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HomeMy WebLinkAboutCOI - Allied Universal Topco, LLC - Expires 2023-01-01AMR ifj CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/23/2021 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 r- OW. TI-IIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED .ESENTATIVE 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 MARSH USA INC 1717 Arch Street Philadelphia, PA 19103 Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360 C N 118025105-ALL-STAND-22-23 INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 CONTACT NAME: PHONE /A/C. No. Extl: EMAIL ADDRESS: Marsh I U.S. Operations 866-966-4664 Philadelphia,Certs@marsh.com INSURER(S) AFFORDING COVERAGE INSURER A ; Indian Harbor Insurance Company INSURER B : Greenwich Insurance Company I INSURER C ; XL Insurance America INSURER D : National Fire & Marine Insurance Company INSURER E ; N/A I INSURER F FAX (A/C, Not: NAIC # 136940 122322 124554 20079 N/A COVERAGES CERTIFICATE NUMBER: CLE-006525310-15 REVISION NUMBER: 2 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. NSR LTR TYPE OF INSURANCE A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X CONTRACTUAL LIABILITY X SIR $1,750,000 OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO X JECT LOC OTHER. 'OMOBILE LIABILITY X—I ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY D UMBRELLA LIAB X X EXCESS LIAR DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPR OPRI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability C C X OCCUR CLAIMS -MADE Y/N N IAUDL'SUBR' INSD WVD POLICY NUMBER RES943799402 N/A POLICY EFP I POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) 01/01/2022 01/01/2023 RAD943781805 01/01/2022 01/01/2023 42XSF10009009 Excess of General Liability, Auto Liability, and Workers' Comp RWD3001203.06(AOS) RWR300120406(WI) RES943799402 01/01/2022 01/01/2023 LIMITS EACH OCCURRENCE IDAMAGE TURENTED PREMISES (Ea occurrence) IMED EXP (Any one person) PERSONAL & ADV INJURY I GENERAL AGGREGATE PRODUCTS - COMP/OP AGG CUMBIN L) blNbLt LIIVIIT (Ea accident) I BODILY INJURY (Per person) 01/01/2023 01/0'1/2022 01/01/2023 01/01/2022 01/01/2023 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE I X I STATUTE I I ERH E.L EACH ACCIDENT I E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT Limit SIR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 3ERTIFICATE HOLDER City of Gilroy ''ublie Works Department 3 Old Gilroy Road Gilroy, CA 95020 CANCELLATION 30,000,000 30,000,000 30,000,000 40,000,000 40,000,000 5,000,000 10,000,000 10,000,000 1,000,000 1,000,000 1,000,000 2,000,000 1,750,000 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 CORD 25 (20.16/03) WcVY4C © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0004975 SP 0004 -001-P04977-1 City of Gilroy Public Works Department 613 Old Gilroy Road Gilroy, CA 95020 4.; 0004-01-00-0004975-0001-0028192 AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia Ate' D Ac. ADDITIONAL REMARKS SCHEDULE Page 2 of 2 MARSH USA INC POLICY NUMBER CARRIER NAIC CODE NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Excess Workers' Compensation Policy No.: RWE943548206 Insurer: XL Specially Insurance Company Effective Dates: 09/15/2021 - 09/15/2022 Limit: Employers Liability Each Accident: $1,000,000 Employers Liability Disease -Policy Limit: $1,000,000 Employers Liability Disease -Each Employee: $1,000,000 SIR: $1,000,000 Crime Policy No.: 01-602-29-33 Insurer: National Union Fire Insurance Co. Effective Dates: 09/15/2021 - 09/15/2022 Limit: yee Theft or Dishonesty: $2,000,000 LA,Cnts' Property: $2,000,000 Deductible: $1,000,000 Contractors Pollution Liability Policy No.: CP013303734 Insurer: Commerce and Industry Insurance Company Effective Dales: 11/01/2021 -11/01/2022 Limit: $5,000,000 Deductible: $250,000 The General Liability and Professional Liability policies evidenced above share in the limits shown. The limits do not apply separately to the individual coverages City of Gilroy Public Works Department is additional insured on the above General Liability, and Auto Liability Policies if required by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD nnn4-m-no-nne4975-e002-002n193 Named Insured: Allied Universal Topco LLC Additional Named Insured: Adesta LLC Advent Systems, LLC Advent Systems, LLC, dba Allied Universal Technology Services Allied Security Holdings LLC Allied Universal Compliance and Investigations, Inc. Allied Universal Compliance and Investigations? Inc., fka 045 Compliance & Investigations, Inc. Allied Universal Executive Protection and Intelligence Services, Inc. Allied Universal Finance Corporation Allied Universal HoIdco LLC Allied Universal Risk Advisory and Consulting Services, Inc. Allied Universal Sideco, LLC AlliedBarton (NC) LLC AlliedBarton (NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC AlliedBarton Security Services LLC, dba Allied Universal Security Services AMAG Technologies, Inc. American Security Programs, Inc. Central Defense Services, LLC ERMC LLC ERMC of America, LLC FJC Security Services, Inc. FJC Security Services, Inc., dba Allied Universal Security Services G45 Holding One LLC G45 Retail Solutions (Canada) Inc. 045 Retails Solutions (USA) Inc. G4S Secure Integration LLC G4S Secure Integration LLC dba Allied Universal Teohnology Services G45 Secure Solutions International Inc. G4S Secure Solutions (USA) Inc. G4S Secure Solutions (USA) Inc., dba Allied Universal G4S Technology Software Solutions LLC Intelligent Access Systems of North Carolina, LLC Intelligent Access Systems of North Carolina, LLC, dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid -Atlantic Michael Stapleton Associates, Ltd. Michael Stapleton Associates, Ltd., dba MSA Security Millard Mali Services Hoidco LLC MSA Investigations, Inc. MSA Security, Inc. MSA Security Canada Limited MSA Security Limited NAKI Cleaning Services, LLC Peoplemark, Inc. RONCO Consulting Corporation SecurAmerica, LLC Securadyne Systems Intermediate LLC Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Universal Protection Security Systems SOS Security LLC SOS Security LLC, dba Allied Universal Risk Advisory arid Consulting Services SOS Security LLC, dba Allied Universal Security Services Spectaguard Acquisition LLC Staff Pro Inc. Staff Pro Inc., dba Allied Universal Event Services Titania Insurance Co. of America TMG Facilities Management, LLC U.S. Security Associates Holding Corp. Universal Building Maintenance, LLC Universal Building Maintenance, LLC,dba AIIid Universal Janitorial Services Universal Building Maintenance, LLC, dba Allied Universal Landscaping Services Universal Protection GP, Inc. Universal Protection Security Systems, LP Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Service of Canada Corporation Universal Protection Service of Canada Corporation, dba Allied Universal Security Services of Canada Universal Protection Service of Canada Corporation, dba Allied, Universal Technology Services Universal Protection Service of Seattle, LLC Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Protection Service, LLC Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection_Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Services of America, LP Universal Services .of America, LP, dba Allied Universal Universal Thrive Technologies, LLC Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Allied Universal Tenhriology Services Universal Thrive Technologies, LLC, dba Thrive Intelligence USAGM Acquisition, LLC POLICY NUMBER: RAD943781805 XIC 414 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modifled by the endorsement. Schedule Additional insured(s) Work Any person or organization you have agreed to ' All Operations include es an additional insured under written contract,, provided such contract was executed prior to the date of Toss. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, Is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additionalinsured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in. the .Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY. All other terms and conditions of this policy remain unchanged. XIC 414 1013 © 2013 X.L. America, Inc. All Rights Reserved, VHAR 02/01/2021 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: RAD943781805 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured ALLIED UNIVERSAL TOPCO, LLC Endorsement Effective Date: January 1, 2022 SCHEDULE IName(s) Of Person(s) Or Organization(s): lAny person or organization where waiver of our right to recover is required by written contract with such person or organizationprovided such contract was executed prior to the date.of loss. Information required to complete this Schedule, if not shown above,.wiil be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply - to the person(s) or organization(s) shown In the Schedule, but only to the extent that subrogation Is waived prior to the "accident" or the "loss° under a contract with that person or organization. CA04441013 0004.01-00-0004975-0004.0028195 CO insurance Services Office, Inc., 2011 Peg( ENDORSEMENT IO5O This endorsement, effective 1201 AM 01/01/2022 Forms part of policy number: RES943799402 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: INDIAN HARBOR INSURANCE COMPANY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided by the following: EXCESS GENERAL LIABILITY POLICY A. SECTION II - Who Is an Insured is amended to include as an additional insured a person(s) or organization(s) who is required to be added by written contract or written agreement which do' es not require that a specific form number be used. B. The insurance provided to additional insureds applies only to "bodily injury", "property damage", "professional liability" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or ()missions; or 2. The acts or omissions of those acting on your behalf Ih the performance of your ongoing operations for the additional insured; or "your work" performed for that additional insured and included in the "products -completed operations hazard" However: 1. The insurance afforded to such additional insured only applies to the extent permitted )ay law; and 2. If coverage provided to the -additional insured is required by a contract or agreementithe insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance; I . Required by the con tract or agreement; or 2� Available Linder the applicable Limits ufInsurance shown |nthe Declarations; whichever |sless. This endorsement shall not increase the applicable Limits of Insurance e shown in the Declarations, D. The additional insured Must see to it that: 1. We are notified as soon as practicable of an 'occurrence" or offense that may result in a claim, 2. VVereceiveaVdttennotice of aclaim o["suit"assoon aspracticable; and. 3. A request for defense and indemnity of the claim or "suit" will promptly be brought a§pi,nstaDy policy issued byanother Insurer under which the additional insured also has rights mninsured or additional insured. E.ThbinsunancebodrnurytoandvNUnotsemkcuntdbutionfuomonyother|nyuranceavaUetdeto�h additional Insured Linder your policy provided that: 1. The additional insured inoNamed Insured under such other insurance; and 2. You have agreed in writing in a contractor agreement that this insurance would be primary and would not see)< contribution from, any other insurance available to the additional insured, All other terms and conditions remain as written, MANUS ENDORSEMENT #24 This endorsement, effective 12:01 AM 01/01/2022 Forms part of policy number: RES943799402 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: INDIAN HARBOR INSURANCE COMPANY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of person or Organization: Where required by written contract. (If no entry appears above, information required to complete this endorsement .will be shown in the Declarations as applicable to this endorsement) The TRANSFER OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard." This waived applies only to the person or organization shown in the Schedule above. All other terms and conditions remain as written. MAN US WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of [OM This endorsement changes the policy to which it Is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured RWD3001203-06 Premium Included Allied Universal Topco, LLC Insurance Company XL Insurance America, Inc. Countersigned by WC 00 03 13 (Ed. 4-84) 1083 National Council on Compensation Insurance.