Loading...
HomeMy WebLinkAboutCOI - Precision Heavy Haul, Inc. - Expires 2023-07-01P52GIlO2N11112 A(CC, 11rr.r" ` 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 Brown & Brown Inc. 257 East 200 South Suite 700 Salt Lake City, UT 84111 INSURED Precision Heavy Haul, Inc. PO Box 797 Tolleson, AZ 85353 COVERAGES 1-801-505-6500 CERTIFICATE NUMBER: 65971122 NAMCONTACT Jennifer Stires E: pac�Np. Extl: 801-505-6500 I FAX No): 801-505-6501 ADDRESS: ]ennifer.stires@bbrown.com INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : I INSURER F : INSURER(S) AFFORDING COVERAGE NAIC # GENERAL SECURITY NATL INS CO 39322 PA Manufacturers Assoc Ins./Gen Sec Inde..12262 OLD REPUBLIC UNION INS CO 31143 PENNSYLVANIA MANUFACTURERS ASSOC INS 12262 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 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY I I JE� [ I LOC OTHER: B AUTOMOBILE LIABILITY X - ANY AUTO - OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY C D UMBRELLA LIAB X EXCESS LIAB DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRI ETOR/PARTN ER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, descdbe under DESCRIPTION OF OPERATIONS below C Riggers Liability C Cargo X CERTIFICATE OF LIABILITY INSURANCE OCCUR CLAIMS -MADE Y/N N ADDL SUBR INSD AND POLICY NUMBER GL-000012-01 N/A POLICY EFF POLICY EXP I MMIDD/YYYY1 I MMIDD/YYYY1 07/01/22 07/01/23 1521011027994/XA-0001640)07/01/22 07/01/23 ORANXS000485-01 07/01/22 07/01/23 202201-10-27-99-4 ORANCP000156-01 ORANCP000156-01 07/01/22 07/01/23 LIMITS EACH OCCURRENCE 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) IPROPERTYDAMAGE (Per accident) EACH OCCURRENCE AGGREGATE X PER STATUTE OTH- ER DATE (MMIDDIYYYY) 06/28/2022 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000 4,000,000 4,000,000 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 07/01/22 07/01/23 $10,000 Ded 5,000,000 07/01/22 07/01/23 $10,000 Ded 5,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mare space Is required) CERTIFICATE HOLDER CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 ACORD 25 (2016103) JStires 65971122 '@CEu u t JUL - 6 2022 GILROY CITY CLERK'S OFFICE CANCELLATION 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 USA © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENV 172.56