Loading...
HomeMy WebLinkAboutCOI - Stinger Transport Company - Expires 2023-08-15ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) '----'' 06/08/2022 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 nghts to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Sentry Customer Service Sentry Insurance r,tJgN~o Extl: 800-473-6879 IFAX 1800 North Point Drive IA/C Nol: 800•514-7191 Stevens Point, WI 54481 EMAIL ADDRESS: businessoroducts direct@senbv.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : Sentry Select Insurance Company 21180 INSURED INSURER B : Sentry Insurance Company 24988 Stinger Transpo,t Company INSURERC: 569 S Van Buren St Placentia, CA 92870 INSURERD: INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 1242600 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 1:~76YJ}t{{Yl ,JaMgrvWvi LIMITS LTR INSR WVD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ,-CJ CLAIMS-MADE 0ocCUR DAMAGE TO RENTED PREMISES <Ea occurrencel $ 100,000 ,_ MED EXP (Any one person) $5,000 A -X 4949236004 08/15/2022 08/15/2023 PERSONAL & ADV INJURY $ 1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 I~ □PRO-DLoc PRODUCTS· COMP/OP AGG $ 1,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ,_ ii:~ accidenll X ANY AUTO BODILY INJURY (Per person) $ ,_ - A OWNED SCHEDULED 4949236005 08/15/2022 08/15/2023 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS ,_ -NON-OWNED lfe?-~~~reniAMAGE HIRED $ AUTOS ONLY AUTOS ONLY -- $ X UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 5,000,000 A X EXCESS LIAB CLAIMS-MADE 4949236006 08/15/2022 08/15/2023 AGGREGATE $ 15,000,000 OED I I RETENTION$ PRODUCTS • COMP/OP AGG $ 15,000,000 WORKERS COMPENSATION X !:PER I I ~~H-AND EMPLOYERS' LIABILITY Y/N STATUTE B ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A 4949236012 08/15/2022 08/15/2023 E.L. EACH ACCIDENT $1,000,000 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 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Refer to attached CERTIFICATE HOLDER City of Gilroy 7351 Rosanna St Gilroy, CA 95020-6141 ACORD 25 (2016/03) 4949236 Sentry Select Insurance Company 3 00003 0000000601 22159 N A o 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. AUT3l:ZNT7~ ~ Page 1 of 2 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 06/08/2022 OFD30420-98E0-4A07 ·BACF-46 E1 46944FBC 0027020044365576301695020619651 I . . . 6 POLICY NUMBER: 4949236004 COMMERCIAL GENERAL LIABILITY CG 2010 0413 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 Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations City of Gilroy All Locations Description: City of Gilroy 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", "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. CG 2010 0413 4949236 © Insurance Services Office, Inc., 2012 Page 1 of 2 06/08/2022 Sentry Select Insurance Company 00003 0000000601 ,22169 N A 0 B1 BEEF89•BE4E-4272·91 F0-381B199673F4 0027020044365676692495020619651 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 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. Page 2 of 2 4949236 © Insurance Services Office, Inc., 2012 CG 2010 0413 06/08/2022 Sentry Select Insurance Company