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HomeMy WebLinkAboutCOI - Crime Scene Cleaners, Inc. - Expires 2021-09-07Pscnu2som ACORD� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09/09/2020 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER LIC #0629370 1-925-682-7001 Edgewood Partners Insurance Center 2300 Contra Costa Blvd Suite 375 Pleasant Hill, CA 94523 CONTACT NAME: Melissa Davis PHONE FAX IA/C No. Ext): 925-852-0436 (A/C, No): 925-852-0486 E-MAILDESS: Melissa.Davis@epicbrokers.com INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: ASPEN SPECIALTY INS CO 10717 INSURED Crime Scene Cleaners, Inc. PO Box 792 Orinda, CA 94563 INSURERB: INFINITY SELECT INS CO 20260 INSURER C NATIONAL UNION FIRE INS CO OF PITTS 19445 INSURERD: STATE COMPENSATION INS FUND 35076 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER: 60175581 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 TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF IMMIDIYYYY) EXP POLICY /Y (MMIDDYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X ER00,72520 09/07/20 09/07/21 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I X I OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 X Per Policy Aggregate: MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 X Unlimited GENERAL AGGREGATE $ 2,000,000 GENL X AGGREGATE POLICY OTHER: LIMIT APPLIES PER: PRO I LOC JECT PRODUCTS - COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE X x LIABILITY ANY AUTO OWNED X X X SCHEDULED AUTOS NON -OWNED AUTOS ONLY Coll Ded: 504610137698001 05/01/20 05/01/21 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLALIAB EXCESS LIAR X O OCCUR CLAIMS -MADE EBU011311181 09/07/20 09/07/21 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2, 000, 000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y N NIA 9070873-20 09/07/20 09/07/21 X PER STATUTE H ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1, 000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Pollution Coverage ER00J2520 09/07/20 09/07/21 Transportation: Contractors: 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Written Contract between parties. Additional Insured(a): The City of Gilroy Applicable Form(s): ASPENV194 0917; ASPENV192 0917; ASPENV254 0917 CERTIFICATE HOLDER CANCELLATION The City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 I USA 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 �� ( q ) � �— v •r^ ^. v��� ACORD 25 (2016/03) BrunyArgo 60175581 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENV 27018 P57e1102s002 Policy No.: ER00J2520 Effective Date: 09/07/2020 Endorsement No.: 2 ASPEN THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following coverages only: Section 1. COMMERCIAL GENERAL LIABILITY AND EMPLOYEE BENEFITS ADMINISTRATION Section 2 GENERAL POLLUTION LIABILITY SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations: Blanket, as required by written contract Blanket, as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section IV. WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 of this endorsement performed for that additional insured and included in the products -completed operations hazard. B. Notwithstanding Section VI. CONDITIONS, paragraph J. Other Insurance, with respect to the insurance afforded to the additional insureds added by this Endorsement, this Policy shall be primary to, and non-contributory with, any other insurance available to that person or organization when required by written contract or agreement. All other terms and conditions of this Policy remain unchanged. ASPENV192 0917 Page 1 of 1 2017 © Aspen Insurance U.S. Services Inc. All rights reserved. ENV 27018