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HomeMy WebLinkAboutCOI - Greyhound Lines, Inc. - Expires 2020-04-01_____, ® �' o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12l19/2019 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 Aon Risk Services Northeast, Inc. c/o Aon client Services 4 Overlook Point Lincolnshire IL 60069 USA CONTACT PHONE FAX (A/C. No. Ext): (866) 283-7122 (A/C. No.): (S00) 363-0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Greyhound Lines , Inc . 350 N Saint Paul St Dallas TX 75201 USA INSURER A: Commerce & Industry Ins Co 19410 INSURER B: National Union Fire Ins Co of Pittsburgh 19445 INSURER C: New Hampshire Insurance Company 23841 INSURER D: Ameri can Home Assurance Co. 19380 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570079669415 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY1 POLICY EXP SMM/DDIvvvv) LIMITS B X COMMERCIAL GENERAL LIABILITY GL3629887 12/31/2018 04/0-1[2020 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $5,000,000 MED EXP (Any one person) Excl uded If this is longer PERSONAL & ADV INJURY $5,000,000 GEN'L ITAPPLIES PER: AGGREGATE LIMO- certificate no required, write "Delete" the front by fax to GENERAL AGGREGATE $10,000,000 X POLICY JECT LOC across and return (800) 363-0105 or email to acs.chicago@aon.com PRODUCTS -COMP/OP AGG $5,000,000 -- OTHER: B AUTOMOBILE LIABILITY CA 192-17-94 12/31/2018 04/01/2020 COMBINED SINGLE LIMIT (Ea accident) $5,000,000 B X ANY AUTO AOS CA 192-17-96 12/31/2018 04/01/2020 BODILY INJURY ( Per person) OWNED S SCHEDULED VA BODILY INJURY (Per accident) B - AUTOS ONLY HIRED AUTOS AUTOS NON -OWNED AUTOS ONLY CA 192-17-95 MA 12/31/2018 04/01/2020 PROPERTYDAMAGE (Per accident) - ONLY _ A X UMBRELLA LIAB X OCCUR- 28295050 12/31/2018 04/01/2020 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS MADE AGGREGATE $10,000,000 DED X RETENTIONS 5 , 000 , 000 f1 O G Q Q L WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC014649556 12/31/2019 04/01/2020 x PER STATUTE 0TTH- ER ANY PROPRIETOR / PARTNER / EXECUTIVE YIN N N/A wC014649552 wC014649553 12/31/2019 12/31/2019 04/01/2020 04/01/2020 E.L. EACH ACCIDENT $5,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) WC014649554 12/31/2019 04/01/2020 E.L. DISEASE -EA EMPLOYEE $5,000,000 If yes, under DESCRIPTION OF OPERATIONS below WC014649555 12/31/2019 04/01/2020 E.L. DISEASE -POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Gilroy, its officers, representatives, agents and employees are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION Holder Identifier : city of Gilroy 7351 Rosanna Street Gilroy CA 95020 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. smiS ft-J AUTHORIZED REPRESENTATIVE tsZa. MveY'etvayed cArtezwoe ffee, or ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . JO. First w- <<America 600 Vine Street Suite 1400 Cincinnati, OH 45202 Tel: 513 241 2200 Fax: 513 381 0149 Auto ID Cards and Certificates of Insurance Issuance for January 1 and April 1 The insurance department is changing the dates of our major insurance policies from a calendar year policy (12/31/18-19) to a fiscal year policy (4/1/20-21). This is being done to assist in the annual budgeting process and to insure historical loss payments are properly aligned to the proper fiscal year. We will be moving our annual issuance of auto ID cards and certificates of insurance from December to March. However, in order to make the transition, we will have to issue documents in December to cover the three-month transition period and then again in March which will become our new annual document renewal date. Aon will issue certificates of insurance and Auto ID cards in December per our usual process, but they will only provide evidence of coverage through 3/31/20. We will then reissue certificates of insurance and Auto ID cards in March, which will provide evidence of coverage for the 4/1/20-3/31/21 period. Thereafter, all certificates and Auto ID cards will be issued in March on an annual basis. We apologize for any inconvenience this may cause. If this change will cause any issues with existing contracts, please let Paul Smith (paulw.smith@firstgroup.com) know as soon as possible and we will work to address your concerns. As a reminder, we have switched brokers from AJG to Aon, so Tanya Stephenson is no longer your broker point of contact. The new point of contact is Alex Workman (alex.workman@aon.com) at Aon. www.firstgroupamerica.com