Loading...
HomeMy WebLinkAboutBiggs Cardosa - Insurance Certificate (2020)~ A{:5!.,RD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 3/3/2020 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 provlsionS 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 ~2AAi~cT Jo Lusk Dealey, Renton & Associates Pl·ll;>~I'.: Ex•'· 510•465-3090 I rffc •• ,, 510-452-2193 P. 0. Box 12675 Oakland CA 94604-2675 ~rl~~SS: certificates=dealevrenton.com INSURERISl AFFORDING COVERAGE NAIC# INSURER A: XL Snecialtv Insurance Co, ' 37885 INSURED BIGGSCARD INSURER B: Travelers Prooertv Casualtv Comoanv of America 25674 Biggs Cardosa Associates, Inc. 865 The Alameda INSURERC :- San Jose CA 95126 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER·67691523 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. 1r:: TYPE OF INSURANCE B X COMMERCIAL GENERAL LIABILITY ~ tJ CLAIMS-MADE [8J OCCUR RGEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 ~f§i □ LOC OTHER: 8 AUTOMOBILE LIABILITY ~ ~ ANYAUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - ,_ ,x SCHEDULED AUTOS NON-OWNED AUTOS ONLY POLICY NUMBER y y 6802H141284 Y Y BA4955L513 8 1. X UMBRELLA LIAB fxl OCCUR y EXCESS LIAB II CLAIMS-MADE Y CUP7177Y078 DE□ 7 7 RETENTION$ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANYPROPRIElOR/PARTNER/EXECUTIVE □ OFFICER/MEMBl:REXCLUDED? N / A (Mandatory In NH) If yas, describe under DESCRIPTION OF OPERATIONS below A Professional Llabllity + Pollution Llablllly Y UB4J530244 DPR9956790 LIMITS 9/1/2019 9/1/2020 EACH OCCURRENCE $1,000,000 $1,000,000 MED EXP (Any ona parson) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 $ 9/1/2019 $1,000,000 BODILY INJURY (Par person) $ BODILY INJURY (Par accident) $ $ $ 9/1/2019 9/1/2020 EACH OCCURRENCE $9,000,000 AGGREGATE $9,000,000 $ 9/1/2019 9/1/2020 E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE· EA EMPLOYEE $1,000,000 E.L. DISEASE· POLICY LIMIT $1,000,000 3/1/2020 3/1/2021 $5,000,000 per Claim $9,00o,ooo Anni. Aggr. DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Addition al Remarks Schedule, may be attached If more space is required) RE: RFP No. 19-RFP-PW--421 / Bridge Preventative Maintenance Program (Federal Project No. BPMP-5034(026). City of Gilroy, its officers, officials and employees are named as Additional Insured on General Liabllity and Auto Liability, per policy forms, with respect to the operations of the Named Insured as required by written contract or agreement. General Llablllty is Primary/Non-Contributory and severability of interests per policy form wording. Insurance coverage lncludes waiver of subrogation per attached. 30 Days Notice of Cancellation. CERTIFICATE HOLDER City of Gilroy its officers, officials and employees 7351 Rosanna Street Gilroy CA 95020 CANCELLATION 30 Da s Notice of 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. © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER 6802H141284 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 3/3/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Names of Additional Insured Person(s) or Organization(s): City of GIiroy its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 Location of Covered Operations: The City of Gilroy, its officers, officials and employees (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II -Who Is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring, or "personal injury" or "advertising injury" arising out of an offense committed, after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been com- pleted; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 6802H141284 COMMERCIAL GENERAL LIABILITY ISSUED DATE: 3/3/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Gilroy its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 Location And Description Of Completed Operations The City of Gilroy, its officers, officials and employees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II -Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional in- sured and included in the "products-completed opera- tions hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 COMMERCIAL GENERAL LIABILITY COVERAGE NAMED INSURED: Biggs Cardosa Associates, Inc. POLICY NUMBER: 6802H141284 ADDITIONAL COVERAGES BY WRITTEN CONTRACT OR AGREEMENT This is a summary of the coverages provided under the following forms (complete forms available): Excerpt from COMMERCIAL GENERAL LIABILITY COVERAGE (FORM #CG T1 00 02 19) SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS 4. OTHER INSURANCE -d. PRIMARY AND NON-CONTRIBUTORY INSURANCE IF REQUIRED BY WRITTEN CONTRACT: If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. Excerpt from XTEND ENDORSEMENT FOR ARCHITECTS, ENGINEERS AND SURVEYORS (FORM #CG D3 79 02 19) PROVISION M. -BLANKET WAIVER OF SUBROGATION -WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT: If the insured has agreed in a written contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the signing of that contract or agreement. Page 1 COMMERCIAL AUTO POLICY NUMBER: BM955L513 1" ·. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organizatlon(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage pro- vided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED TO INCLUDE AS ADDITIONAL INSURED ON THE COVERAGE FORM IN A WRITTEN CONTRACT OR AGREEMENT THAT IS SIGNED AND EXECUTED BY YOU BEFORE THE BODILY INJURY OR PROPERTY DAMAGE OCCURS AND THAT IS IN EFFECT DURING THE POLICY PERIOD. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provi- sion contained in Paragraph A.1. of Section II -Cov- ered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 4810 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLIC,)'·:• ENDORSEMENT WC 99 03 76 ( A)- POLICY NUMBER: UB4J530244 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be mium. % of the California workers' compensation pre- Schedule Person or Organization Job Description Any Person or organization for which the insured has agreed by written contract executed prior to loss to furnish this waiver. This endorsement changes the policy to which I1 ls attached and Is effective on the date issued unless otherwise slated.· (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Insurance Company Countersigned by_-~.;;.-·::c···=----=·------- Travelers Property Casualty Company of America DATE OF ISSUE: 10/712019 Page 1 of 1 POLICY NUMBER: 680"2Hl41284"18"47 ISSUE DATE: 08/31/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY-NOTICE OF CANCELLATION/NONRENEWAL PROVIDED BY US This endorsement modifies Insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: NON RENEWAL: PERSON OR ORGANIZATION: SCHEDULE Number of Days Notice of cancellation: 3 o Number of Days Notice of Nonrenewal: 30 ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OR NONRENEWAL OF THIS POLICY WILL BE GIVEN, BUT ONLY IF1 1, YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE Nl\1-!E AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST Nl\1-!ED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OR NONRENEWAL OF .'J.'.llIS POLICY I AND 2, WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNINCI":-~!'.,. THE APPLICABLE NUMBER OF DAYS _SHOWN_ .. IN THIS SCHEDULE, ADDRESS: Tl!E ADDRESS FOR THAT PERSO!, OR ORCll\lllZ -. ATION WCLUD>:D IN SUCll WR!TT>:N P.EQ!)'l;JllT .. l'ROM YOU TO US. .• .... PROVISIONS: A, If we cancel this policy for any statutorily permit- ted reason other than nonpayment of premium, and a number of days Is shown for cancellation in the schedule above, we will mall notice of cancel" lation to the person or organization shown in the schedule above, We will mall such notice to the address shown In the schedule above at least the number of days shown for cancellation In the schedule above before the effective date of can- cellation, B. If we decide to not renew this pol Icy for any statu- torily pern1~ted reason, and a number of days is shown for nonrenewal in the schedule above, we will mall notice of the nonrenewal to the person or organization shown in the schedule above, We · will mail such notice to the address shown In the schedule above at least the number of days shown for nonrenewal in the schedule above be- fore the expiration date. IL T4 00 12 09 © 2009 The Travelarn Indemnity Company Page 1 of 1 • POLICY NUMBER: BA4955L513 ISSUE DATE: 09/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY -NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE NUMBER OF DAYS NOTICE OF CANCELLATION: 30 PERSON OR ORGANIZATION: Any person or organization to whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: 1. You send us a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured shown in the Declarations receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this Schedule. ADDRESS: The address for that person or organization included in such written request from you to us. PROVISIONS: A. If we cancel this policy for any statutorily permitted reason other than nonpayment of premium we will mail notice of cancellation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. ILT4001209 © 2009 The Travelers Indemnity Company Page 1 of 1 POLICY NUMBER: UB4J530244 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY -NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE NUMBER OF DAYS NOTICE OF CANCELLATION: 30 PERSON OR ORGANIZATION: Any person or organization to whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: 1. You send us a written request to provide such notice, including the name and address of such person or or- ganization, after the first Named Insured shown in the Declarations receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this Schedule. ADDRESS: The address for that person or organization included In such written request from you to us. PROVISIONS: A. If we cancel this policy for an/statutorily permit- ted reason other than nonpayment of premium we will mail notice of cancellation to the person or or- ganization shown In the schedule above. We will mall such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above be- fore the effective date of cancellation. ILT4001209 © 2009 The Travelers Indemnity Company Page 1 of 1 This endorsement, effective 12:01 a.m., 03101/2020 forms a part of Policy No. DPR9956790 Issued to Biggs Cardosa Associates, Inc. by XL Specialty Insurance Com~. TH IS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CANCELLATION -NOTICE TO DESIGNATED ENTITIES This endorsement modifies insurance provided under the following: PROFESSIONAL, ENVIRONMENTAL AND NETWORK SECURITY LIABILITY POLICY-ARCHITECTS, CONSULTANTS AND ENGINEERS Section XI. OTHER CONDITIONS, Paragraph A. Cancellation is amended by the addition of the following: In the event that the Company cancels this Policy for any statutorily permitted reason other than non- payment of premium, the Company agrees to provide Thirty (30) days' notice of cancellation of this Policy to any entity with whom the NAMED INSURED agreed in .a written contract or agreement would be provided with notice of cancellation of this Policy, provided that: 1. The. Company receives, at least fifteen (15) days prior to the date of cancellation, a written request from the NAMED INSURED to provide notice of cancellation to entities designated by the NAMED INSURED to receive such notice and; 2. The written request includes the name and address of each person or entity designated by the NAMED INSURED to receive such notice. This endorsement does not apply to non-renewal of the Policy, cancellation at the INSURED'S request, or to cancellation of the Policy for non-payment of premium to the Company or to a premium finance company authorized to cancel the Policy. Furthermore, nothing contained in this endorsement shall be construed to provide any rights under the Policy to the entities receiving notice of cancellation pursuant to this endorsement, nor shall this endorsement amend or alter the effective date of cancellation stated in the cancellation notice issued to the NAMED INSURED. All other terms and conditions of the Policy remain unchanged. LOO 4521116 Page 1 of 1 3/212020 9:28:25 PM © 2016 X.L. America, Inc. All Rights Reserved. May not be copied without permission. POLICY NUMBER: UB4J530244 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY -NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE NUMBER OF DAYS NOTICE OF CANCELLATION: 30 PERSON OR ORGANIZATION: Any person or organization to whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: · 1. You send us a written request to provide such notice, Including the name and address of such person or or- ganization, after the first Named Insured shown in the Declarations receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this Schedule. ADDRESS: The address for that ·person or organization included in such written request from you to us. PROVISIONS: A If we cancel this policy for any statutorily permit- ted reason other than nonpayment of premium we will mail notice of cancellation to the person or or- ganization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation In the schedule above be- fore the effective date of cancellation. IL T4 00 12 09 © 2009 The Travelers Indemnity Company Page 1 of 1 This endorsement, effective 12:01 a.m., 03/01/2019 forms a part of Policy No. DPR9938701 Issued to Biggs Cardosa Associates, Inc. by XL Specialty Insurance Company. TH IS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CANCELLATION -NOTICE TO DESIGNATED ENTITIES This endorsement modifies insurance provided under the following: PROFESSIONAL, ENVIRONMENTAL AND NETWORK SECURITY LIABILITY POLICY -ARCHITECTS, CONSULTANTS AND ENGINEERS Section XI. OTHER CONDITIONS, Paragraph A. Cancellation is amended by the addition of the following: In the event that the Company cancels this Policy for any statutorily permitted reason other than non- payment of premium, the Company agrees to provide Thirty (:iQ) days' notice of cancellation of this Policy to any entity with whom the NAMED INSURED agreed in a written contract or agreement would be provided wtth notice of cancellation of this Policy, provided that: 1. The Company receives, at least fifteen (15) days prior to the date of cancellation, a written request from the NAMED INSURED to provide notice of cancellation to entities designated by the NAMED INSURED to receive such notice and; 2. The written request includes the name and address of each person or entity designated by the NAMED INSURED to receive such notice. This endorsement does not apply to non-renewal of the Policy, cancellation at the INSURED'S request, or to cancellation of the Policy for non-payment of premium to the Company or to a premium finance company authorized to cancel the Policy. Furthermore, nothing contained in this endorsement shall be construed to provide any rights under the Policy to the entities receiving notice of cancellation pursuant to this endorsement, nor shall this endorsement amend or alter the effective date of cancellation stated in the cancellation notice issued to the NAMED INSURED. All other terms and conditions of the Policy remain unchanged. LDD 452 1116 Page 1 of 1 3/14/2019 9:28:25 PM © 2016 X.L. America, Inc. All Rights Reserved. May not be copied without permission.