HomeMy WebLinkAboutCOI - Ericsson Inc. - Expires 2022-11-01AC(7R" CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
11/01/2021
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.
4400 Comerica Bank Tower
CONTACT
NAME:
PHONE FAX No):
E-MAIL
ADDRESS:
1717 Main Street
Dallas, TX 75201-7357
Attn: dallas.certs@marM.com 212-948-0519/866-966-4664
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: ACE American Insurance Company
22667
CN101764695-GAWU-21-22
INSURED Ericsson Inc.
INSURER B : ACE Property & Casualty Insurance Company
20699
INSURER C : ACE Fire Underwriters Insurance Company
20702
Attn: Timothy Shires
INSURER D : Indemnity Insurance Company of North America
43575
6300 Legacy Drive
Plano, TX 75024
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: HOU-003536650-10 REVISION NUMBER: 1
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
ADD
I=
UBR
Jana
POLICY NUMBER
MM/DDYIYYYY
POLICY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IT I OCCUR
HDO G72484964
11/01/2021
11/01/2022
EACH OCCURRENCE
$ 2,000,000
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY1:1 PRO LOC
JECT
OTHER:
GENERAL AGGREGATE
$ 4,000,000
X
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
ISA H25546246
11/01/2021
11/0112022
COCa aBINEDtSINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
XEU G27975422 007
11/01/2021
11/01/2022
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DED I RETENTION $
$
D
C
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? a
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WLR C68924820
(AOS Except AZCAMA & WI)
, ,
SCF C68924789 I
WLR C68924741 (AZ, CA, MA)
11/01/2021
11/01/2021
11/01/2022
11/0112022
11/01/2022
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1.000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
CERTIFICATE HOLDER CANCELLATION
City of Gilroy
7351 Rosanna St.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Gilroy, CA 95020
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Zt.19'plo 47"-C.
01988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD