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HomeMy WebLinkAboutCOI - Ross Recreation Equipment Company, Inc. - Expires 2021-10-01ROSSREC-01 SRSPATRA4 A 'ORO CERTIFICATE OF LIABILITY INSURE DATE(MMfDDNYYY) ANC10/7/2020 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 CONTACT Kim Christensen NAME: ProCo Insurance Services PHONE f FAX 910 E Hamilton Ave (A/C, No, Ext): (408) 510-5487 (A/C, No): - #410 E-MAIL kihitn m.csenseroco. lob _ADDRESS: - �p al � -- -- - - Campbell, CA 95008 INSURER(S) AFFORDING COVERAGE NAIC t!_ _ INSURER A: Associated Industries Insurance Company, Inc. 23140 INSURED INSURER B : General Casualty Company of Wisconsin _--_24414 Ross Recreation Equipment Company, Inc. _INSURER C :Oak_ River Insurance _ Company - �34630-_ 100 Brush Creek Road, Ste 206 INSURER D : Santa Rosa, CA 95404 - - - - - INSURER E INSURER F : r_nVFRAnPA (_FRTIFIr_ATG Aa11MRF12• DC\/ICInAI All IMCICD- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY ELTR XP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ __- 1,000,000 CLAIMS -MADE X OCCUR AES102952402 10/1/2020 10/1/2021 X DAMAGE TO RENTED PREMISES (Ea occurrence) S_ 50,000 - - _ MED_EXP (Anyone person) _ _ S - __ _ 1,000,000 PERSONAL B ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY X jPCT LOC _S PRODUCTS - COMP/OP AGG S - 2,000,000 OTHER: S B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident). - _- - . $ - 1,000,000 X ANY AUTO BCA000407000 10/1/2020 10/1 /2021 BODILY INJURY (Per person) _ S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident).-S- HIRD NON -OWNED AU S ONLY AUTOS ONLY PROPERTY DAMAGE _(Per accident) S * S A UMBRELLA LIAR X OCCUR . EACH OCCURRENCE_ , 5_ ___ 2,000,000 _ X EXCESS LIAB CLAIMS -MADE EXA105529402 10/112020 10/1/2021 -- .AGGREGATE -- - -DED -_ $ 2,000,000 X RETENTION $ O`- , $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PR STATUTE _ ERH _ ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N ROWC123733 10/1/2020 10/1/2021 E.L. EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) - _ _ 1,000,000 If yes, describe under E.L. DISEASE - EA EMPLOYEE S 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S Q DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) Re: Service Agreement: Fire Department Personnel Testing. City of Gilroy, its officers, officials and employees are named as an additional Insured on General Liability policy per the attached endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, City of Gilroy ACCORDANCE WITH THE POLICY ROVISIONSCE WILL BE DELIVERED IN. Its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE N �w ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AES102952402 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) I Location(s) Of Covered Oaerations All persons or organizations where required by contract with the Named Insured I 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 L 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 Page 2 of 2 2. Available under the applicable Limits Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. © Insurance Services Office, Inc., 2012 of the the CG20100413 N CO w U 0 �v U) it LLI U W UQo Q z m O U Z�J O=m w O drnU T U) w w } 0 J a w 0 z Q CO LL Q U � LL p0¢o z� O U�U LL LL O } OOQ�p H U) J_ U t�C7 O.v • 91, 9 1L a