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HomeMy WebLinkAboutCOI - Global Water Technology, Inc. - Expires 2023-01-01ACORV CERTIFICATE OF LIABILITY INSURANCE DATE /28 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, AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the pollcy(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 endomement(s). PRODUCER CONTACT Helen Brown NAME: McGowan Insurance Group AICNE Ext : (317) 464-5000 FAX No : (317) 464-5001 355 Indiana Avenue ADDRIESS: helenb@mcgowaninsgrp.com INSURER(S) AFFORDING COVERAGE NAIC 0 Suite 200 INSURERA: Crum & Forster Specialty Insurance Co. 44520 Indianapolis IN 46204 INSURED INSURER B: Hanover Insurance Companies 22292 Global Water Technology, Inc. DBA Water Tech Specialties INSURER C : United States Liability Insurance Co. 25895 P.O. Box 32846 INSURER D : INSURER E : San Jose CA 95152 INSURER F : COVERAGES CERTIFICATE NUMBER: watertech 22-23 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADULbUBR INSD WVD POLICY NUMBER MMOIIIDY EFF MM/DD� LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 50,00 X MED EXP (Any one person) $ 5,000 Contractors Pollution X1 Professional/Contructual Liability PERSONAL &ADV INJURY $ 1,000,000 A EPK133604 01/01/2022 01/01/2023 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000 Contractors Pollution $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS AWWH465898 01/01/2022 01/01/2023 BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 9,000.000 A EXCESS LIAB CLAIMS -MADE EFX116727 01/01/2022 01/01/2023 DED I I RETENTION $ $ WORKERS COMPENSATION OTH- X1 AND EMPLOYERS' LIABILITY Y 1 N STA UTE ER E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N ! A WMVVi-i4c5o7 i v^ 1 /01 /2022 01 /01 /2023 E.L. DISEASE - EA EMPLOYEE S 1,000,000 (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Management Liability C CD1552353 01/01/2022 01/01/2023 EPUFidiciary $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The following apply when required by written agreement: General Liability Additional Insured including Ongoing and Completed Operations on a primary and non-contributory basis, and Waiver of Subrogation per forms EN0230, EN0111, EN0109 & En0188 ; Auto Liability Additional Insured on a primary and non-contributory basis, and Waiver of Subrogation per forms 461-0478 & 461-0155 Workers Compensation Waiver of Subrogation per form WC000313 Umbrella is follow form over the underlying limits and endorsements applicable to General Liability, Auto Liability and Employer's Liability. GEKTIFIGATE BOLDER 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 and Employees ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street AUTHORIZED REPRESENTATIVE � Gilroy CA 95020 04I 4 "+/ l �'} /p, If `6 vl llv ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD