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HomeMy WebLinkAboutCOI - Golden State Utility Co. - Expires 2023-01-31AC R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/03/2022 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 **Marsh USA, Inc. Two Alliance Center 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 CN102986923--GAWU-22-23 INSURED Golden State Utility Co. 8766 Fruitridge Road Sacramento, CA 95826 CONTACT NAME: PHONE (A/C. No. Extl: E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Liberty Mutual Fire Insurance Company INSURER B : LM Insurance Corporation INSURER C : N/A INSURER D : Liberty Insurance Corporation INSURER E INSURER F FAX (A/C, No): NAIC # 23035 33600 N/A 42404 COVERAGES CERTIFICATE NUMBER: ATL-004679490-16 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSQWVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY TB2-631-004260-012 01/31/2022 01/31/2023 EACH OCCURRENCE CLAIMS -MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- JECT LOC OTHER: A AUTOMOBILE LIABILITY X ANY AUTO B B D OWNED AUTOS ONLY x HIRED AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY UMBRELLA LIAB EXCESS LIAB DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIV E OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below OCCUR CLAIMS -MADE Y/N N N/A AS2-631-004260-022 01/31/2022 01/31/2023 WA5-63D-004260-032 (AOS) WC5-631-004260-042 (MN,WI) WA7-63D-510689-512 (MA) 01/31/2022 01/31/2022 01/31/2022 01/31/2023 01/31/2023 01/31/2023 DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE X STATUTE I I OTH- ER E.L. EACH ACCIDENT I$ E.L. DISEASE - EA EMPLOYEE' $ E.L. DISEASE -POLICY LIMIT I $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy, its Agents, Officers, Officials, Employees & Volunteers is/are included as additional insured where required by written contract with respect to general liability and auto liability. CERTIFICATE HOLDER City of Gilroy its Agents, Officers, Officials, Employees & Volunteers 7351 Rosanna Gilroy, CA 95020 CANCELLATION 5,000,000 1,000,000 5,000,000 10,000,000 10,000,000 5,000,000 1,000,000 1,000,000 1,000,000 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 ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD