERB:Emplovers Compensation Insurance 11512 DU -ALL SAFETY I INSURER C :Great American E&S Insurance 37532 45950 HOTCHKISS STREET I INSURERD: I INSURER E : FREMONT CA 94539 I INSURERF: COVERAGES CERTIFICATE NUMBER:18-19 MASTER 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INL�n Wvn POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY A _� CLAIMS -MADE X� OCCUR X AS6AZC80919569 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC JECT OTHER: AUTOMOBILE LIABILITY A ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS X X UMBRELLA LIAB OCCUR A EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N I A B (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below C PROFESSIONAL LIABILITY CLAIMS MADE AS6MZA80328221 AS6AZC80919569 EIG240384802 SCL5477776 11/1/2018 11/1/2019 11/1/2018 11/1/2019 EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ IEACH OCCURRENCE $ (AGGREGATE $ 11/1/2018 11/1/2019 $ X IPER STATUTEI I OERH E.L. EACH ACCIDENT $ 11/1/2018 11/1/2019 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 11/1/2018 11/1/2019 LIMIT AGGREGATE $2,000,000 1,000,000 300,000 15,000 1,000,000 2,000,000 2,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 $1,000,000 DED $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Gilroy, its officers, representatives, agents and employees are included as additional insureds as respects General Liability per form AB9189 0807 attached per written contract. CERTIFICATE HOLDER CANCELLATION ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF GILROY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 ROSANNA ST . ACCORDANCE WITH THE POLICY PROVISIONS. GILROY, CA 95020 AUTHORIZED REPRESENTATIVE !!� L Stellman/LESTEL © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NS025 (201401) ABC MultiCover - AB 91 89 08 07 This endorsement modifies insurance provided under the following: American Business Coverage Your policy is broadened and clarified as follows: 1. Non Employment Discrimination Liability Unless Personal Injury or Advertising Injury is excluded from this policy: A. Section HI - Definitions, Item 17. Personal Injury is amended to include: f. Discrimination B. Section III - Definitions, Item 2. Advertising Injury is amended to include: e. Discrimination C. Section III - Definitions is amended to in- clude: 30. Discrimination means the unlawfiil treat- ment of individuals based on race, color, ethnic origin, gender, religion, age, or sexual preference. D. Section II - Liability Coverage, Part H. Ex- clusions, Item Lp Personal Injury or Adver- tising Injury is amended to include: (11) Arising out of discrimination directly or indirectly related to the past employ- ment, employment or prospective em- ployment of any person or class of persons by any insured; or (12) Arising out of discrimination directly or indirectly related to the sale, rental, lease or sub -lease or prospective sale, rental, lease or sub -lease of any dwelling, permanent lodging, or premises by or at the direction of any insured; or (13) Arising out of discrimination, if insurance thereof is prohibited by law; or (14) Fines, penalties, specific performance, or injunctions levied or imposed by a go- vernmental entity, or governmental code, law, or statute because of discrimination 2. Blanket Additional Insured Section H - Liability Coverage, Part I. Who Is An Insured, Item 2. is amended to include: f. Any person or organization that you are re- quired by a written insured contract to include as an insured, subject to all of the following provisions: (1) Coverage is limited to their liability aris- ing out of: (a) the ownership, maintenance or use of that part of the premises, or land owned by, rented to, or leased to you; or (b) your ongoing operations performed for that insured; or (c) that insured's financial control of you; or (d) the maintenance, operation or use by you of equipment leased to you by such person(s) or organization(s); or This Form must be attached to Change Endorsement when issued after the policy is written. One of the Fireman's Fund Insurance Companies as named in the policy )144-0 FZ."- Secretary v President AB9189 8-07 Page 1 of 6 (e) a state or political subdivision per- assumption of liability in a contract mit issued to you. or agreement. This exclusion does not apply to liability for damages (2) Coverage does not apply to any occur- that the vendor would have in the rence or offense: absence of the contract or agree - (a) which took place before the exe- ment; cution of, or subsequent to the b. Any express warranty unauthorized completion or expiration of, the by you; written insured contract, or c. Any physical or chemical change in (b) which takes place after you cease to the product made intentionally by be a tenant in that premises. the vendor; (3) With respect to architects, engineers, or d. Repackaging, unless unpacked solely surveyors, coverage does not apply to for the purpose of inspection, dem- Bodily Injury, Property Damage, Per- onstration, testing, or the substi- sonal Injury or Advertising Injury arising out of the rendering or the failure to tution of parts tinder instructions render any professional services by or for from the manufacturer, and then re - you including: packaged in the original container. (a) The preparing, approving, or failing e. Any failure to snake such in- to prepare or approve maps, draw- spections, adjustments, tests or ser- ings, opinions, reports, surveys, vicing as the vendor has agreed to change orders, designs or specifica- make or normally undertakes to tions; and make in the usual course of busi- ness, in connection with the distrib- (b) Supervisory, inspection, or engi- ution or sale of the products; neering services. f. Demonstration, installation, servic- If an Additional