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HomeMy WebLinkAboutCOI - Summit Crane Company of Solano, Inc - Expires 2022-10-07Aeb CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 9/30/2021 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 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 NAME: Jeff Hardwick PHONEo FAX aic No ; (503) 941-8018 Emery & Karrigan Inc. 9880 SW Beaverton Hillsdale HWY E-MAIL certs@emerykarrigan.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Suite 202 INSURERA:United Specialty Insurance Company 12537 Beaverton OR 97005 INSURED INSURER B: National Interstate Insurance 32620 INSURER C: Scottsdale Insurance Company 41297 Summit Crane Company of Solano, Inc INSURER D : Summit Crane; AAA Crane Services LLC INSURER E PO BOX 6714 INSURER F : Vacaville CA 95696 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. 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 SUER POLICY NUMBER POLICY EFF MMIDDIYYYY). POLICY EXP IMMIDDfYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE T -RENTED PREMISES PREMISES Ea occurrence S X MED EXP (Any one person) $ 5,000 Hook Liability X DLJ-GL-00000016-01 10/7/2021 30/7/2022 X Over the Road PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE HOTHER: LIMIT APPLIES PER POLICY PRO ❑ LOC JECT GENERAL AGGREGATE S 2,000,000 MOBILE EQUIPMENT *Capped at $5,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 Employee Benefits S 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 BODILY INJURY (Per person) S B ANYAUTO ALL OWNED X SCHEDULED AUTOS AUTOS CRA 5500045-04 30/7/2021 10/7/2022 BODILY INJURY (Per accident) S X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident)S S UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ S X DLJ-EX-00000187-01 10/7/2021 10/7/2022 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � NIA PER OTH- STATUTE ER E.L EACH ACCIDENT S E.L DISEASE - EA EMPLOYEE S (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT S C Excess Auto Liability XLS0121007 10/7/2021 10/7/2022 Limit $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City Of Gilroy is named as additional insured when required by written contract per the attached endorsement. Excess policy is follow form over the General and Employer Liability policies, including Hook Liability. 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 ick Emery/AAP � L_ ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: DU-GL-00000016-01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - ONGOING OPERATIONS OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION 11— WHO IS AN INSURED is amended to include as an additional insured any person or organization that the Named Insured has agreed to name as an Additional Insured on its policy. However, such additional insured status shall be granted only if such agreement was evidenced "in writing" or by a written contract executed by the Named Insured before the "occurrence" took place. Furthermore, the conditions triggering such additional insured status are governed as follows: A. Such person or organization is an Additional Insured only with respect to liability for "bodily injury" or "property damage" that is directly caused by the Named Insured's performance of "ongoing operations" for at least one of the Additional Insureds. B. However, where the Named Insured has agreed in a written contract to specific editions of ISO additional insured endorsements or to specific language as delineated in those ISO additional insured endorsements, Paragraph A above is deleted and replaced with either paragraph B.1 or 13.2 below. 1. Caused in Whole or in Part — Where the Named Insured is required by a written contract to make a person or organization an Additional Insured using the language from ISO Additional Insured forms CG2033 or CG2010 with edition dates of July 2004 (07/04), or April 2013 (04/13) such person or organization is an Additional Insured only with respect to liability for "bodily injury" or "property damage" that is caused in whole or in part by the Named Insured's performance of "ongoing operations" for at least one of the Additional Insureds. - OR 2. Arising Out Of — Where the Named Insured is required by a written contract to make a person or organization an Additional Insured using the language from ISO Additional Insured forms CG2033 or CG2010 with edition dates of 2001, 1993 or 1985, such person or organization is an Additional Insured only with respect to liability for "bodily injury" or "property damage" arising out of the Named Insured's performance of "ongoing operations" for at least one of the Additional Insureds. C Additionally: 1. The insurance afforded to any Additional Insured only apples to the extent permitted by law; and 2. If coverage provided to the Additional Insured is required by contract or agreement an in writing, the insurance afforded to such additional insured will not be broader than that which the Named Insured is required by the contract or agreement to provide for such Additional Insured. Exclusions With respect to the insurance afforded to the Additional Insureds: A. This endorsement does not eliminate any other exclusions in this policy or the CG0001 (10/01) policy form. B. This Additional insured Endorsement does not apply to: 1. Any damages arising from the "products completed operations hazard"; 2. "Bodily injury" or "Property damage" arising out of the rendering of or GLM 2033 03 15 Page 1 of 2 Policy Number: DU-GL-00000016-01 failure to render any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, filed orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural, or engineering activities; 3. "Bodily injury" or "property damage" occurring after: a. All the work on the project to be performed by Named Insured on behalf of the Additional Insured has been completed; or b. That portion of the work performed by he Named Insured, out of which the injury or damage arises, has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project; or c. The Named Insured completes delivery, and/or assembly of equipment at the project site pursuant to the terms of the bare lease agreement; or d. The Named Insured;s equipment has been assembled at the project site, if the work to be performed by the Named Insured on behalf of the Additional Insured is limited to the rental of equipment that must be set up or assembled at the project site. This exclusion does not apply to liability caused by the Named Insured's acts or omissions during the disassembly or the equipment. Definitions As used in this Endorsement, the following definitions apply: A. "Ongoing operations" shall mean that period of time in which any insured is actively performing work or operations on a project or in preparation for work on a project. That period of time commences when the insured actively begins work to fulfill its contractual obligations, and ends when their contractual obligations have been fulfilled. ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. On File Authorized Representative Includes copyrighted material of Insurance Services Office, Inc., GLM 2033 03 15 with its permission. Page 2 of 2