HomeMy WebLinkAboutCOI - Jim Dias Trucking Inc - Expires 2023-10-10A� V CERTIFICATE OF LIABILITY INSURANCE
DAM0(/3/20 )
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 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
CONTACT
NAME:
PHCN Q Eu. (530) 365-1009 PAX INC,No: 1630I247-7808
Roberson 6 Sons Insurance Services, Inc.
E-MAIL
ADDRESS:
P.O. Box 491719
INSURERS AFFORDING COVERAGE
NAIC 0
INSURER A: Northfield Insurance Cc
27987
Redding CA 96049-1719
INSURED
INSURERB:Hudson Insurance CompanyCompaurly
25054
INSURER C: Travelers Property Casualty Co Of Am
25682
Jim Dias Trucking Inc
INSURERD:
Bidwell Transportation
INSURER E:
690 W llth Ave
INSURERF:
Chico CA 95926
COVERAGES CERTIFICATE NUMBER:2022-10-03 KA - REVISION NUMBER:
THIS IS TO CERTIFYTHATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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
ADDLS
BR
POUCYNUMBER
MMIDDPOLICYIY EFF
YYY)
POLICY UP
IMMIDDrYYYY1
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE ❑X OCCUR
PREMISES Ea occurrancel,
$ 100,000
MED EXP (Any one person)
$ 5,000
WS166394
10/10/2022
10/10/2023
PERSONAL B ADV INJURY
S 1,000,000
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERALAGGREGATE
$ 2,000,000
1L POLICY EPRO-❑LOC
2,000,000ECT
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accitlent
$ 1,000,000
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED X AUTOS SCHEDULED
AUTOS
X
BUI-002773-09
10/10/2022
10/10/2023
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per dent
actl
g 1,000 Ded
HIREDAl1T05 X NON -OWNED
AUTOS
S
UMBRELLA LUIB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LUIB
CLAIMS -MADE
DED
RETENTION S
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
ANY PROPRIETORTARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED? ❑
NIA
E.L. DISEASE -FA EMPLOYEE
$
(Mandatory In NH)
If yes, describe under
nFSr:RIPTInN OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
C
Hotor Truck Cargo
pT-660-de989612-TIL-22
10/10/2022
10/10/2023
Una: $750,000
17
$5,000 Dad
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may ba attached if more apace Is required)
City of Gilroy is named Additional Insured. Additional Insured applies to Auto Liability only.
OCT 14 2022
CERTIFICATE HOLDER UILKU1611 6LtKft0UrrtUt1 CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Gilroy
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7351 Rosana Street
ACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy, CA 95020
AUTHORIZED REPRESENTATIVE
Eric Roberson/KRA
ACORD 25 (2014101)
INS025 (201401)
01988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD