HomeMy WebLinkAboutCOI - CivicPlus, LLC - Expires 2023-05-17INSR
LTR TYPE OF INSURANCE
X COMMERCIAL GENERAL LIABILITY
ACCORD)
Page 1 of 1
DATE (MM/DD/YYYY)
05/20/2022
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.
CERTIFICATE OF LIABILITY INSURANCE
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,
If SUBROGATION IS WAIVED, subject to the terms and conditions
this certificate does not confer rights to the certificate holder in lieu
PRODUCER
Willis Towers Watson Northeast, /no.
c/o 26 Century Blvd
H.O. Box 305191
Nashville, TN 372305191 USA
INSURED
Civic91us, LLC
302 S 4th Street, Suite 500
Manhattan, KS 66502
the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
of the policy, certain policies may require an endorsement. A statement on
of such endorsement(s).
CONTACTWillis Towers Watson Certificate Center
NAME:
PHONE 1-877-945-7378 FAX 1-888-467-2378
(Atli, No. Eril: (A/C. Nol:
E-MAIL ADDRESS: certificates@willis.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Great Northern Insurance Company ( 20303
INSURERS: Federal insurance Company 20281
INSURER C :
INSURER D :
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: W24806236 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.
IADDL SUBR1 j POLICY EFF POLICY EXP
IINSD WVD: POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYY) LIMITS
IEACH OCCURRENCE
I DAMAGE TO RENTED
CLAIMS -MADE OCCUR I PREMISES (Ea occurrence)
MED EXP (My one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
X
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY f I JL-PRO-CT I LOC
OTHER:
AUTOMOBILE LIABILITY
X ANY AUTO
B ^' OWNED
AUTOS ONLY
HIRED
_ AUTOS. ONLY
B
B
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
UMBRELLA LIAB X
X EXCESS LIAB
DED I X I RETENT ON $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRI ETOR/PARTNER/EXECUTIVE
OFFIGER/MEMBEREXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS betow
OCCUR
CLAIMS -MADE
0
YIN
3602-53-12 05/17/2022 05/17/2023
7358-87-92
7989-49-14
N/A (23) 7174-92-49
1.05 /17 /2 022
105/17/2022
1$
$
PRODUCTS - COMP/OP AGG $
1$
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
05/17/2023 BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
EACH OCCURRENCE
05/17/2023 AGGREGATE
X 1 STATUTE I I EORH
05/17/2022 05/17/2023 E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS t VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
City of Gilroy, its officers, officials
and employees
Gilroy
CA 95020
CANCELLATION
2,000,000
2,000,000
10,000
1,000,000
2,000,000
2,000,000
1,000,000
5,000,000
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
SR IS: 22596306 HATCH: 2534245
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