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HomeMy WebLinkAboutCOI - Graham Prewett Inc - Expires 2023-02-01CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOM'YY) 01/25/2022 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 CONTACT Came Stubblefield CISR NAME: James G. Parker Insurance n oN c a' (559) 222-7722 AIC No : (559) 222-1724 License#0554959 ADDREss: CameStubblefield@igparker.com P O Box 3947 INSURERS AFFORDING COVERAGE NAIC 0 Fresno o INSURER a: Redwood Fire &Casualty Ins Co 11673 INSURED N INSURER 9: Graham Prewett Inc INSURER C: 2773 N Business Park Ave If 102 INSURER o: INSURER E: Fresno CA 93727 COVERAGES CERTIFICATE NUMBER: Zd-zd WV REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 AVUL I= UUUK VWD POLICYNUMBER POLICY E F MMIDDA'Y1'V POLICY MMIDDrYyYY LIMITS COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ CLAIMS -MADE DOCCUR PREMISES Eaoocunence $ MED UP (Any one person) S PERSONAL S ADV INJURY $ N GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S O POLICY JET LOC PRODUCTS-COMP,OPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea a¢iCan $ BODILY INJURY (Par person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Peraccldaht) S PROPERTY DAMAGE Peraccident S HIRED NIXJ-OVMED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB Cl.AIMS-MADE DED RETENTION $ $ WORKERSCOMPENSATION PER OTH- A AND EMPLOYERS'LIABILITY YIN ANY PROPRIETC) / ARTNER/EXECUTIVE OFFICERRAEMBER EXCLUDED? (Mandatory In NH) NIA Y GRWC322698 02/012022 021012023 STATUTE ER E.L. EACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 If yea, desodbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached N mom apace Is required) Job: City Hall - City of Gilroy, 7351 Rosanna Street, Gilroy CA 95020 Blanket waiver of subrogation in favor of The City of Gilroy, its officers, officials and employees are included as per form WC990410 attached. 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 SIN) rry�4 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium (priorto adjustments) All CA Operations 9839.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2022 Policy No.: GRWC322698 Endorsement No.: Insured: Premium $ Insurance Company. Redwood Fire and Casualty Ins Co Countersigned by WC 99 0410 C (Ed. 01-19)