Loading...
HomeMy WebLinkAboutCOI - JT Martin Trucking, Inc. - Expires 2021-04-27TNOLAN ACORL?' `r____ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/22/2021 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 CoreNAME: 4430 D rk Insurance Services Inc. 4430 Duckhorn Drive Sacramento, CA 95834 CONTACT Tammy Nolan, CISR PHONE 916 779-6984 FAX (A/C, No, Ext): ( ) (wc, No):(916) 923-2797 E-MAILtnolan@coremarkins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Williamsburg National Insurance 25780 INSURED JT Martin Trucking, Inc. P.O. Box 741 Winters, CA 95694 J.Irait' '!1b10E I r. INSURER B : Preferred Professional Insurance Company 36234 INSURERC:The Ohio Casualty Insurance Company 24074 INSURER D : INSURER E : INSURER: UMBER: 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRINSD TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF 4MM/DD/YYYYI POLICY EXP IMM/DD/YYYYL LIMITS A X COMMERCIAL GENERAL LIABILITY X GL095254400 4/27/2020 4/27/2021 EACH OCCURRENCE $ 1,000,000 PAMAGE TO RENTED PREMISES (Ea occurrence) 50,000 $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE X POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP/OPAGG $ Included $ A AUTOMOBILE X LIABILITY X X SCHEDULED AUTOOoSW� AUOTOS ONLY X CA095057201 4/27/2020 4/27/2021 (Ea accdenSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY accidentDAMAGE $ $ U UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Mandatory in NER EXCLUDED? H) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N / A ON1080101 1/17/2021 1/17/2022 X PER OOTH ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ C Motor Truck Cargo BM059412398 4/27/2020 4/27/2021 Deductible $1,000 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) This Certificate is for Work Comp renewal only, please refer to previously issued certificate for any endorsements referenced. City of Gilroy is additional insured respects General Liability per attached form CG2026 1185 and respects Auto Liability per attached form CCIA 01 CERTIFICATE HOLDER CANCELLATION Cityof GilroyTHE 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.