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Home My WebLink AboutCOI - Greyhound Lines, Inc. - Expires 2022-04-01CERTIFICATE OF LIABILITY INSURANCE rATE(MM/DDNYYY) o/2s/2o2, 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 Aon Risk Services Northeast, Inc. Cincinnati OH Office CONTACT NAME' PHONE (A/C. No. Ext): (866) 283-7122 aC No.):(800) 363-0105 8044 Montgomery Road Suite 405 E-MAIL ADDRESS: Cincinnati OH 4S236-2919 USA INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE Property & Casualty insurance Co. 20699 Greyhound Lines, Inc. 350 N St Paul Street Dallas TX 75201 USA INSURER B: National union Fire Ins Co of Pittsburgh 19445 INSURER C: AIU insurance Company 19399 INSURER D: INSURER E: INSURER F: GUVtHAULb GEHIIFIGATE NUMBER: 9/U09UUbU119 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. Limits shown are as requested LTRINSR TYPE OF INSURANCE INTO VYVO POLICY NUMBER MM/DD/YYY MM/DD/YY LIMITS X COMMERCIAL GENERAL LIABILITY 6547201 EACH OCCURRENCE $10, 000, 000 CLAIMS MADE Q OCCUR PREMISES Ea occurrence $ 5 , 000 , 000 IVIED EXP (Any one person) PERSONAL & ADV INJURY $10, 000, 000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10, 000, 000 X POLICY ❑ PRO LOC JECT PRODUCTS- COMP/OP AGG $10,000,000 OTHER: B AUTOMOBILE LIABILITY 7031017 AOs 10/21/2021 04/01/2022 COMBINED SINGLE LIMIT aaccident)$10,000,000 BODILY INJURY ( Per person) B X ANYAUTO 7031018 10/21/2021 04/01/2022 B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY VA 7031019 MA 10/21/2021 04/01/2022 BODILY INJURY (Por accident) PROPERTY DAMAGE Per accident A X UMBRELLA LIAB EXCESS LIAB H OCCUR CLAIMS -MADE XEUG72512832001 SIR applies per policy terms 04 01 2021 & conditions 04/01/2022 EACH OCCURRENCE $5 , 000, 000 AGGREGATE S5,000,000 DED X RETENTION C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) It as. describe under DESCRIPTION OF OPERATIONS below N/A wC 58 5824 ADS WC65885825 NY 1012112021 10/21/2021 04/01/2022 04/01/2022 X PER STATUTE I OTH. ER E.L. EACH ACCIDENT $ 3 , 000 , 000 E.L. DISEASE -EA EMPLOYEE S3,000,000 E.L. DISEASE -POLICY LIMIT $ 3 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Gilroy, its officers, representatives, agents and employees are included as Additional Insured in accordance with the policy, provisions of the General Liability and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. gv;� City Of Gi1roy AUTHORIZED REPRESENTATIVE 7351 Rosanna street Gilroy CA 95020 USA d 0 0 CD 0 0 r. u7 ti- a kn 04 S 0 N ti 0 w 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 57000008849S LOC #: A ADDITIONAL REMARKS SCHEDULE LE U Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Greyhound tines, Inc. POLICY NUMBER see certificate Number: 570090068119 CARRIER See Certificate Number: 570090068119 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. WSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE. DATE (NINI/DD/YYYY) POLICY EXPIRATION DATE (MNI/DD/YYYY) LIMITS WORKERS COMPENSATION C N/A WC65885826 CA 10/21/2021 04/01/2022 ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD