HomeMy WebLinkAboutCOI - Sebring Transport, Inc. - Expires 2024-03-01^ciic Rh® CERTIFICATE OF LIABILITY INSURANCE
DA4/19//2202�'
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
Noble West Insurance Services License #OB10706
205 Natoma Street
Folsom CA 95630
CONTACT
NA
PHONE FAX
916-355.1300 I= Na:916-355-1306
ADDRESS:
PRODUCER
CUSTOMER to
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
Sebring Transport, Inc.
2100 Carden Street
INSURER A: Great West Casualty Co.
11371
INSURER B: Travelers Insurance Group
25682
INSURER C : Great American Ins Cc
16691
San Leandro CA 94577
INSURER D : Crum & Forster Specialty
44520
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 66183918 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
AMBUBR
POLICY NUMBER
MWD�/YYYP
MMD�/YYXYP
OMB
A
GENERAL LIABILITY
X COMMERCIAL GENERALUABILnY
CLAIMS -MADE Fx_] OCCUR
Y
GWP597400
3112023
3/12024
EACH OCCURRENCE
$1.000000
OAMA O RENTE
PREMISES Ea occurrence
$100,000
MED EXP (Any oneperson)
$5000
PERSONAL B ADV INJURY
$1000000
GENERAL AGGREGATE
$2D00000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES PER:
X PRO- LOC
JECT
PRODUCTS-COMP/OP AGG
$2000,G00
$
A
AUTOMOBILE
LIABILRY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Y
GWP597400
3112023
3112024
COMBINED SINGLE LIMIT
(Ea accident)
$10000m
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
X
X
$
D
UMBRELLA LIAR
EXCESS LAB
X
OCCUR
CLAIMS -MADE
SE0122864
3112023
31IM024
EACH OCCURRENCE
$1,000000
X
AGGREGATE
$1,000000
DEDUCTIBLE
RETENTION $
S
$
C
WORKERS COMPENSATION
AND EMPLOYER$' LIABILITY Y/N
ANYPROPRIETORIPARTNER/EXECUTIVE❑
OFFICER/MEMBER EXCLUDE07
(Mandatory In NH)
If yes, describe undo,
DESCRIPTION OF OPERATIONS below
N/A
VJC4671971
1/182023
1/182024
X WCSTATIU OTH-
-
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE -EA EMPLOYE
$1000000
El. DISEASE -POLICY LIMIT
$r.
B
A
A
Cargo
Bolles (Non -Owned Trailer
Physical Damage
QT6602L1B1464TIL23
GVJP597400
GWP597400
4202023
3/112023
3/112023
4202024
3/1/2024
3112024
$250,000 $2,500 Ded.
$75,000 $1,000 Detl.
$2.500 Detl.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
Evidence of Insurance.
Certificate holder is additional insured with regards to the auto and general liability coverage.
I n{I g(_ LgUNWMDD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL
ENDEAVOR TO MAIL <DAYS> DAYS WRITTEN NOTICE TO THE
APR 2 4 2023
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO
City of Gilroy Public Works De
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
7351 Rosanna Street
Gilroy CA95020
GILROY CITY CLERK'S OFFICE
AUTHORIZED REPRESENTATIVE
USA
I
01988-2009 ACORD CORPORATION. All Hants reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD