HomeMy WebLinkAboutCOI - Geo M Robinson & Co - Expires 2022-06-01GEOMROB-01 TTAGANAP
CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDNYYY)
5/2612021
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 License i# OC36861
Alliant Insurance Services, Inc.
100 Pine St 11th FI
San Francisco, CA 94111
CONTACT Laurie Phlrlppldls
PHONE FAX
(A/C, No, Ext): (415) 403-1449 (A/C, No):(415) 874-4818
a DR1EsS: 1phirippidis@alliant.com
INSURERS AFFORDING COVERAGE
NAIC t1
INSURER A: Gemini Insurance Company
10833
INSURED
INSURER B: Travelers Property Casualty Company of America
I25674
Geo M Robinson & Co
INSURER C : Allied World Assurance Company (U.S.) Inc
19489
INSURER D : Allied World National Assurance Company 10690
1461 Atteberry Lane
San Jose, CA 95131
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER- RFVISIAN NIIMRFR-
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
SUER
POLICY NUMBER POLICY EFF
POLICY EXPLTR
LIMITS
A
I X !COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
CGP026620
6/1/2021
6/1/2022
EACH OCCURRENCE $ 1,000,000
DAMAGERENTED 60,000
,PREMISESS (Ea occurrence):� $
5,000
MEQ EXP (Any oneperson) $
PERSONAL & ADV INJURY $ 11000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY I " I Pp0 F7 LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMPIOP AGG I_ $ 2,000,000
$
OTHER:
B
AUTOMOBILE LIABILITY
COMaBBIINdEeD SINGLE LIMIT $ 1,000,000
1 BODILY INJURY Perperson) $
X ANY AUTO DT8100N81983A 6/1/2021 l 6/1/2022
OWNED SCHEDULED
AUTOS ONLY AUTOS
X7HIRES X NUTI OPV NED
AUTOS ONLY AUTOS ONLY(Per
BODILY INJURY Per accident S
PROPERTY DAMAGE
accident $
$
C
X
UMBRELLA LIAB
EXCESS LIAB
X I OCCUR
CLAIMS -MADE
103075721 6/1/2021 6/1/2022
EACH OCCURRENCE
$ 10,000,000
_
AGGREGATE
$ 10,000,000
DED I X RETENTION $ 10,000
$
B
WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS' LIABILITY YIN UB5K566988202SG 6/1/2021 6/1/2022 STAT TE R
ANY PROPRIETOR/PARTNER/EXECUTIVE �� 1,000,000
OFFICERIMl MgE R EXCLUDED) " 1 N / A E.L. EACH ACCIDENT $
(Mandatory in NFI) I 1,000,000
I E.L. DISEASE - EA EMPLOYEE $
1 If yes, describe under E.L. DISEASE -POLICY LIMIT $ 1> 000> 000
I DESCRIPTION OF OPERATIONS below
D
Prof/Poll 15K Deduct
0312-3536
6/1/2021
6/1/2022 Limit/Mold Cov Inc'I
5,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Evidence of Insurance
City of Gilroy Building Dept.
7361 Rosanna St.
Gilroy, CA 95020-0000
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
ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD