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Home My WebLink AboutCOI - Combined Transport, Inc. - Expires 2022-08-01A` oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/29/2021 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, ANDTHE 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 McGriff Insurance Services, Inc. 1800 SW First Avenue, Suite 400 CONTACT NAME: PHONE FAX A/C No Fat): 503-943-6621 A/C Na 503-943-6622 Portland, OR 97201 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC fl INSURER A :The Travelers Indemnity Company of Connecticut 25682 INSURED Combined Transport, Inc. INSURER B : INSURER C : Blackwell Consolidation, LLC 5656 Crater Lake Highway P.O. Box 3667 INSURER 0 INSURER E : Central Point, OR 97502 INSURER F : COVERAGES CERTIFICATE NUMBER:HMTXHE9P REVISION MLIMRFR- 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 INSURANCEADDLSUBR p POLICY NUMBER POLICY EFF MM/DD/YYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y-630-071OR943-TCT-21 06/01/2021 06/01 /2022 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECT LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS COMP/OP AGG S 2,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS i BODILY INJURY (Per accident) ) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident S $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) If ves. describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT -- S S S S S S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 11 more space Is required) Certificate Holder is named as an Additional Insured as respects the ongoing operations of the Named Insured with respects to General Liability coverage where required by written and signed contract subject to policy terms, conditions, limits and exclusions. CERTIFICATE HOLDER CANCELLATION City of Gillroy 7351 Rosanna St Gillroy, 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 Page 1 of 1 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD