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Home My WebLink AboutCOI - Sedgwick LP and Subsidiaries - Expires 2022-09-30ACORHDATE �. CERTIFICATE OF LIABILITY INSURANCE (MM/DDIYYYY) 09/24/2021 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. 6410 Poplar Ave Suite 540 Memphis, TN 38119 CONTACT Karen Angus PHONE (901) 684-3725 AM No IAc. E-MAIL us k.an marsh.com ADDRESS: k.angus@marsh.com AFFORDING COVERAGE NAIC # INSURER A . Hardord Fire Insurance Co 19682 CNIO1395638-GAWU-21-22 INSURED Sedgwick LP and Subsidiaries INSURER B : Hartford Underwriters Insurance Company 30104 INSURER C : Twin City Fire Insurance Co 29459 8125 Sedgwick Way Memphis, TN 38125 INSURER D : Everest National Insurance Co 10120 INSURER E : Hartford Insurance Company of the Midwest 37478 INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-005079443-06 REVISION NUMBER: 0 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 SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 20CSEC75302 09130/2021 09130/2022 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 2,000,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 2,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A B AUTOMOBILE LIABIuTY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 20CSEC75305 (ADS) 20CSEC75307 (HI) 09/30/2021 09/30/2021 09/30/2022 09/30/2022 Ea COMBINEDce�iiSINGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XC5C000153211 09/30/2021 09/30/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED 7 RETENTION $10,000 $ A C E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 20WNC75300 (AOS) 20WBRC75301 ( ) MA, Wi, PR 20 WN C75308 (AK, ID, MT, MN) 09/30/2021 09/3012021 09/30/2022 09/30/2022 09/30/2022 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 I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) THE CITY OF GILROY IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION CITY OF GILROY 7351 ROSANNA STREET GILROY, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 7-t„19'P4 42•ac. 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD W - 77 '] k�L