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HomeMy WebLinkAboutTJKM Transportation Consultants - Insurance Certificate (2020)� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/29/2019 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 NAME: Doris A. Chambers Dealey, Renton & Associates PHONE FAX Attn: David„C..Eckman (A/C. No. Ext): 510-465-3090 (A/C, No): 510-452-2193 P. O. Box 12675 ADDRESS: dchambers@,dealeyrenton.com Oakland CA 94604-2675 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co of Ameri 25674 INSURED TJKMTRANS INSURER B : Travelers Casualty & Surety Co. America 31194 TJ KM dba: TJKM Transportation Consultants INSURER C 2055 Gateway Place, Suite 400 INSURER D San Jose CA 95110-2798 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 306975990 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 NUMBER POLICY EFF ' POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y 6800JO39683 4/1/2019 4/1/2020 EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ® POLICY E O LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y BA9C242599 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ Y OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR Y Y CUPOD451898 4/1/2019 4/1/2020 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 5,000,000 I I DED RETENTION $ $ A WORKERS COMPENSATION Y UBOK938923 4/1/2019 4/1/2020 X PER I STATUTE I I EERH AND EMPLOYERS' LIABILITY I E.L. EACH ACCIDENT 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE N N N ! A $ OFFICER/MEMBER EXCLUDED? (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 B Professional Y 106898029 4/1/2019 4/1/2020 $2,000,000 per Claim Liability $2,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) TJKM's Professional Liability policy with Travelers includes Pollution Liability coverage. REF: Service Agreement: Fire Department Personnel Testing. GENERAL LIABILITY/AUTOMOBILE LIABILITY ADDITIONAL INSURED: City of Gilroy, its officers, officials and employees. Commercial General Liability is primary and non-contributory and includes severability of interests per policy form. Cancellation provisions are solely as shown on this certificate. Cancellation: 30 Day/10 Day for Non -Payment of Premium. CERTIFICATE HOLDER CANCELLATION 30 Day NOC/10 Day for NonPay of Prem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Ate^ �7► 0 DATE (MM/DD/YYYY) 4_csJ/�.Q CERTIFICATE OF LIABILITY INSURANCE I 3/.29/2019 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 NAME: Doris A Chambers Dealey, Renton & Associates PHONE FAX P. O. Box,1.2675 (A/C. Nq. EXt): 510-465-3090 (A/C. No): 510-452-2193 Attn: David C. Eckman ADDRESS: dchambers(a-dealevrenton.com Oakland. CA 94604-2675.. - INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co of Ameri 25674 INSURED TJKMTRANS INSURER B : Travelers Casualty & Surety Co. America 31194 TJ KM dba: TJKM Transportation Consultants 2055 Gateway Place, Suite 400 San Jose CA 95110-2798 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:804802920 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 INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y 6800JO39683 4/1/2019 4/1/2020 1 EACH OCCURRENCE It 1 000 000 CLAIMS -MADE Fk] OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY DX PEC LOC OTHER: A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y Y BA9C242599 UMBRELLA LIAB OCCUR EXCESS LIAB HCLAIMS-MADE DIED I I RETENTION $ A WORKERS COMPENSATION Y UBOK938923 AND EMPLOYERS' LIABILITY Y / N ANYPROPRI ETOR/PARTN E R/EXECUTI V E OFFICER/MEMBEREXCLUDED? N / A (Mandatory in NH) If yes, -de -scribe under _ DESCRIPTION OF OPERATIONS below B Professional 106898029 Liability DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) EACH OCCURRENCE $ AGGREGATE $ ER 4/1/2019 4/1/2020 X I STATUTE I I ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 4/1/2019 4/1/2020 $2,000,000 per Claim $2,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) TJKM's Professional Liability policy with Travelers includes Pollution Liability coverage. REF: Award of Project 2019 Citywide Speed Survey Project No.: 18-RFP-PW-413. GENERAL LIABILITY/AUTOMOBILE LIABILITY ADDITIONAL INSURED: City of Gilroy, its officers, officials and employees. Commercial General Liability is primary and non-contributory and includes severability of interests per policy form. Waiver of Subrogation applies to Commercial General Liability, Automobile Liability and Workers Compensation. Professional Liability Prior Acts Date 01/01/1974. Cancellation provisions are solely as shown on this certificate. Cancellation: 30 Day/10 Day for Non Payment of Premium. CERTIFICATE HOLDER CANCELLATION 30 Day NOC/10 Day for NonPay of Prem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD