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HomeMy WebLinkAboutCOI - Jensen Landscape Holdings, LLC - Expires 2023-05-01CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/30/2022 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. "Thcf175141-anniriFFeairaieFoiali:TrarabWIEKETOCI-171—E17,Th—eFOIWYTIFiriiriu-ith77/r011YtiblwrizoR ED provisions or CoeedT SUBROGATION IS WAIVED, subject 'o.J the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to PRODUCER Aon Risk Insurance services West Los Angeles CA office 707 Wilshire Boulevard Suite 2600 Los Angeles CA 90017-0460 USA VfkR Inc. MAY 1 7 2022 GILROY CIP,' CLERK'S OFFICE uch endorsement(s). KAA A 11 I1 ma, thm. AA. AAA. 1.1* 110.1.1111119 MAMA ....,1.1.1...n,..,A...A1...A.WMAN`••AA ARAMAAAAA".1 CONTACT NAME: let Eat): (866) 283-7122 E-MAIL ADDRESS: FAX No: (800) 363-0105 INSURER(S) AFFORDING COVERAGE NAIC It NSURED Jensen Landscape Holdings, LLC; Jensen Landscape Contractor, LLC; Jensen Landscape Services, LLC;Jensen Landscape & Construction Company,LLC 1250 Ames Ave. Milpitas, CA 95035 USA COVERAGES INSURER A: LM Insurance Corporation 33600 INSURER B: Liberty Mutual Fire Ins Co 23035 INSURER c: Starr Indemnity & Liability company 38318 INSURER D: INSURER E: INSURER F: CERTIFICATE NUMBER: 570092907372 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF 10-URA—RIM 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 POL CIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested TYPE OF INSURANCE ID INSO *rm----- WVO POLICY NUMBER 0 Y F— Turzym 11/1M/OD/YVYL 411/1M/DD/ral) LIMITS X COMMERCIAL GENERAL LIABILITY TBYSTUienTnT 0571717262.2 0 57717z u J EACH OCCURRENCE $1,000,000 CLAIMS -MADE I X I OCCUR DAMAGE TO HEM PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENII. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PRC)" JECT 1 X I LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY As2-661-067138-022 05/01/2022 05/01/2023 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) 1111 AUTOS ONLY HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) C li UMBRELLA LIAB X OCCUR 1000585092221 05 01 2022 153761 2023 EACH OCCURRENCE .-----15 , 000 , 000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 DED RETENTION Products / Completed One $5,000,000 A WORKERS CBMPENSANON AND EMPLOYERS' LIABILITY WA5660067138012 0 (01/2022 .............................7,..... 05/01/2023 x PER STATUTE7 OTH- ER y / N ANY PROPRIETOR / PARTNER / EXECUTIVE N N / A E.L, EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? pindMory In NH) E.L, DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: JL$ will provide Landscape maintenance services to The city of Gilroy at their parks, sound walls, street medians & islands, City buildings, downtown areas and water facility sites. These routine services include plant & tree care, weed/pest control, litter/debris removal, irrigation maintenance and general maintenance such as seasonal leaf removal. City of Gilroy, its officers, officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED15FigarAlicr .%:47,7fredidgam N:54`,..Zet I Certificate No : 570092907372 1 NM ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TB2-661-067138-032 COMMERCIAL GENERAL RAL LIABILITY CO20100413 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 A. Section II — Who Is An insured is amended to include 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" or "personal and 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) designated above. 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 agreement, the 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is Less. This endorsement shall not Increase the applicable Limits of Insurance shown in the Declarations. CG20100413 © ISO Properties, Inc., 2012 Page 1 of 2 r.1 SCHEDULE Name Of Additional Insured Person(s) Or Or All persons or organizations with whom you have entered into a written contract or agreement, prior to an 'occurrence' or offense, to provide additional insured status. Location s Of Covered Operations All locations as required by a written contract or agreement entered into prior to an 'occurrence' or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CO 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER: TB2-661-067138-032 COMMERCIAL. GENERAL LIABILITY CC 20 37 04 13 THIS END RSEMENT 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement prior to an occurrence. All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" 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 insured and included In the "products -completed operations hazard". 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 agreement, the 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. B. 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CC 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 'I of 1 Policy Number TB2-661-067138-032 Issued by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Person(s) or Organization(s): All persons or organizations with whom you have entered into a written contract or agreement, prior to an "occurrence" or offense, to provide additional insured status. If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person(s) or organization(s) shown in the Schedule of this endorsement that qualifies as an additional insured on this Policy, this Policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4, Other Insurance of Section IV — Conditions will apply, However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured for the same "occurrence", claim or "suit". 000000 04 04 001006 002021 P LC 24 20 11 118 © 2018 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission.