Loading...
HomeMy WebLinkAboutCOI - SEIU Local 2015 - Expires 2021-10-02Client#: 393230 SEIULOCA ACO DTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/02/2020 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services LLC-CL Lic # 0G11911 21700 Oxnard Street, Suite 1200 Woodland Hills, CA 91367 CONTACT Natasha Wu PHONE (A/C, No, Ext): gig 251-3152 FAX (A/C, No): 610 362-8480 E-MAILDRESS: natasha.wu@usi.com AD INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Wesco Insurance Company 25011 INSURED SEIU Local 2015 2910 Beverly Blvd. Los Angeles, CA 90057-1003 INSURER B : Redwood Fire and Casualty Insurance Co. 11673 INSURER C INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISI 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X WPP166044302 10/02/2020 10/02/2021 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR PREMISO(Ea occur ence) $300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $0 GEN'L X AGGREGATE LIMIT APPLIES POLICY 1 JECTRP O OTHER: PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE X X XComp./Coll. LIABILITY ANY AUTO OAUTOS ONLY HIRED AUTOS ONLY X CHEDULED SAUTOS NON -OWNED AUTOS ONLY Ded.: $1,000 X X WPP166044402 10/02/2020 10/02/2021 (E0aaocdeD SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE WUM183671401 10/02/2020 10/02/2021 EACH OCCURRENCE $5,000,000 $5,000,000 $ AGGREGATE DED X RETENT ON $10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A SEWC141653 08/01/2020 08/01/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 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: Personal Protective Equipment (PPE) Dr've-Thru Distribution Event at Gilroy City Hall on 08/22/2020. City of Gilroy is included as Additional Insured per form #33-0729(10/13). Blanket Additional applies as respects General Liability (per form #33-0729-10/13), Auto Liability (per form #CA990187-07/15). Umbrella Liability coverage is follow form per form #CU990001(02/14). Policy is (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Gilroy City Hall 7351 Rosanna Street Gilroy, CA 95020 ACORD 25 (2016/03) 1 of 2 #S30111064/M30098824 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 (ice ©'I8 015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD or"-- HZVZP DESCRIPTIONS (Continued from Page 1) Primary & Non -Contributory as respects General Liability (per form #33-0729-10/13), Auto Liability (per form #CA990187-07/15). Waiver of Subrogation applies as respects General Liability (per form #33-0729 10/13), Auto Liability (per form #CA990187-07/15). Additional Insured status is valid only if a written contract/agreement is required of the insured and is in effect. SAGITTA 25.3 (2016/03) 2 of 2 #S30111064/M30098824 POLICY NUMBER: WPP1660443-02 COMMERCIAL GENERAL LIABILITY 33-0729 10-13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY COVERAGE EXPANSION ENDORSEMENT (NON -CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CG 00 01 With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Additional Premium $200 SECTION I — COVERAGES COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions 9. Aircraft, Auto Or Watercraft Paragraph (2) is replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge. This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft, This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess, or contingent. Damage To Property Paragraph (2) is not applicable. (2) This paragraph is deleted. Paragraph (4) replaced with the following: (4) Personal property in the care, custody or control of the insured which exceeds $50,000 regardless of the number of: (a) Insureds (b) Claims made; or (c) Persons or organizations making claims The most we will pay under this coverage is $50,000. Our duty to pay and defend ends under this coverage when the coverage limit has been exhausted, n, Recall Of Products, Work Or Impaired Property Replace with the following: Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; 33-0729 10 13 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 6 Used with permission (2) "Your work"; or (3) "Impaired property"; If such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it, but this exclusion does not apply to "product recall expenses" that you incur for the "covered recall" of "your product". This Insurance does not apply to "Product Recall Expense" arising out of or resulting from: a. Any product withdrawal initiated due to: (1) The failure of "your products" to accomplish their intended purpose, including any breach of warranty of fitness, whether written or implied. This exclusion does not apply if such failure has caused or is reasonably expected to cause "bodily injury" or physical damage to tangible property. (2) Copyright, patent, trade secret or trademark infringements; (3) Transformation of a chemical nature, deterioration or decomposition of "your product", except if it is caused by: (a) An error in manufacturing, design, processing or transportation of "your product"; or (b) "Product tampering" (4) Expiration of the designated shelf life of "your product". b. A "product withdrawal", initiated because of a "defect" in "your product" known to exist by the Named Insured or the Named Insured's "executive officers", prior to the inception date of this Coverage Form or prior to the time "your product" leaves your control or possession. c. Recall of any specific products for which "bodily injury" or "property damage" is excluded under COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE LIABILITY by endorsement. d. Recall of "your products" which have been banned from the market by an authorized government entity prior to the policy period. e. The defense of a claim or "suit" against you for "product withdrawal expenses". f. COVERAGE A does not apply to "product recall expense" arising out of any withdrawal or recall that occurred before you acquired or formed the organization. We will not pay more than $100,000 annually for "product recall expense" incurred from all "Covered Recall" events covered during this policy term. Replace the following paragraph: Exclusion c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits Of Insurance. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 2. Exclusions Paragraph e. Contractual Liability is amended as follows: a. Contractual Liability This paragraph is deleted. Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., 33-0729 10 13 Used with permission COVERAGE C — MEDICAL PAYMENTS Paragraph 1.a. (3)(b) under SECTION I — COVERAGE C — MEDICAL PAYMENTS is replaced with the following: (b) The expenses are incurred and reported to us within two years of the date of the accident; However, expenses reported to us after two years of the date of the accident will not be denied solely because of the late submission unless such late submission operates to prejudice our rights; and SUPPLEMENTARY PAYMENTS — COVERAGES A AND B Paragraph 1.b. and 1.d. under SECTION I SUPPLEMENTARY PAYMENTS — COVERAGE A AND B is replaced with the following; b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not furnish these bonds. d. All reasonable expenses Incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $300 a day because of time off from work. SECTION II WHO IS AN INSURED Paragraph 3.a. is amended as follows: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. However, provision a. above does not apply if the newly formed or acquired organization is excluded by either a provision of the Coverage Form or by endorsement. The following is added under SECTION II WHO IS AN INSURED:: 4. Organization over which you maintain ownership of more than 50% will be a Named Insured If there is no other similar insurance available to that organization; however a. COVERAGE A. does not apply to "bodily injury" or 'property damage" that occurred before you acquired or formed the organization; and b. COVERAGE B. does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. If such organizations are not shown in the DECLARATIONS, you must report them to us within 180 days of inception date of the policy. 5. Any person or organization with whom you agreed, because of written contract or written agreement to provide insurance, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendors business, subject to the following additional exclusions: The Insurance afforded the vendor does not apply to; a, "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instruction from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspection, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the sale of the product; 33.0729 10 13 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 6 Used with permission f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendors premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any thing or substance by or for the vendor. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering Into accompanying or containing such products. 6. Any person or organization to whom you are obligated by virtue of a written contract to provide insurance such as is afforded by this policy, but only with respect to liability arising out of the maintenance or use of that part of any premises leased to you, including common or public areas about such premises if so required in the contract. However, no such person or organization is an insured with respect to: a. Any "occurrence" that takes place after you cease to occupy those premises; or b. Structural alterations, new construction or demolition operations performed by or on behalf of such insured. 7. Any person or organization granting a license to make, or distribute "your products" including "your products" which use the name or logo of grantor and to whom you are obligated by virtue of the written contract to provide insurance such as afforded by this policy, but only with respect to liability arising out of "your products". SECTION III — LIMITS OF INSURANCE The following is added to Paragraph 2. of SECTION III — LIMITS OF INSURANCE: d. The General Aggregate Limit applies separately to each of your "locations". For the purpose of this provision only, "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. Paragraph 6. is replaced with the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is replaced by a "Specific Perils" Limit which is the greater of: a. $300,000; or b. The amount shown in the DECLARATIONS for Damage To Premises Rented To You Limit. The "Specific Perils" limit is the most we will pay under COVERAGE A for damages because of "property damage" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. However, provisions a. and b. above do not apply if any reference in the DECLARATIONS for Damage to Premises Rented to You is deleted from this policy either by the provisions of the Coverage Form or by endorsement. The following is added under SECTION III — LIMITS OF INSURANCE: 8. Product Recall Expense $100,000 is the most we will pay for all "product recall expenses" arising out of the same defect or deficiency. 9. Professional Services Subject to provisions in SECTION I — COVERAGES - COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY — 2. Exclusions r. and COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY — 2. Exclusions q. the most we will pay for Professional Services is $50,000 each annual period. Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., 33-0729 ID 13 Used with permission SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit Replace paragraph 2.a. with the following: a. You must see to it we are notified as soon as practicable of an "occurrence" or an offense, which may result in a claim. Knowledge of an "occurrence" or an offense by your "employees" shall not, in itself, constitute knowledge to you unless any one of your partners, 'executive officers", directors or insurance managers shall have actually received notice. To the extent possible, notice should include: (1) How, when and where the "occurrence" took place; (2) The names and addresses of any injured persons and witnesses; and, (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. The following is added to paragraph 2. under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: e. Your rights afforded under this policy shall not be prejudiced if you fail to give us notice of an "occurrence", offense, claim or "suit", solely due to your reasonable and documented belief that the "bodily injury' or "property damage" is not covered under this policy. f You must see to it that the following are done in the event of an actual or anticipated "covered recall" that may result in "product recall expense": (1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled. Include a description of "your product" and the reason for withdrawal or recall. (2) Cease any further release, shipment, consignment or any other method or distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under this insurance. 4. Other Insurance The following is added to Other Insurance and supersedes any provision to the contrary with respects to the Commercial General Liability Coverage Part and Products/Completed Operations Liability Coverage Part. d. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (I) The additional insured is a Named Insured under such other insurance; and (ii)You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 6. Representations Replace with the following: By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. Any knowledge of an error or omission in the description of, or failure to completely describe any premises or operations intended to be covered by the Coverage Form will not invalidate or affect coverage for these premises or operations. You must report such error or omission to us as soon as practicable after its discovery. However, this provision does not affect our right to collect additional premium or exercise our right to cancellation or non -renewal. 8. Transfer Of Rights Of Recovery Against Others To Us Replace with the following: 33.0729 10 13 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 6 Used with permission If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit or transfer those rights to us and help us enforce them. However, if the insured has waived those rights to recover through a written contract or if "your work" was commenced under a letter of Intent or work order, subject to a subsequent reduction to writing with customers whose customary contracts require a waiver, we waive any right to recovery we may have under this Coverage Form. SECTION V — DEFINITIONS Paragraph 3. of SECTION V — DEFINITIONS is replaced with the following: 3. "Bodily Injury" means injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death resulting from "bodily injury", sickness or disease. The following definitions are added: 23. "Covered recall," means: a. A product recall made necessary because you determine that the product recall is necessary; or b. An authorized government entity has ordered you to conduct a product recall. 24. "Product recall expense" means necessary and reasonable expenses for: a. Costs of notification; b. Costs of stationery, envelopes, production of announcements and postage or facsimiles; c. Costs of overtime paid to your regular non -salaried employees and costs incurred by your employees, including costs of transportation and accommodations; d. Costs of computer time; e. Costs of hiring independent contractors and other temporary employees; f. Costs of transportation, shipping or packaging g. Costs of warehouse or storage space; or h. Costs of proper disposal of "your products", or products that contain "your products", that can not be reused, not exceeding your purchase price or your cost to produce the products; 25. "Specific Peril" means fire; lightning; explosion or leakage from fire sprinkler extinguishing equipment. 26. "Professional services" means: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and b. Supervisory or inspection activities performed as part of any related architectural or engineering activities. All other policy wording not specifically changed, modified, or replaced by this endorsement wording remains in effect. Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., 33-0729 10 13 Used with permission