The URL can be used to link to this page

Home My WebLink AboutCOI - SSI Express Transport, Inc. - Expires 2023-02-11ACORO® E DATE (MMIDD/YYYY) C RTIFICATE OF LIABILITY INSURANCE o2(MMIDD22 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 endorsements . PRODUCER CONTACT NAME: Carol Knox, Debbie Waller or Kory Butler KGIB, INC. PHONE (714) 744-3300 FAX • No ; (714) 744-6537 KNOX GENERAL INSURANCE BROKERS E-MAIL Carol k ESS @ gibinc.com, Dwailer@kgibinc.com, Kory@kgibinc.com 226 SOUTH GLASSELL STREET INSURERS AFFORDING COVERAGE NAIC 0 ORANGE CA 92866 INSURER A : EMPLOYERS MUTUAL CASUALTY COMPANY 21415 INSURED INSURER a: HARCO NATIONAL INSURANCE COMPANY 26433 SSI EXPRESS TRANSPORT INC. INSURER C : CRUM & FORSTER SPECIALTY INSURANCE CO 44520 SSI EXPRESS INC INSURER D : BERKLEY NATIONAL INSURANCE COMPANY 38911 150 S. LARACH AVENUE INSURER E: RIALTO CA 92376 INSURER F : 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 ADDL SUBR LTR TYPE OF INSURANCE WynPOLICY NUMBER POLIICDY EFF MMLIID EXP YYyJ LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE FK OCCUR DAMAGE TO RENTED i PREMISES Ea occurrence S 500,000 MED EXP (Any one person) $ 10,000 A 2D18813 02/11/2022 02/11/2023 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS -COMP/OP AGG S 2,000,000 OTHER: I S AUTOMOBILE LIABILITY CEOM�BI NESINGLE LIMIT S 1,00a,000 ANY AUTO — BODILY INJURY (Per person) $ AUTOS ONLY X AUTOS SCHEDULED X B RFL0000508-00 02/11/2022 02/11/2023 BODILY INJURY (Per accident) $ AUTOS X HIRED �/ NON -OWNED S AUTOS ONLY X PROPERTY DAMAGE AUTOS ONLY Per accident $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 C X EXCESS LIAB CLAIMS -MADE SEO-117081 02/11/2022 02/11/2023 AGGREGATE S 2,000,000 DED RETENTION $ $ WORKERS COMPENSATION TH AND EMPLOYERS' LIABILITY STATUTE ER - ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N / A —N/A— E.L. EACH ACCIDENT $ (Mandatory In If i E.L. DISEASE - EA EMPLOYE S yes, describe under nd DESCRIPTION OF OPERATIONS below i E.L. DISEASE • POLICY LIMIT S MOTOR TRUCK CARGO ; $1,000,000 LIMIT D j MIM 1048491-50 02/11/2022 02/11/2023 $5,000 DEDUCTIBLE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: ROAD PERMIT CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORM CA 2048 1013 WITH RESPECT TO AUTO LIABILITY. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 7351 ROSANNA STREET AUTHORIZED REPRESENTATIVE GILROY CA 95020 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: RFL 0000508 00 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is in- dicated below. Named Insured: SSI EXPRESS TRANSPORT INC Endorsement Effective Date: 2/11 /2022 SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization is an additional insured solely with respect to bodily injury or property damage caused by an accident arising out of the ownership, maintenance or use of a covered auto provided you have agreed to add the person or organization as an additional insured pursuant to an express provision in a written insured contract or other written agreement or in a permit issued to you by a governmental or public authority, and your operations under the insured contract or written agreement or the permit take place after you executed the insured contract or written agreement or the permit has been issued to you —and then only to the limited extent and for no higher limits of insurance than required in such insured contract, other written agreement or permit. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Cover- age, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coveragesof the Auto Dealers Coverage Form. CA 20 48 10 13 C Insurance Services Office, Inc., 2011 Page 1 of M