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HomeMy WebLinkAboutCOI - Coombs-Hopkins Company & DC Frost Associates - Expires 2023-11-01.aco CERTIFICATE OF LIABILITY INSURANCE °A10103r O22 10/032022 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 SUBROGATIONIS 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 PROFESSIONAL INS ASSOC INC/PHS 57141078 The Hartford Business Service Center NAME, PHONE (866)467-8730 (Are' No. Ear) FAX (AIC. N.Y. 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICS INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 COOMBS-HOPKINS COMPANY & DC FROST ASSOCIATES INSURERS : Hartford Fire and Its P&C Affiliates 00914 2011 PALOMAR AIRPORT RD STE 303 INSURERC: CARLSBAD CA 92011-1432 INSURER D INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER: 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.NOTWRHSTANDING 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 TYPEOFINSURANCE ADDL INSR BUHR WVD POUCYNUMBER POLICY EFF MIUDO POLICY EXP MMIDD/YYYY UNITS COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $2,000,000 CLAIMSWADE OCCUR DAMAGETORENTED PREMISES a¢ummce $1,000,000 X General LabilF `l MED EXP(Arq. one Person) $10.000 A X 57 SBA BNO942 11/01/2022 11/01/2023 PERSONAL a ADV INJURY $2,000.000 GEN'L AGGREGATE UMIT APPLIES PER: GENERALAGGREGATE $4,000.000 POLICY E]PR ❑ LOC PRODUCTS-COMP/OPAGG Excluded OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2000000 (EaAwklm, BODILY INJURY (Per person) ANY AUTO A ALLOWNED SCHEDULED OS AUTOS AUT 57 SBA BNO942 11/01/2022 11/01/2023 BODILY INJURY (Per accident) X HIRED NON -OWNED AUTOS X AUTOS PROPERTY DAMAGE (Par acadent) UMBRELLA LIAS OCCUR EACH OCCURRENCE $1.000.065 A EXCESS LWB CLAIMS - MADE 57 SBA BNO942 11/01/2022 11/01/2023 I AGGREGATE $1.000,000 ED X RETENTION$ 10,000 WORKERSCOMPENSATI°N AND EMPLOYERS' UABIUTY X PER OTH- EL EACH ACCIDENT $1,000,000 B ANY YM PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?EL NIA 57 WEC GB3401 11/01/2022 11/01/2023 DISEASE -FA EMPLOYEE $1,000.000 (Mandatory in NH) Iryes,desaibaunder ELDISEASE-POLICYUMIT $1,000,000 DESCW PTION OF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this Policy. CERTIFICATE HOLDER CANCELLATION City Of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Attn: City Clerk 0 C T 12 2022 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 7351 ROSANNA ST IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR17FD REPRESENTATIVE GILROY CA 95020-6141 GILROY CITY CLERICS OFFICE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD N m—