HomeMy WebLinkAboutCOI - Syngenta Flowers, LLC - Expires 2024-01-01ACC)Ro® CERTIFICATE OF LIABILITY INSURANCE
`� vv2o24
DATE(MWDDIYYYY)
12/29/2022
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(les) 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 Lockton Companies
CONTACT
PHONE
444 W. 47th Street, Suite 900
Kansas City MO 64112-1906
E-MAIL
ADDRESS
(816) 960-9000
kctsu@lockton.com
INSURER(SI AFFORDING COVERAGE
NAIC4
INSURER A: ACE American Insurance Company
22667
INSURED SYNGENTA FLOWERS, LLC
INSURER B: Zurich American Insurance Company
16535
INSURER C:
5131222280 HECKER PASS HIGHWAY
GILROY CA 95020
INSURER D :
NSURER E
NSURER F
COVERAGES CERTIFICATE NUMBER: 18784487 REVISION NUMBER: XXXXXXX
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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
AL THE TERMS rXQI UAIQNS AND COKN SUCH I SH ED 13Y PAID CLAIMS
INSR
LTR
TYPE OF INSURANCE
ADOL
INSD
UB
LU D
POLICY NUMBER
POLICY EFF
MMIDDIYYVY
POLICY EXP
MM/DD/YYYY
LIMITS
B
X
COMMERCIALGENERALLIABILITY
LC 1444 3-06
01/01/202
01/01/2U2
EACHOCCURRENCE
$ 5000000
X CLAIMS -MADE❑ OCCUR
$ 5,000,000
MEDUP An one rsen
$ 5,000
Y
N
PERSONAL SAOV INJURY
$ 5,000,000
GEML
AGGREGATE LIMIT APPLIES PER:
POLICY❑ JEG LOC
GENERAL AGGREGATE
$ 5,000,000
]q
PRODUCTS - COMP/OP AGO
$ 5,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
ISAH10704285
01/01/202
01101/2024
COMBINED SINGLE INGLELIMIT
SSOOOOOO
X
BODILY INJURY (Per Pelson)
$XXYXV, ((
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
N
N
BODILY INJURY (Per accident)
S XXXXXXX
Pd20PERTY AMAGE
eramidenl
$ XXXXXXX
$XXXXXXX
UMBRELLA LIAR
OCCUR
NOT APPLICABLE
EACH OCCURRENCE
SXXXXXXX
AGGREGATE
S XXXXXXX
EXCESS LIAR
LAIMS-MADE
DEC) I I RETENTION S
S
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFICERAIEMBEREXCWER ECO LEI
1MandatorylnNR)
NIA
N
WLR C70308526
SCF C70308563
SCFC70308484
01/01/202
01/01/202
01/01/202
01/01/202
01/01/202
01/01/2024
X -
E.L. EACHACCIDENT
S5,000000
E.L. DISEASE -EA EMPLOYEE
S5000000
DESLRIa MO OF Oetr
E.L. DISEASE -POLICY LIMIT
$5000000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remark, Schedule, may be attached If more space Is required)
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY COVERAGE, WHICH IS PRIMARY COVERAGE TO THE
ADDITIONAL INSURED AND OTHER AVAILABLE INSURANCE WILL BE NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, SUBJECT TO THE TERMS
AND CONDITIONS OF THE POLICY.
�D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
18784487 JAN 2 5 2023 AUTHORIZED REPRESENTATIVE
CITY OF GILROY
7351 ROSANNA STREET GILROY CRY CLERICS OFFICE
GILROY CA 95020 fl
ACURU 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE DATEY)
vvzo2a 12/29/2022022
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 endomement(s).
PRODUCER Lockton Companies
444 W. 47th Street, Suite 900
Kansas City MO 64112-1906
(816) 960-9000
kctsu@lockton.com
NAME' I
PHONE
IAIC, Rol,
E-MAIL
INSURERS AFFORDING COVERAGE
NAICN
INSURERA: ACE American Insurance Company
22667
INSURED SYNGENTA FLOWERS, LLC
5131222280 HECKER PASS HIGHWAY
GILROY CA 95020
INSURERS: Zurich American Insurance Company
16535
INSURERC:
COVERAGES CERTIFICATF NUMRFR- 1R7RddAA RFvlslnM MnN1RCR• YVYYYYY
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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
E T NS AND CONDITIONSOF SUCH POLICIES, LIMITSOW MAY H BEEN REDUCED BY PAID CLAIMS,
ILTR
TYPE OF INSURANCE
IN30
NND
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY
MM/DDIYYYY
EXP
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
0144423-06
01/01/202
01/01/2 2
EACH OCCURRENCE
S 5000000
X CLAIMS -MADE ❑ OCCURPREMISES
(Fa oocume,oW,
$ 5,000,000
MED EXP An one rson
S 5,000
Y
N
PERSONALS AOV INJURY
$ 5,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
PRO-
POLICY❑ JE T ❑LOC
GENERALAGGREGATE
S 5.000.000
PRODUCTS - COMPIOPAGO
S 5000000
S
OTHER:
A
AUTOMOBILE
LIABILITY
ANY AUTO
ISA H10704285
01/01/202
0110112021
COaBINED SINGLE LIMIT
$ 5,000000
X
BODILY INJURY (Per person)
$ XX�XXX
W ONED SCHEDULED
AUTOS ONLY AUTOS
NON-OMED
AUTOS ONLY AUTOS
NN
IHIRED
BODILY INJURY (Per accident)
S xxxxXXX
Pfge0ecudent AMAGE
S XXXXXXX
$XXXXXXX
UMBRELLA LIAB
OCCUR
NOT APPLICABLE
EACH OCCURRENCE
s XXXXXXX
AGGREGATE
s XXXXXXX
EXCESS LIAR
LAWS -MADE
DED I RETENTION $
S
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANTPROPRIEfORNARTNE114NECl?NE
OFFICERMEMBEREXCLUDED> N
(Mandatory In NMI
DESCRIPTION OF OPEMTIONS Oebx
DESCRIPTION OFO
N/A
N
WLR C70308526
SCFC70308563
SCF C70308484
01/01/202
01/01/202
01/01/202
01/01/202
01I01/202
01/0112024
X
E.LEACHACCIDENT
$ 5,000,000
E.L. DISEASE - EA EMPLOYEE
$5000000
E.L. DISEASE - POLICY LIMIT
$SOOOOOO
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is requlmtl)
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY COVERAGE, WHICH IS PRIMARY COVERAGE TO THE
ADDITIONAL INSURED AND OTHER AVAILABLE INSURANCE WILL BE NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, SUBJECT TO THE TERMS
AND CONDITIONS OF THE POLICY.
[' }CSC OMMD
JAN 2 5 2023
18784486
CITY OF GILROY
7351 ROSANNA STREE TGILROY CITY CLERICS OFFICE
GILROY 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
AUUKU 20 tLU1b/UJ) Fhe ACORD name and logo are registered marks of ACORD