The URL can be used to link to this page

Home My WebLink AboutCOI - Frontier California, Inc. - Expires 2023-06-01ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~-05/31/2022 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. 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 Marsh I U.S. Operations MARSH USA INC. NAME: f.,tJgNJo Evl\• (866) 966-4664 I FAX 540 W. MADISON IA/C No\: 212-948-0770 CHICAGO, IL 60661 E-MAIL Chicago.CertRequest@marsh.com ADDRESS: INSURER{Sl AFFORDING COVERAGE NAIC# CN102898337--GAW-22-23 FC610 GAW INSURER A: Steadfast Insurance Company 26387 INSURED INSURER B : Zurich American Insurance Comoanv 16535 Frontier California Inc. 401 Merritt 7 INSURER c : American Zurich Insurance Company 40142 Norwalk, CT 06851 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CHl-010079164-01 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ''""' W\/n POLICY NUMBER IMM/DD/YYYY\ IMM/DD/YYYY\ LIMITS A X COMMERCIAL GENERAL LIABILITY X GLO 0285992 05 06/01/2022 06/01/2023 EACH OCCURRENCE $ 1,000,000 1 CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES /Ea occurrence) $ 500,000 ,_ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Pl □ PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ B AUTOMOBILE LIABILITY X BAP 0285990 05 06/01/2022 06/01/2023 (E~~~~d~~trlNGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ --OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ f---------HIRED -NON-OWNED PROPERTY DAMAGE $ -AUTOS ONLY -AUTOS ONLY /Per accident\ $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ -EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ C WORKERS COMPENSATION WC 0285988 05 (AOS) UO/Ul/~UL<: 06/01/2023 X I ~f~TUTE I I OTH- AND EMPLOYERS' LIABILITY ER B Y/N WC 0285989 05 (WI) 06/01/2022 06/01/2023 ANYPROPRIETOR/PARTNER/EXECUTIVE 0 E,L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (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 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Frontier Work Order #5268859, Frontier California lnc.'s insurance certificate for permitting purposes with the City of Gilroy, CA. The City of Gilroy, and its officers, employees and agents shall be named as Additional Insureds as respects the General Liability and Auto Liability policies where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7351 Rosanna Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gilroy, CA 95020 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ~USA'?~. © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 0285992-05 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement rnodlfies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oruanization(s) Location(s} Of Covered Operations THE CITY OF GILROY, AND ITS OFFICERS, EMPLOYEES AND AGENTS THE CITY OF GILROY, CA Information required to complete this Schedule, if not shown above, wm be shown in the Declarations. CG 20101219 © Insurance Services Office, Inc., 2018 Page 13 of 80 0189-01-00-0000757 -0002-0001764 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 llability 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 re.quired 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 foflowlng additional exclusions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after: 1.AII 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 lnsured(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 Ill -Limits Of Insurance: If coverage provided to the additional insured ls 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.AvaHable under the applicable limits of insurance; whichever ls less. This endorsement shall not increase the applicable limits of insurance. CG 2010 1219 © Insurance Services Office, Inc., 2018 Page 14 of 80