HomeMy WebLinkAboutSouth Santa Clara County Fire District - Insurance Certificate (2020)a DATE (MMIDDIYYYY)
AC"RV CERTIFICATE OF LIABILITY INSURANCE I 6/27/2019
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(les) 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
Arthur J. Gallagher & Co„ PHOnsM�EM.,__.. FAX �....
Insurance Brokers of CA. Inc., License' #07 2g3 Eke. 4�15-546-9300 � rarc. No):415-536.8499
1255 Battery Street #450 ADDRESS:
Qnn P:rnnnicnn r`A QA4 4 4
INSURED FIREAGE-01
South Santa Mara County PPP
15670 Monterey Street
Morgan Hill, CA 95037
(Sj_/kFEQRDING COVERAGE ,
INSURER INSURER A.- Allied World Assurance Company Ltd
INSUREq R a
INSU ER 0:,
INSI.JRER E
INSURER F
COVERAGES CERTIFICATE NUMBER:1443031639 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE. LISTED BELOW HAVE Be -EN 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,
_ ..._.,., POLICY ,.....n......,,M�.,... .w...m.�..�.M.w�.M...,,..�..,,,.,,..,,..,.....,.,.....�.,w_..m,_.�,.,�.�.,...w...m,_�..,w...�..��.....w.w.�.._.,.... ,
i s� ..�,_..,..T, �.�..,..�.....,...„_,_w.... AG?bL SUI�i� �....,.�.,�.W,��w..,_�,._.�...�..M.�...�,..__,�.,_�.,.�,�... I��aLld�`�i�F �Pbi..lY"Er�"' LIMITS
TYPE OF INSURANCE ,JMRD WVD (MM(DI?IYYYY1�M pD/X YYM
;
A. X COMMERCIAL GENERAL LIABILITY Y JPAPKG-00237-DOF-01 7/112019 7/1/2020 EACH OCCURRENCE $1,000,000
,_,.,__.. _...... OCCUR CLAIMS -MADE �
_.� PREMISES �I=.;� oppurren�jti$ 1,ODO,000
SIR:.....,.. _......_ ., .,.,. ,.....__ ......__._..w......._.. MEa EXP (And aideersan $10,DOO
PERSONAL & ADV INJURY
$1,000,000
C.EN'L AGGREGATE LIMIT APPLIES PER;
GENERAL AGGREGATE
$10,000,000
X POLICY JE � _„I LOC
_,.µ__
_ _
PRODUCTS - COMPIOP AGiG
„
$10.,000;0D0
_ __...�..„.. OTHER:
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
BODILY INJURY (Per person)
$
OWNED _ SCHEDULED
..�. AUTOS ONLY AUTOS
��. ,�, _..,�..�,�
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
—�..,�.,_�.m,...,.-....,,,�.,...
PROPERTY DAMACaE
$.._._..��..,_...,......_,�_.�..,.....,.._
AUTOS ONLY _ AUTOS ONLY
(P_.,...,............ .,.,.._ r..,_
... ...._,._...�__.,M....�,_..
UMBRELLA LIAR OCCUR
� EACH OCCURRENCE
_ ,__...�,.,�,..._..�
$
EXCESS LMAB CLAIMS TMADE
�.._
AGGREGATE
._.,..,�.,..,....�,.,.�....
$ .�....�....._....,..._._�....w..._.
.. DEC?. 1J DETENTION $
�$
NN
WORKIrRS COMPENSATION
PER ¢j OTH-
TAT
ACTION
AND E PLOYERV YIN
�.�,J_ ..1�
ANYPROPRIETORIPARTNER/EXECu"rMVE NIA
OFyyPICEM�(MEMI'iER EXCLUDED?
E.L. EACH ACCIDENT
,.M _ m,
$
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE
If
C7F OPERATIONS
~$
'POLICY
D ERIOUN below
_ _ E.L. AT
$
CityofGilroy, its Officers, and Employees are alsonamedasAddSchedule,tioIs reds as respects the
y stared If more spade Is rewired)
y y p ItIOnR! Insureds p shared of
Battalion Chief Agreement,
CERTIFICATE HOLDER
City of Gilroy
7351 Rosanna Street
Gilroy CA 95020
USA
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.
AU HORIZED REPRESENTATIVE
;.M
A-1
ftj
ACCORD 2.5 (2016/03)
01988.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
2* of 3 25382
POLICY NUMBER:-JPAPKG-00237-00E-01
ADDITIONAL INSURED - AUTOMATIC
THIS ENDORSEMENT CHANGES THE COVERAGE FORM.
PLEASE READ IT CAREFULLY.
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SECTION 11. — WHO IS AN INSURED is amended to include as an insured any person or organization
but only with respect to the following:
A. Liability for "bodily injury", "property damage", or "personal and advertising injury" caused , in whole
or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:
1. in the performance of your ongoing operationt; or
2. in connection with premises owned by or rented to you;
B. Liability arising out of the ownership, maintenance or use of premises leased to you and subject to
the following additional exclusions:
1. any "occurrence" which takes place after you cease to be a tenant at that premises.
2. structural alterations, new construction or demolition operations performed by or on behalf of
the person or organization you have leased from.
FR-GL 00006 00 (05/15) Page I of I r.
Includes copyrighted material of Insurance Services Offices, Inc. with its permission.
3* of 3 25382