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HomeMy WebLinkAboutCOI - Kent Construction - Expires 2023-12-01ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 11/28/2022 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 Insurance Services LLC CA License CA License No. OG47886 2033 Gateway Place, Suite 150 San Jose CA 95110 CONTACT NAME: Jody Nelson PHONE . 408-418-2742 aC No:408 418-2721 EMAINo L ADDREss: inelson0pentarisk.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Insurance Company 19682 ILarry S. Kent, Inc. NSURED 652 dba: Kent Construction INSURER B: Trumbull Insurance Company 27120 INSURER c: Pacific Insurance Company LTD 10046 INSURER o: Hartford Casualty Insurance Company 29424 8505 Church Street, #12 Gilroy CA 95020 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 111075974E 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 rypE OF ADDL SUER POLICYNUMBER POLICY EFF MM/DID POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY Y 57 LEA QT4351 1212O22 12/1Y2023 EACH OCCURRENCE $2,000,000 CLAIMS -MADE r-k] OCCUR DAMAGE TO RENTED PREMISES Meoccvnencel $300.000 MEG EXP (Any oneperson) $10,000 PERSONAL &ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jECO7 LOC GENERAL AGGREGATE $4,000,000 PRODUCTS-COMP/OP AGO $4.000,000 $ X OTHER: Dad$10000 B AUTOMOBILE LIABILITY 57 UEA 01`9232 12/12022 12/12023 COMBINED SINGLE LIMIT Ea acculem $ BODILY INJURY(Per person) _1000000 $ ANY AUTO ALL OWNED SCHEDULEDBODILY AUTOS AUTOSHIRED 1xx INJURY(Per accident) $ PROPERTY DAMAGE$ AIONN08WNED AUTOS Mx $ comp$1.000 Coll $1,000 D X UMBRELLA LIAB X OCCUR 57 RHA BC12S4 12/12022 12/12023 EACH OCCURRENCE $10.000,000 AGGREGATE $10.000.000 EXCESS LIAR CLAIMS -MADE DEO X RETENTION$ in nno $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY YIN 57 WEA OT7105 12/112022 12/12023 X I PER OM- STATUTE I I ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? MIA E.L. DISEASE - EA EMPLOYEI $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS bel. E.L DISEASE -POLICY LIMIT I $1,000 wo C PollutloNPmfesslonal 57 CPI FN8101 12/12022 12/12023 Poll Condition $2,000,000 Pmflesslonal $3,000,000 T. SIR $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Encroachment Permit The City of Gilmy, its officers, officials, employees and volunteers are added as additional insureds as required by Written Contract, agreement or permit for General Liability, per attached. CERTIFICATE HOLDER CANCELLATION I n1I 91HO V MT) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Gilroy DECO 1 2D22 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Stree AUTHORIZED REPRESENTATIVE ri. Gilroy CA 95020 GILROYMY CLERICS OFFICE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Larry S. Kent, Inc. D.B.A. Kent Construction 12-01-2022 to 12-01-2023 1 57UEAQT4351 POLICY NUMBER: 57 UEA QT4351 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations The City of Gilroy its elected and appointed City of Gilroy Project No. 18-PW-244 officers, officials, employees and volunteers Christopher High School Aquatic Center Shade Structure Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. 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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 Larry S. Kent, Inc. D.B.A. Kent Construction. 12-01-2022 to 12-01-2023 1 57UEAQT4351 POLICY NUMBER: 57 UEA QT4351 COMMERCIAL GENERAL LIABILITY CG20100413 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations The City of Gilroy its elected and appointed City of Gilroy Project No. 18-PW-244 officers, officials, employees and volunteers Christopher High School Aquatic Center Shade Structure Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury' "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. 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. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413