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HomeMy WebLinkAboutCOI - EPC Computer Solutions - Expires 2021-10-01EPCCO-1 OP ID: TT2 4 RL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY} o9r24rzo2a 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 San Jose Insurance Agency Inc. Atlantic -Pacific Ins. Brokers 2542 S. Bascom Ave #280 Campbell, CA 95008 San Jose Insurance Agency CONTACT Tina Tremain X340 NAME: SAHC No, Ext):408-371-3700 FAX No): E-MAIL tina@sanjoseins.com ADDRESS: san J INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hanover insurance Company 22292 INSURED EPC Computer Solutions, 1324 El Camino Real Belmont, CA 94002 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: • THIS IS TO CERTIFY THAT THE POLICIES INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR LTR TYPE OF INSURANCE • DDL INSR SUBR WVD POLICY NUMBER POLICY EFF • IMMlDDlYYW) POLICY EXP (MMIDD/YYW) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X 970188607 10/01/2020 10/01/2021 EACH OCCURRENCE $ 2,000,000 DAMAGE PREMISES Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENT. AGGREGATE LIMIT APPLIES PER: LOC PRODUCTS - COMP/OP AGG S 4,000,000 $ A AUTOMOBILE ri LIABILITY ANY AUTOALL QED I SCHEDULED AWFD39174603 10/04/2020 10/04/2021 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y, N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N 1 A WC STATU- TORY LIMITS IOTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional E&O • LHFH364494 10/01/2020 10/01/2021 PEO 1,000,000 Ded 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is named as additional insured with respects to the insured operations HOLDER CANCELLATION CITYGIL City of Gilroy, its officers, officials and employees 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 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hanover Insurance Group.. OHF 9701886 5701132 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 CITY OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYEES 7351 ROSANNA ST GILROY, CA 95020 (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 I1 - LIABILITY: A. The following is added to SECTION 11 - 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 Tess. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. 391-1602 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 MARKEL INSURANCE COMPANY 222 S. 15TH ST., SUITE 1500N OMAHA NE 68102-1680 REINSTATEMENT NOTICE Named Insured & Mailing Address: Producer: 4970 ADVANTAGE PEAK, LLC 140 5TH ST GILROY CA 95020 WESTERN VALLEY INS ASSOC, INC. - LOS BANOS 810 WEST K STREET LOS BANOS CA 93635 Policy No.: BOM0020019-01 Type of Policy: BOP You recently received a notice advising this policy was being cancelled effective 10/11 /2020 . This notice is to advise that the policy is being reinstated without lapse in coverage. Additional Insured CITY OF GILROY 7351 ROSANNA STREET GILROY CA 95020 Date Mailed: 2 rd d y of September, 20 1< JOHN K. CLARK FORM# CT969897CA51995 ODEN 3.0.20.08a Copy for Additional Insured CACT19 09232020SINY Page 1 of 1