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HomeMy WebLinkAboutSecond Harvest Food Bank - Insurance Certificate (2020)SECONHAR3 AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE3/7/20D/YYYY) 110m � I 3/7/2019 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 I CONTACT NAME: Susan Boutchie Commercial Lines - (628) 201-9001 PHONE FAX (A/C, No. Extl: (628) 201-9041 (AIC, No): USI Insurance Services LLC - CA Lic#: OD08408 E-MAIL ADDREss: susan.boutchie@usi.com 201 Mission St, 11 th Floor I INSURER(S) AFFORDING COVERAGE NAIC # San Francisco, CA 94105 I INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED I INSURER B : Second Harvest Food Bank INSURER C of Santa Clara and San Mateo Counties INSURER D : 750 Curtner Avenue INSURER E San Jose CA 95125 INSURER F : COVERAGES CERTIFICATE NUMBER: 13994501 REVISION NUMBER: See below 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 (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY A X PHPK1945706 03/01/2019 03/01/2020 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED CLAIMS -MADE OCCUR I PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 3,000,000 X PRO- ❑ I JECT POLICY LOC PRODUCTS - COMP/OP AGG $ 3,000,000 X OTHER: Sexual Abuse molestation Per Occ/Agg $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ (Ea accident) 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 LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETORIPARTNERIEXECUTIVEOFFICE I SPER TATUTE I ( EORH I EMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ (Mandatory in NH) (Mandatory in ( E.L. DISEASE - EA EMPLOYEE $ If as, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 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, employees, and agents are included as additional insureds as respects General Liability in accordance with the terms and conditions of the policy. CERTIFICATE HOLDER City of Gilroy, its agents, officers and employees 7351 Rosanna Street Gilroy CA 95020 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) *CYB01 A07l000198/02/03/0/0!0!0 POLICY NUMBER: PHPK1945706 COMMERCIAL GENERAL LIABILITY CMG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE, READ tT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies: insurance provided under the following, COMMERCIAL GENERAL. LIABILITY CO' ERA E PART SCHEDULE Narna Of Additional Insured Person(s) Or Organization(s)- City of Gilroy, its agents, officers and employees 7351 Rosanna Street Gilroy CA 95020 Lrmation re quked to. comp!ete.t.hi.s Sct-tedule, it riot shown above, will be shown in the Declarations. A. Section It - Who Is An Insured is amended to include. as an addilional insured the person(ts) or organization(s) shown in. the brit only with respect to liability for "bodily injury", "property dams,lqeft or "personal and adv€�rfisinq injury` Caused, in whole or in part, by your acts or ornissions or the acts or, omissions of thosecting on your behaff. I.. In the performance of your ongoing operationsi or 2. In connection with your premises owned by Dr rented to yotjM However,. 1. The insurance affor-ded to such additional insured only applies to th e. exte-nt permitted by law; and 2-w It coverage provided to the additional insured is required by a cont.-act or agr-oQrnent, thQ Insurarme afforded to such additional insured will not tic. Uroader than, that which you are rN.-uired by the: contract or agreement to provide. for such additional insured. CG 20 26 04 13 B. With respect to the insurance afforded to these additional insum-ds, the following is added to Section 11t - Limits Of Inst4rance.- If' coverage provide-d to the audifional insure-d K- reqtAr Mx by a contract or agreement, the most we wiff pay on behaff of the, additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2, Aunif-ablia. undor the appi icafAe Limits of Insurance i5.ftwn in the. DecWations; whichever is tess. This endorsement applicable Limits of Declarations. 0 Insurance service's Office, Inc., 2012 shall riot increase the Insurance shown in the Page 1 of I *CYB01A071000198/03/03/0/0/0/0* GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY PRO JECT LOC X OTHER: Sexual Abuse molestation AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYP ROP RI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below SECONHAR3 AC" " CERTIFICATE OF LIABILITY INSURANCE DATE/5/2019YYY) I 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 Commercial Lines - (628) 201-9001 I PHONE Susan) 201- ie9041 FAX I (A/C, No. Ext): (62801 (AIC, No): US] Insurance Services LLC - CA Lic#: OD08408 I E-MAIL ADDREss: susan.boutchie@usi.com 201 Mission St, 11 th Floor � INSURER(S) AFFORDING COVERAGE NAIC # San Francisco, CA 94105 (NSURERA: Philadelphia Indemnity Insurance Company 18058 INSURED Second Harvest Food Bank of Santa Clara and San Mateo Counties 750 Curtner Avenue INSURER B : INSURER C : INSURER D : INSURER E San Jose CA 95125 INSURER F : COVERAGES CERTIFICATE NUMBER: 13986715 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE I INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MMIDD/YYYY) (MMIDDfYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X PHPK1945706 03/01 /2019 03/01 /2020 1 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED I PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY I S $ GENERAL AGGREGATE I PRODUCTS - COMPIOP AGG $ Per Occ/Agg $ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) I $ PROPERTY DAMAGE I $ (Per accident) I$ EACH OCCURRENCE $ (AGGREGATE $ PER I STATUTE I (EERH I E.L. EACH ACCIDENT $ I E.L. DISEASE - EA EMPLOYEEI $ I E.L. DISEASE - POLICY LIMIT I $ 100,000 5,000 1,000,000 3,000,000 3,000,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Gilroy, its officers, employees, and agents are included as additional insureds as respects General Liability in accordance with the terms and conditions of the policy. CERTIFICATE HOLDER City of Gilroy, its agents, officers and employees 7351 Rosanna Street Gilroy CA 95020 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) *CYB01 A05/001304/02/03/0/0/0/0* P01-tCY NLJMJ3ER-, PHPK1945706 C0MMERCIAL GENERAL LIABILITY GG 20 26 04 1:3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE, READ tT CAREFULLY. , 0, 10 Thts e.ndursernent modifle.s. insurance provided under the following.' COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Namo Of Additional Insured Per on() Or Orqa-nization�s)- City of Gilroy, its agents, officers and employees 7351 Rosanna Street Gilroy CA 95020 Lj n! atton required to comptete this Schedule,. Knot shown above, wit[ be shown in the Declarations. A. Section It - Who is An Insured is amended to include as an. additional insured the person(s) or organization(s) show- n in the Sc-ho-dille, but only With respect to liability for "robodify injury", pf'operty darnage" or "'personal and adwi.-Hising injcoyft Qajjse.d. in wfjt)1e car irt part.,, by your acts or omissions or the acts or omissions of thus(-: 4actinq- on your behalf. I .. (n the pedbrmance of your ongoing operations: or 2. in C.0",nectioll with your premises owned by or rented to youN However, 1. The insurance afforded. to such additional insured only applies to the extent permitted by law; and 2,. if coverage provided to the additional insured is required by a contract or insurance. afforded to such additional Insured will fiat bra,: broader tharv. that which you are required by the contract Or' agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the ffafluwinq i-,i added to Se ction fit - Liniks Of Insurance: V coverage provided to the additional insured Is reeltAll-ed 1>y a contract cal' agreement, the most we will pay an behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreemenit; or 2, Available under the applicable Limits of jnsuroric+� shown in the Declarations; whichever is less. This endorsernem shall not increase the applicable Limits of InsuranQeshown in the Declarations. 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