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HomeMy WebLinkAboutCOI - Page & Turnbull, Inc. - Expires 2024-01-01SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 12/27/2022 Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 949-242-9240 www.risk-strategies.com CA DOI License No. 0F06675 RSC Insurance Brokerage Risk Strategies Company syoung@risk-strategies.com Page & Turnbull, Inc. 170 Maiden Lane, 5th Fl. San Francisco CA 94108 72134538 3 City of Gilroy, its officers and employees are named as additional insureds on the general liability policy-see attached endorsement. City of Gilroy, its officers, officials and employees 7351 Rosanna St. Gilroy CA 95020 Projects as on file with the insured including but not limited to On-Call Historical Evaluations Project #21-RFQ-CDD-330. The above policies contain a 30 day notice provision for non-renewal and cancellation, 10-day notice for non-payment of premium. $2,000,000 $1,000,000 $10,000 $2,000,000 $4,000,000 $4,000,000 $2,000,000 $5,000,000 $5,000,000 A OB3D457135 1/1/2023 1/1/20243 3 3 A OB3D457135 1/1/2023 1/1/2024 3 3 A OB3D457135 1/1/2023 1/1/202433 3 0 B Professional Liability PAAEP0010807 1/1/2023 1/1/2024 Per Claim: $2,000,000 Aggregate: $4,000,000 Citizens Insurance Company of America 31534 Arch Insurance Company 11150 72134538 | 23-24 GL-HNOA-UL-PL | Sherry Young | 12/27/2022 1:28:55 PM (PST) | Page 1 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.   ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION     This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM   SCHEDULE Name of Person or Organization Location of Covered Operations    (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)     For the purpose of coverage provided by this endorsement, the following changes are made to SECTION II – LIABILITY: A. The following is added to SECTION II – LIABI LITY, C. Who is a n Insured: Any person or organization shown in the Schedule above is also an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured at the location designated above. However: c. The insurance afforded to such additional insured only applies to the extent permitted by law; and d. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. The following is added to SECTION II – LIABILITY, B. Exclusions: This insurance does not apply to "bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than servic e, maintenance or repairs) to be performed by or on behalf of the additional insured at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The following is added to SECTION II – LIABILITY, D. Liability and Medical Expenses Limits of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.     ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.          391-193 7 08 16 Includes copyrighted material of Insurance Servi ces Offi ces, Inc., with i ts permission. Page 1 of 1 OB3D457135 City of Gilroy, its officers and employees On-Call Historical Evaluations 72134538 | 23-24 GL-HNOA-UL-PL | Sherry Young | 12/27/2022 1:28:55 PM (PST) | Page 2 of 3 391-1602 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name Of Person Or Organization Location And Description Of Completed Operations (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) For the purpose of coverage provided by this endorsement, the following changes are made to SECTION II – LIABILITY: A. The following is added to SECTION II – LIABILITY, C. Who Is An Insured: Any person or organization shown in the Schedule above is also an additional insured, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule above, performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. The following is added to SECTION II – LIABILITY, D. Liability And Medical Expenses Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. OB3D457135 City of Gilroy, its officers and employees On-Call Historical Evaluations Page & Turnbull, Inc. 72134538 | 23-24 GL-HNOA-UL-PL | Sherry Young | 12/27/2022 1:28:55 PM (PST) | Page 3 of 3