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HomeMy WebLinkAboutGranite Rock - Insurance Certificate (2020)ACC> ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I 5/23/2019 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 Woodruff -Sawyer & Co. PHONE FAX 50 California Street, Floor 12 (A/C, No. Ext): 415-391-2141 (A/C, Nor 415-989-9923 San Francisco CA 94111 E-MAIL ADDRESS: I INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: American Contractors Insurance Co RRG 12300 INSURED GRANCOM-01 INSURER B : ACIG Insurance Company 19984 Granite Rock Company INSURER C : P.O. Box 50001 Watsonville CA 95077 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:1815488973 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GL19A00056 6/1/2019 6/1/2020 EACH OCCURRENCE $10,000,000 GL19B00056 (GL EXCESS) 6/1/2019 6/1/2020 DAMAGE TO RENTED AI CLAIMS -MADE � OCCUR GL19C00056 (GL EXCESS) 6/1/2019 6/1/2020 PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 10,000,000 C POLICY JE LOC PRODUCTS - COMP/OP AGG $ 10,000,000 OTHER: $ A AUTOMOBILE LIABILITY AL19000019 6/1/2019 6/1/2020 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED _ AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE $ _ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATION WCA000019019 6/1/2019 6/1/2020 X AND EMPLOYERS' LIABILITY Y 1 N ANYPROPRIETOR/PARTNER/EXECUTIVE SPER TATUTE ERH I N OFFICER/MEMBEREXCLUDED? N / A E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy, its officers, officials, and employees is named as additional insured as respects general liability per endorsement attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy, its Officers, officials and ACCORDANCE WITH THE POLICY PROVISIONS. employees 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy CA 95020 F &4k;'_ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 205 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person(s) or Organization (s): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery wemay have against the person ororganization shown inthe Schedule above because ofpayments we make for injury or damage arising out of your ongoing operations or "your work" done under e contract with that person or organization and included in the "prod uc10-comp|eted operations hazard". This waiver applies only tothe person ororganization shown inthe Schedule above. Nothing herein contained shall beheld tovary, elter, waive orextend any ofthe terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Same as policy effective date unless otherwise indicated above. Policy Effective Date: 2V1/201g PolicyNu.: GL19AO0058 Endorsement No.: Insured: Granite Rock Company Insurance Company: American Contractors Insurance CoRRG Premium$ �3191 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written contract to include as an additional insured on this policy if the contract is executed prior to the loss. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured, and only to the extent and for the minimum limits required in the written contract. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization, whichever occurs first. 2. Unless specifically required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury', "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured or on any insured's behalf, including: a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; and b) Supervisory, inspection, architectural or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the scope of coverage, including minimum limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and/or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Same as policy effective date unless otherwise indicated above. Policy Effective: 6/1 /2019 Policy No.: GO 9A00056 Endorsement No.: Insured: Granite Rock Company Premium $ Insurance Company: American Contractors Insurance Co. RRG ACCWLIP CERTIFICATE OF LIABILITY IN DATE(MM/DDNYYY) INSURANCE RAN Ci E I 5/23/2019 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 Woodruff -Sawyer & Co. PHONE FAX 50 California Street, Floor 12 (A/C, No. Ext): 415-391-2141 (A/C, No): 415-989-9923 San Francisco CA 94111 AD RIESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: American Contractors Insurance Co RRG 12300 INSURED GRANCOM-01 INSURER B : ACIG Insurance Company 19984 Granite Rock Company P.O. Box 50001 INSURER C : Watsonville CA 95077 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:850192050 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X I COMMERCIAL GENERAL LIABILITY Y Y GL19A00056 6/1/2019 6/1 /2020 EACH OCCURRENCE $ 10,000,000 GL19B00056 (GL EXCESS) 6/1/2019 6/1/2020 DAMAGE TO RENTED A I I CLAIMS -MADE ® OCCUR GL19C00056 (GL EXCESS) 6/1/2019 6/1/2020 PREMISES (Ea occurrence) $100 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ® ECOT- LOC OTHER: A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED _ AUTOS ONLY AUTOS ONLY Y Y AL19000019 UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRI ETOR/PARTN ER/EXECUTIVE OFFICER/MEMBEREXCLUDED? NI N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WCA000019019 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY I $ 10,000,000 GENERAL AGGREGATE I $ 10,000,000 PRODUCTS, COMP/OP AGG $ 10,000,000 6/1/2019 6/1/2020 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) I $ PROPERTY DAMAGE I $ (Per accident) �$ EACH OCCURRENCE $ AGGREGATE I $ I$ 6/1/2019 6/1/2020 X PER ERH E.L. EACH ACCIDENT I $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy is named as additional insured as respects general liability and automobile liability per endorsements attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Marilyn 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy CA 95020-6141 �4 1_�4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 596 This endorsement modifies insurance provided under the following: BUSINESS AUTO LIABILITY COVERAGE PART Any person or organization you are required by contract toinclude aoanadditional insured onthis policyison "insured" but onlyvvith respecttoliability arising out ofthe ownership, maintenance oruse ofon"auto"inthe operations incidental tothe contract and tothe extent set forth below: (1) The limit of insurance will not be greater than that required by such contract. (2) The coverage providedtotheadditiona|inouuadvvi||notbegnaoterthenYhotcuotomoh|yprovidedbythepo|icy forms specified inand required bythe contract. (3) All insuring agreements, exclusions and conditions of this policy will apply. (4) In no event shall the coverage or limit of insurance in this coverage form be increased by such contract. This insurance is excess to any other insurance, whether primary, ntignt or on - other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However, this insurance is always enoaao to other insurance, whether primary,excess, contingent oron any other basis, when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall beheld tovary, alter, waive orextend any ofthe terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy it is attached and is effective on the date issued unless otherwise stated. (The information below mxrequired only when this endorsement hmissued subsequent topreparation ofthe poUcy.) Endorsement Effective: same as policy eff. date unless otherwise indicated above. Policy Effective: 6/1/2019 Policy No.: AL19000010 Endorsement No.: insured: Granite Rock Company Premium $ Insurance Company: American Contractors Insurance CoRRG 441 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO LIABILITY COVERAGE PART The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section III - BUSINESS AUTO CONDITIONS) is amended by the addition of the following: All rights of recovery against others are waived hereunder to the extent required by contract executed prior to "accident" or "loss" and with respect to such insurance provided by this policy. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: same as policy eff. date unless otherwise indicated above. Policy Effective: 6/1/2019 Policy No.: AL18000019 Endorsement No.: Insured: Granite Rock Company Premium $ Insurance Company: American Contractors Insurance Co RRG 205 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name ofPeroon(s)orOrganization (m): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery wemay have against the person ororganization shown 1nthe Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "prod ucts-com pleted operations hazard". This waiver applies only tothe person ororganization shown inthe Schedule above. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Same as policy effective date unless otherwise indicated above. Policy Effective Date: 6/11/2019 Policy No.: GL1 9AO0056 Endorsement No.: insured: Granite Rock Company Insurance Company: American Contractors Insurance OoRR8 Premium $ 933 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured, and only to the extent and for the minimum limits required in the written contract. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization, whichever occurs first. 2. Unless specifically required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury', "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured or on any insured's behalf, including: a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; and b) Supervisory, inspection, architectural or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the `occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the scope of coverage, including minimum limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and/or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Same as policy effective date unless otherwise indicated above. Policy Effective:6/1/2019 Policy No.: GL19AO0056 Insured: Granite Rock Company Insurance Company: American Contractors Insurance Co. RRG Endorsement No.: Premium $