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HomeMy WebLinkAboutCOI - Kovatch Mobile Equipment Corp. - Expires 2022-07-01ACo CE F LIABILITY IN URAN E 07/01/2021 �� RTIFICATE 4 S C 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 1-414-443-0000 CONTACT NAME: _ Hays Companies PHONE FAX (A1C,_No, Ext): (A1C, No): _ - E-MAIL 1200 North Mayfair Road, Suite 100 ADDRESS:__ — - INSURER(S) AFFORDING COVERAGE NAIC # Milwaukee, WI 53226 _ INSURER A: GREAT AMER E&S INS CO 37532 INSURED INSURER B : TRAVELERS PROP CAS CO OF AMER 25674 Kovatch Mobile Equipment Corp. INSURERC:AXIS SURPLUS INS CO 26620 One Industrial Complex INSURER D : Mercer Insurance Company INSURER E : Nesquehoning, PA 18240 INSURERF: CnVFRAnFS r_FRTIFIr_ATF NIIMRFR• 62625639 RFVICICINI 10IMRFR• 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PL 3403401-01 07/01/21 07/01/22 EACH OCCURRENCE S 1,000,000 CLAIMS -MADE X . __ OCCUR DAMAGERENTED PREMISESSt �Ea occurrence) S 300,000 MED EXP (Any one person) S _ PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 X POLICY JE� LOC PRODUCTS - COMP/OP AGG S 4,000,000 OTHER: S B AUTOMOBILE LIABILITY TC2J—CAP-9P529106—TIL-21 07/01/21 07/01/22 COMBINED SINGLE LIMIT g 2 000,000 +Ea accident) , X ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY .Per accident) S HIRED NON -OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY tPer accident) S C X UMBRELLA LIAB X OCCUR P-001-000123735-03 07/01/21 07/01/22 EACH OCCURRENCE S 3,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE S 3,000,000 DIED RETENTION S S WORKERB UBSP8079802151R AZ,MA,WI 07/01/21 07/01/22 X STATUTE ERPER H AND AND EMPLOYERS' LIABILITY YERS'LSAILITTION IN YL _ _ B ANYPROPRIETOR,PARTNERIEXECUIIVE UB6P6778892151K AOS 07/01/21 07/01/22 E.L. EACH ACCIDENT S 1,000,000 OFF ICER/MEMBEREXCLUDED? N / A ------ (Mandatory in NH) J E.L. DISEASE - EA EMPLOYEE 000 S 1,000400 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 D Excess Liability 2 20000000174 07/01/21 07/01/22 Limit 2,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95020 Q�) Qom;__ USA .c7 .�'�`"+� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD npielmeier