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HomeMy WebLinkAboutCOI - Ghirardelli Associates, Inc. - Expires 2021-11-15r.HIRASS_ni RR011ART ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)6/2/2021 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 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 License # 0757776 C ACT Concord, CA - HUB International Insurance Services Inc. 2300 Clayton Rd Concord, CA 94520 A1CNN , Ext}: (925} 609-6500 FAX No):(925) 609-6550 1 : INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Continental Insurance Company 35289 INSURED INSURER B : Transportation Insurance Com any 20494 INSURER C : Travelers Pro a Casualty Company of America 25674 Ghirardelli Associates, Inc. INSURER D : Continental Casuaft Company 20443 2055 Gateway Place, Suite 470 San Jose, CA 95110 INSURER E INSURER F : CnVFRAGFS CFRTIFICATF NIIMRFR- REVISION NLJMRER- 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 I TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I S 1,000,000 CLAIMS -MADE X OCCUR X 6075689503 11/15/2020 11/15/2021 DAMAGES ( RENTED PREMISES Ea o 1,000,000 S X MED EXP (Any oneperson) S 15,000 Ded: 0 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JERO LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 S OTHER: B AUTOMOBILE LIABILITY ANY AUTO X �6075689498 11/15/2020 11/15/2021 COMBINED ccciien SINGLE LIMIT $ 1,000,000 BODILY INJURY Per person)S BOODILY INJURY Per accident S OWNED SCHEDULED AUTOS ONLY AUTOS Ix (ROaax�RdentDAMAGE S D AUTOS ONLY AUTO ONLY Ded:0 $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE 6075689517 11/15/2020 11/15/2021 DED X RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPREIETgOER�/PARTNER/EXECUTIVE Y❑ OpFFICER ry in NHS EXCLUDED? (Mandato IVH N 1 A UB-5K662"2-21-43-G 6/1/2021 6/1/2022 X PE OTH- AT E.L. EACH ACCIDENT 1,000,000 S E.L. DISEASE - EA EMPLOYE $ 1'000'000 E.L. DISEASE - POLICY LIMIT 1,000,000 S If es, describe under DESCRIPTION OF OPERATIONS below D PROFESSIONAL LIAB AEH288376164 6/1/2021 6/1/2022 Per Claim &Aggregate 5,000,000 D PROFESSIONAL LIAB AEH288376164 6/1/2021 6/1/2022 Deductible 50,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Inspection and Labor Compliance Services for FY21 Citywide Pavement Project (GAI Project #19028). City of Gilroy, its officers, officials and employees as Additional Insured as respects General Liability and Auto Liability per attached forms CG20101219 and CA20481013. Professional Liability Retroactive Date: Full Prior Acts CERTIFICATE Nnl ni=R CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy tY y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department 7351 Rosanna Street AUTHORIZED REPRESENTATIVE 4qllaL_ Gilroy, CA 95020 ACORD 25 (2016103) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CNA Business Auto Policy Policy Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 indicated below. Named Insured: GHIRARDELLI ASSOCIATES, INC. Endorsement Effective Date: 11 /1512020 SCHEDULE Name Of Person(s) Or Organization(s): CITY OF GILROY 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 Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. 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 Coverages of the Auto Dealers Coverage Form. Form No: CA 20 48 10 13 Policy No: BUA 6075689498 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 11/15/2020 Endorsement No: 9; Page: 1 of 1 Policy Page: 70 of 342 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 0 Copyright Insurance Services Office, Inc., 2011