Loading...
HomeMy WebLinkAboutGriswold Industries - Insurance Certificate (2020)A'�"• � ® CERTIFICATE OF DATE (MM/DD/YYYY) LIABILITY INSURANCE I 04116I2019 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 Risk & Insurance Services NAME: PHOE FAX 17901 Von Karman Avenue, Suite 1100 (A/C, No. Ext): (A/C. Not: (949) 399-5800; License #0437153 E-MAIL Irvine, CA 92614 ADDRESS: Attn: NewportBeach.CertRequest@marsh.com/F: 212-948-4323 INSURER(S) AFFORDING COVERAGE NAIC # CN102166416-STND-GAWUP-19- INSURER A : Hartford Fire Insurance Company 19682 INSURED Griswold Industries, Cla-Val Company INSURER B : Continental Insurance Company 35289 1701 Placentia Avenue INSURER C : Twin City Fire Insurance Company 29459 Costa Mesa, CA 92627-4475 INSURER D : N/A N/A INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002407367-09 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 LIMITS LTR INISD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY 72ECSOA1987 04/01/2019 04/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGES RENTED CLAIMS -MADE a OCCUR PREMISES (Ea occurrence) $ ( X $1,000,000 SIR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ X POLICY PRO- ❑ LOC JECT PRODUCTS - COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY 7211ENUM3154 04/01/2019 04101/2020 COMBINED SINGLE LIMIT $ _ I (Ea accident) X ANY AUTO I BODILY INJURY (Per person) $ OWNED SCHEDULED _ AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) X B X UMBRELLA LIAB OCCUR _ 6011983924 04/01/2019 04/20/2019 EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE I AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION 72WNC93100 04/01/2019 04/01/2020 X I PER I 1OTH- AND EMPLOYERS' LIABILITY C YIN ANYPROPRIETOR/PARTNER/EXECUTIVE 72WEH03564 IL,MD,MI,NJ,NC, ( 04/01/2019 04/01/2020 STATUTE ER OFFICER/MEMBER EXCLUDED? NI N / A OR,TX,VA) E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below 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, its officers, officials and employees are included as additional insured (except workers' compensation) where required by written contract. 300,000 1,000,000 2,000,000 2,000,000 1,000,000 10,000,000 10,000,000 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER CANCELLATION City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE its officers, officials, and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Claudia Hernandez ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD ACC> CERTIFICATE OF LIABILITY DATE /2019 /YYYY) i,,.. ITY INSURANCE I 04101/2019 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 Marsh Risk & Insurance Services NAME: PHONE FAX 17901 Von Karman Avenue, Suite 1100 (A/C. No. Extl: (A/C, No): (949) 399-5800; License #0437153 E-MAIL - Irvine, CA 92614 ADDRESS: Attn: NewportBeach.CertRequest@marsh.com/F: 212-948-4323 INSURER(S) AFFORDING COVERAGE NAIC # CN102166416-STND-GAWUP-19- INSURER A: Hartford Fire Insurance Company 19682 INSURED Griswold Industries, Cla-Val Company INSURER B : Continental Insurance Company 35289 1701 Placentia Avenue INSURER C : Twin City Fire Insurance Company 29459 Costa Mesa, CA 92627-4475 INSURER D : N/A N/A INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002407367-07 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 COMMERCIAL GENERAL LIABILITY 72ECSOA1987 04/01/2019 04/01/2020 EACH OC R 1 000 000 CLAIMS -MADE 1-i-I OCCUR X $1,000,000 SIR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT ❑ LOC OTHER: A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED _ AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY H X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ A WORKERS COMPENSATION C AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 72UENUM3154 04/01/2019 04/01/2020 CU RENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ 6011983924 04/01/2019 04/20/2019 I EACH OCCURRENCE $ AGGREGATE $ 72WNC93100 04/01/2019 04/01/2020 X I PER STATUTE ERH 72WEHO3564 (IL,MD,MI,NJ,NC, 04/01/2019 04101/2020 E.L. EACH ACCIDENT $ OR,TX,VA) ( 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, its officers, officials and employees are included as additional insured (except workers' compensation) where required by written contract, 300,000 1,000,000 2,000,000 2,000,000 1,000,00Q . 10,000,000 10,000,000 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER CANCELLATION City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE its officers, officials, and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Claudia Hernandez ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD