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HomeMy WebLinkAboutCOI - E-3 Systems - Expires 2023-02-01ACCPR ®P CERTIFICATE OF LIABILITY INSURANCE 1DATE /31/2022YY) 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 NTACT NAME: Cynthia Austin Mt. Diablo Insurance Brokers, Inc. PHONE (925)297-4070 FAX A/C NO; (925)297-4074 3557 Mt. Diablo Boulevard ADDRESS: certificatedesk@mtdiabloinsurance.com Suite 21 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Massachusetts Bay Insurance Co 22306 Lafayette CA 94549 INSURED INSURER B: Allmerica Financial Benefits 41840 INSURER C : INSURER D : E-3 Systems INSURERE: 1220 Whipple Road INSURERF: Union City CA 94587 COVERAGES CERTIFICATE NUMBER:2022 A/L 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY DAMAX RENTED PREMISES Ea occurrencel PREMISES (Ea occurrence) 30O 000 S + A CLAIMS -MADE Fx_� OCCUR X X BFA53955407 /1/2022 /1/2023 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY S 2,000,000 GF.^:F^AL = ;GREGATE S 4, 000 ; 000 i PRODUCTS -COMPIOPAGG $ 4,000,000 GEN'LAGGREGATELIMITAPPLIESPER POLICY X PRO- JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 X BODILY INJURY (Per person) $ B ANYAUTO f f BODILY INJURY S ALL OANED SCHEDULED X t F736034506 /1/2022 /1/2023 AUTOS .AUTOS I (Per accident) X X 'NON-O+AT7ED PROPERTY CAMAGE S HIREDAUTOS I AUTOS (Per accident) uno--t notc st wmbmed smale S 1,000,000 X UMBRELLA LIAB X OCCUR X I X �BFA5395540'7 EACH OCCURRENCE $ 5,000,000 AGGREGATE S 5,000,000 A EXCESS LIAB CLAIMS-NADE /1/2022 /1/2023 DED RETENTIONS $ WORKERS COMPENSATION X X WC STATU- OTH- LIMITS ER AND EMPLOYERS' LIABILITY Y / NTORY E.L. EACH ACCIDENT S 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N/A E.L. DISEASE- EA EMPLOYEE S 11000,000 B (Mandatory in NH) 2FH86108000 /1/2022 /1/2023 It yes, describe under E.L. DISEASE - POLICY LIMIT S 1, 000 000 DESCRIPTION OF OPERATIONS below A + Tools & Equipment c �BFA53955407 /1/2022 /1/2023 550.000Limit DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Service Agreement: Gilroy City Hall Cabling Project City of Gilroy, its officers, officials and employees are recognized as additional insured, but only as respects liability arising from named insured operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy, its officers, ACCORDANCE WITH THE POLICY PROVISIONS. officials and employees AUTHORIZED REPRESENTATIVE 7351 Rosanna St Gilroy, CA 95020 1 Robert Salvo/BECKY 'R%'Urw ca izvlu/ua) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD