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HomeMy WebLinkAboutCOI - Coombs-Hopkins Company & DC Frost Associates - Expires 2022-11-01CERTIFICATE OF LIABILITY INSURANCE i�•..-�'' DATE(MMIDDIYYYY) 10/03/2021 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 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 5-1141078 The Hartford Business Service Center NAME: PHONE (866) 467-8730 (A(C, No. Ext): FAX (888) 443-6112 (AIC, No): 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICII INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 COOMBS-HOPKINS COMPANY & DC FROST ASSOCIATES INSURER B : Hartford Fire and Its P&C Affiliates 00914 2011 PALOMAR AIRPORT RD STE 303 CARLSBAD CA 92011-1432 INSURER C : INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NIIMRFR- Qs:utclnu Nl INM=Q- 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIY YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2.000.000 CLAIMS -MADE OCCUR General Liability X DAMAGE TO RENTED PREMISES a occurrence)$1'o0a'a00 MED EXP (Any one person) $10.000 A X 57 SBA BNO942 11/01/2021 11/01/2022 PERSONAL a ADV INJURY $Z 000 000 GEN'LAGGREGATE LIMIT APPLIES PER; POLICY PRO- ❑ LOC GENERAL AGGREGATE $4.000,000 PRODUCTS - COMPIOP AGG Excluded OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$2,000,000 BODILY INJURY (Per person) ANY AUTO A ALLOWNED SCHEDULED AUTOS AUTOS 57 SBA BNO942 11/01/2021 11/01/2022 BODILY INJURY Per accident) HIRED NON -OWNED X AUTOS X AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIA13 X OCCUR EACH OCCURRENCE $1.000.000 A EXCESS LIAR CLAIMS- MADE 57 SBA BNO942 11/a1/20Z1 11/01/2022 AGGREGATE $1.000.000 DED1 X I RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER STATUTE OTH- ER B ANY YIN PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA 57 WEC GB3401 11/01/2021 11/01/2022 E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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. or,11,'r1I:J0W,%rr.Ia City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Attn: City Clerk BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 7351 ROSANNA ST IN ACCORDANCE WITH THE POLICY PROVISIONS_ GILROY CA 95020-6141 AUTHORIZED REPRESENTATIVE et ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD