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HomeMy WebLinkAboutCOI - Golden State Utility Co. - Expires 2024-01-31ACORO® CERTIFICATE OF LIABILITY INSURANCE °01127/2g23°"Y"' 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 "Marsh USA, Inc. Tyro Alliance Center CONTACT NAME: PHONE ac NO. E-MAIL ADDRESS: 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURERS AFFORDING COVERAGE NAIC0 INSURER A: Liberty Mutual Fire Insurance Company 23035 CN102986923-GAWU-23-24 INSURED Golden Slate Utility Co. INSURER B : LM Insurance Corporafian 33600 INSURER C: WA WA 8766 FIuieidge Road Sacramento, CA 95826 INSURER D: Liberty Insurance Corporation 42404 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-004679490-21 REVISION NUMBER: 2 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. ILTR TYPE OF INSURANCE ADDL B POUCYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERA, LIABILITY CLAIMS -MADE OOCCUR TB2-631-510825-233 0113112023 01/31/2024 EACH OCCURRENCE $ 5,000.000 DANOUE TO RENTED PREMISES Ea oeamenci $ 1,000,000 MED EAR (Any onePerson) $ PERSONAL a ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY[fl JECT LOC OTHER: GENERAL AGGREGATE $ 10,000.000 PRODUCTS-COMPIOP AGG $ 10,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY AS2-631-004260-023 01/31/2023 01/31/2024 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ BODILY INJURY( Per accident) $ X PROPERTYDAMAGE Per aetitlent $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B B D WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEM HER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WA5$3D-004260-033 (ADS) WC5-631-0042"3(MN,WI) WA7-63D-510689-513 (MA) 01/3112023 01I3112023 011312 01/3112024 01I31I2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1006,00 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 E.L. DISEASE -POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addi°onal Remarks Schedule, may be attached If more apace Is required) City of Gilroy, its Agents, Officers, Officials, Employees & Volunteers is/are included as additional insured where required by written contract with respect to general liability and auto liability. City of Gilroy SHOULD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE its Agents, Officers, Officials, Employees 8 o un V11 LASS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 FEB - 9 2023 AUTHORIZED REPRESENTATIVE GILROYCR CEEWS OFFICE ©1988-2016 ACORD CORPORATION. All rights reserve) ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD m 3 0 m CD UN 90 C 0 NOTICE OF CANCELLATION STATE OF CALIFORNIA 0 Liberty Mutual. INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 12/04/2020 Date of Notice: 11/19/2020 Policy No.: BZS58160351 Issued at: DOVER, NH Agent No: 4294152 Agent: TELEPHONE (408) 847-1000 Account of: PACIFIC COAST BENEFITS INSURAN ARTICULATE SOLUTIONS, INC. CE SERVICES LLC 7365 MONTEREY ST 2ND FL 7600 MONTEREY ST STE 140 GILROY, CA 95020 GILROY, CA 95020-5264 Notice Issued To: THE CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 NOTICE TO: ADDITIONAL INTEREST Line of Business: BUSINESS OWNERS Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline. libertymutual.com You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 00154 BZS58160351 11190050 000316 GCXCPCN Page 1 NOTICE OF CANCELLATION STATE OF CALIFORNIA Liberty Mutual. INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 02/07/2021 Date of Notice: 01/19/2021 Policy No.: BZS58160351 Issued at: DOVER, NH Agent No: 4294152 Agent: TELEPHONE (408) 847-1000 Account of: PACIFIC COAST BENEFITS INSURAN ARTICULATE SOLUTIONS, INC. CE SERVICES LLC 7365 MONTEREY ST 2ND FL 7600 MONTEREY ST STE 140 GILROY, CA 95020 GILROY, CA 95020-5264 Notice Issued To: THE CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 NOTICE TO: ADDITIONAL INTEREST Line of Business: BUSINESS OWNERS Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 00604 BZS58160351 01190121 001257 GCXCPCN Page 1 10. Li bei-ty Mutual. INSURANCE NOTICE OF REINSTATEMENT Policy number BZS58160351 is reinstated without any lapse in coverage for the period of 06/1112020 - 0611112021. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4294152 Agent: TELEPHONE (408) 847-1000 PACIFIC COAST BENEFITS INSURAN CE SERVICES LLC 7600 MONTEREY ST STE 140 GILROY, CA 95020-5264 Notice Mailed To: THE CITY OF GILROY 7351 ROSANNA ST GILROY. CA 95020 Date of Notice: 12/02/2020 Policy Number: BZS58160351 Account of: ARTICULATE SOLUTIONS, INC. 7365 MONTEREY ST 2ND FL GILROY, CA 95020 Coverage Provided By: OHIO SECURITY INSURANCE COMPANY Policy Period: 06/11/2020 - 06/11/2021 Account Number: 902259530 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com Info Copy REINS 01215 BZS58160351 12020418 002633 ZCXCPEN Page 1