The URL can be used to link to this page

Home My WebLink AboutCOI - Impact Transportation, LLC - Expires 2021-08-01Ac®gyp /5 . CERTIFICATE OF LIABILITY INSURANCE k.,.,,..-' DATE(MM/DD/YYYY) 07/29/2020 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 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 Commercial Carriers Insurance Agency, Inc. 4 Centerpointe Drive, Suite 300 La Palma, CA 90623 (562) 404-4900 CONTACT NAME: Sherri Jackson PHONE FAX (A/C, o, Extl: (562 ) 733-6636 (A/C, No): (562) 356-0321 E-MAIL ADDRESS: SJackson@Meadowbrook.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Allianz Global Corporate & Specialty 22837 INSURED Impact Transportation, LLC P.O. Box 8530 Emeryville, CA 94662 INSURER B :Star Insurance Company 18023 INSURER C : Williamsburg National Insurance Co. 25780 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY GL0866377 08/01/2020 08/01/2021 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 $ C AUTOMOBILE X X LIABILITY X SCHEDULED AUTOS AUTOS NON -OWNED X CA0329924-13 08/01/2020 08/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ C C A Trailer Interchange Physical Damage Cargo- Legal Liability CA0936681-02 CA0936681-02 MX193060641 08/01/2020 08/01/2020 08/01/2020 08/01/2021 08/01/2021 08/01/2021 $40,000 less $1,000 ded *`ACV less $1,000 ded. $250,000 less $2,500 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is requl ed) The City of Gilroy is named as additional insured. CERTIFICATE HOLDER CANCELLATION City of Gilroy Attn: Public Works Dept. 7351 Rosanna Street Gilroy, CA 95020 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 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Williamsburg National Insurance Co. ADDITIONAL INSURED ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement forms a part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the policy). Named Insured Impact Transportation, LLC P.O. Box 8530 Emeryville, CA 94662 It is agreed that: Endorsement Effective Date 08/01/2020 at 12:01 am standard time Policy Number CA0329924-13 Policy Effective Date 08/01/2020 at 12:01 am standard time Policy Expiration Date 08/01/2021 12:01 am standard time Countersigned by The "Persons Insured" provision is amended to include as an ADDITIONAL INSURED the person or organization named below, but solely with respect to liability arising out of operations performed for such ADDITIONAL INSURED by or on behalf of the NAMED INSURED. Name of Person or Organization (Additional Insured) City of Gilroy Attn: Public Works Dept. 7351 Rosanna Street Gilroy, CA 95020 CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, the issuing Company will endeavor to mail 30 days written notice, except for Non -Payment of Premium and then 10 days will be given, to the above named ADDITIONAL INSURED, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. Nothing in this endorsement shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limitations of this policy other than above stated. Nothing elsewhere in this policy shall be held to vary, alter, waive or limit the terms, conditions, agreements or limitations of this endorsement. CCIA-01