Insured endorsement is attached ing or repair operations, except such to this policy that specifically names a person or operations performed at the vendor's organization as an insured, then this coverage does premises in connection with the sale not apply to that person or organization. of the product; 3. Blanket Additional Insured for Vendors Unless the Products -Completed Operations Haz- ard is excluded from this policy, Section H - Li- ability Coverage, Part I. Who Is an Insured, Item 2. is amended to include: g. Any vendor but only with respect to Bodily Injury or Property Damage arising out of your products which are distributed or sold in the regular course of the vendor's business, sub- ject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. Bodily Injury or Property Damage for which the vendor is obligated to pay damages by reason of the AB9189 8-07 g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. 2. This insurance does not apply to any in- sured person or organization, from whom you have acquired such products, or any ingredient, part or container, en- tering into, accompanying or containing such products. If an Additional Insured - Vendors endorsement is attached to this policy that specifically names a person or organization as an insured, then this coverage does not apply to that person or organ- ization. Page 2 of 6 4. Blanket Waiver of Subrogation Section II - Liability Coverage, Part K. Liability and Medical Payments General Conditions, is amended to include: 6. Transfer of Rights of Recovery Against Oth- ers to us and Blanket Waiver of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. b. If required by a written insured contract, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your operations or your work for that person or organ- ization. 5. Broadened Named Insured Section H - Liability Coverage, Part I. Who Is An Insured, Item 4. is replaced with: 4. All of your subsidiaries, companies, corpo- rations, firms, or organizations, as now or hereafter constituted, qualify as Named In- sured under this policy if. (a) you have the responsibility of placing in- surance for each such entity; and (b) coverage for the entity is not otherwise more specifically provided; and (c) the entity is incorporated or organized under the laws of the United States of America. But each entity is insured only while you own, during the policy period, a controlling interest in such entity of greater than 50% of the stock or assets. However: (a) Coverage under this provision is afforded only until the end of the policy period, or the 12 month anniversary of the policy inception date, whichever is earlier; (b) Coverage C does not apply to bodily in- jury or property damage that occurred AB9189 8-07 before you acquired or formed the or- ganization; (c) Coverage C does not apply to personal injury or advertising injury arising out of an offense committed before you ac- quired or formed the organization. 6. Medical Payments Unless Coverage D. Medical Payments is excluded from this policy: A. Section II - Liability Coverage, Part H. Ex- clusions, Item 2.£ is replaced with: f. Included within the products -completed operations hazard However, this exclu- sion does not apply to expenses for den- tal services. B. Section H - Liability Coverage, Part G. Cov- erage, Item 2., is amended to include: c. Coverage D. Medical Payments is pri- mary and not contributing with any other insurance, even if that other insur- ance is primary also. 7. Tenant's Legal Liability A. Section HI - Liability Coverage, Part J. Li- ability and Medical Payments Limits of In- surance, Item 3. is replaced with: 3. The most we will pay under Coverage C - Liability for damages because of prop- erty damage to premises while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner: a. arising out of any Covered Cause of Loss shall be the greater of: (1) $1,000,000; or (2) The Tenant's Legal Liability limit shown in the Declarations. 8. Chartered Aircraft Section H - Liability Coverage, Coverage C, Part H. Exclusions, Item l.g. is amended to include: (5) An aircraft in which you have no ownership interest and that you have chartered with crew. Page 3 of 6 9. Coverage Territory Broadened Section III - Definitions, Item 5.a. is replaced with: a. The United States of America (including its territories and possessions), Puerto Rico, Ca- nada, Bermuda, the Bahamas, the Cayman Islands and the British Virgin Islands. 10. Broadened Advertising Injury Unless Advertising Injury is excluded from this policy: A. Section III - Definitions, Item 2. is replaced with: 2. Advertising Injury means injury arising out of one or more of the following of- fenses: a. Oral, written, televised or videotaped publication of material that slanders or libels a person or organization or disparages a person's or organiza- tion's goods, products or services; b. Oral, written, televised or videotaped publication of material that violates a person's right of privacy; C. Misappropriation of advertising ideas or style of doing business; or d. Infringement of trademark, copy- right, title or slogan. B. Section II - Liability Coverage, Coverage C, Part H. Exclusions, Items l.p.(I) and (2) are replaced with: (1) Arising out of oral, written, televised or videotaped publication of material, if done by or at the direction of the insured with knowledge of its falsity; (2) Arising out of oral, written, televised or videotaped publication of material whose first publication took place before the beginning of the policy period; 11. Broadened Personal Injury Unless Personal Injury is excluded from this pol- icy, Section III - Property, Liability and Medical AB9189 8-07 Payments Definitions, Items 17.b., d. and e. are replaced with: b. Malicious prosecution or abuse of process; d. Oral, written, televised or videotaped publica- tion of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral, written, televised or videotaped publica- tion of material that violates a person's right of privacy; 12. Broadened Personal or Advertising Injury Unless Personal Injury or Advertising Injury is excluded from this policy, Section H - Liability Coverage, Coverage C, Part H. Exclusions, Item l.p.(4) Exclusions is deleted in its entirety. 13. Fellow Employees Coverage Section H - Liability Coverage, Part I. Who Is an Insured, Item 2.a.(1) is amended as follows: (1) Personal Injury to you or to a co -employee while in the course of his or her employment, or the spouse, child, fetus, embryo, parent, brother, sister or any member of the house- hold of that employee or co -employee as a consequence of such Personal Injury, or for any obligation to share damages with or repay someone else who must pay damages because of the injury; or 14. Mental Anguish Is Included in Bodily Injury Section III - Definitions, Item 4. is replaced with: 4. Bodily injury means bodily injury, sickness or disease sustained by a person. It includes death or mental anguish which result at any time from such physical harm, physical sick- ness or physical disease. Mental anguish me- ans any type of mental or emotional illness or disease. 15. Unintentional Failure to Disclose Hazards Section H - Liability Coverage, Part K. Liability and Medical Payments General Conditions, is amended to include: Page 4 of 6 6. Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any ha- zards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. 16. Supplementary Payments, Increase Limits Section H - Liability Coverage, Part G. Coverage, Items Le. (2) and (4) are replaced with: (2) The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the in- sured at our request to assist us in the inves- tigation or defense of the claim or suit including substantiated loss of earnings up to $500 a day because of time off work. 17. Per Location Aggregate A. Section H - Liability Coverage, Part J. Limits of Insurance, Item 4. is amended to include: The Aggregate Limit of Insurance applies se- parately to each location owned by you, rented to you, or occupied by you with the permission of the owner. B. Section HI - Property, Liability and Medical Payments Definitions, is amended to include: 31. Location means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of- way of railroad. 18. Amended Duties in the Event of an Occurrence, Offense Claim or Suit Section II - Liability Coverage, Part K. Liability and Medical Payments General Conditions, Items 2.a. and b. are replaced with: a. In the event of an occurrence, offense, claim, or suit, you must promptly notify us. Your duty to promptly notify us is effective when your executive officers, partners, members, or AB9189 8-07 legal representatives are aware of the General Liability occurrence offense, claim, or suit. Knowledge of an occurrence offense, claim, or suit by other employee(s) does not imply you also have such knowledge. b. To the extent possible, notice to us should include: (1) How, when and where the occurrence or offense took place; (2) The names, addresses, and telephone numbers of any injured persons and wit- nesses; and (3) The nature and location of any injury or damage arising out of the occurrence, of- fense, claim, or suit. 19. Common Policy Conditions (AB 00 09 A 01 87), Part H. Other Insurance, Item 2. is replaced with: 2. Coverage C - Liability If other valid and collectible insurance is available to any insured for a loss we cover under Coverage C of this Coverage Part our obligations are limited as follows: a. The insurance provided under this policy is primary if you are required by a written insured contract to include any person or organization as an insured, but only with respect to that insured's liability arising out of the ownership, mainte- nance, or use of that part of the premises owned by or rented to you, or your work for that insured by or for you. Any other insurance available to that person or or- ganization is excess and noncontributory with this insurance, or; b. Except for the circumstance described in 2.a., above, the insurance provided under this policy is excess over any other li- ability insurance available to any insured whether such other insurance is written as primary, excess, contingent or any other basis. An exception applies when any insured specifically has purchased excess insurance to apply in excess of the limits of insurance shown in the Decla- rations of this Coverage Part for Cover- age C. Page 5 of 6 20. Damage to Invitees' Automobiles from Falling Trees or Tree Limbs - Limited Coverage The policy applies to direct physical damage to automobiles owned by invitees subject to all of the following: 1. Provided such damage originates from prem- ises owned, managed, leased or rented by an insured; 2. Coverage applies only to invitees of an in- sured or an insured's tenant; 3. Such damage is directly caused by wind -driven falling trees or tree limbs; 4. The most we will pay for any one loss is the lesser of the actual cash value of the damaged automobile as of the time of the loss; or the cost of repairing or replacing the damaged automobile with another automobile of like AB9189 8-07 kind and quality; subject to a limit of $25,000 in any one policy period; and 5. This coverage is not subject to the General Liability General Aggregate Limit. 21. Expected or Intended Injury - Amendment to Ex- clusion SECTION I. - 2. EXCLUSIONS a. Expected or Intended Injury, is replaced by the following: a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or prop- erty. All other terms and conditions of the policy apply. Page 6 of 6