HomeMy WebLinkAboutCOI - Par Western Line Contractors, LLC - Expires 2024-05-01CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDm )
s/1/zoza 04/25/2023
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 LOCKTON COMPANIES
LOCKTON COMPANIES
3657 BRIARPARK DRIVE, SUITE 700
HOUSTON TX 77042
•.
..Deco PAR WESTERN LINE CONTRACTORS, LLC - DIVISION #
364692A QUANTA SERVICES COMPANY
4770 N. BELLEVIEW AVE., SUITE 100
KANSAS CITY MO 64116
147
COVERAGES CERTIFICATE NUMBER- 17RRH31A RFVLCIMJ MIIMRFD• VYVVVVV
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
T Y VPPIJ REDUCEDY PAID CLAIMS.
ILTR
TYPE OF INSURANCE
INSD
BS
MD
POUCYNUMBER
MWOO
EFF
lAllVDDUEXP
LIMITS
A
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Fx_1 OCCUR
MINTY 313093 23
MWZX31309523
05 01 202
05/01/202
U51U112024
05/01/202
EACH OCCURRENCE
$ 5.000.000
51000000
MED EXP (My a. cc.
$ Excluded
Y
N
PERSONAL SADV INJURY
$ 1 000000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICV� JECT LOC
GENERAL AGGREGATE
$ 5.000.000
PRODUCTS-COMP/OPAGG
$ 5000000
S
OTHER:
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
MWTB 313092 23.
MWZX31309123
05/01/202
05101/2023
05/01/202
0510112024
OMBINEDISINGLE LIMIT
Es accide
$5,000000
X
BODILY INJURY (Per person)
$XXXXXXX
X
BODILY INJURY (Per acdclenl
$XXXXXXX
WNE
A OSDONLY AUTOSULED
HAUTOS IRED ONLY X AUTOS ONLY
Y
N
X
Perna Q AMAGE
S XXXXXXX
s XXXXXXX
UMBRELLALIAB
OCCUR
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
EXCESS LIAB
CLAIMSWADE
DED I I RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS'UABILIT' YIN
MWC31309423
05/01/202
05/01/202
X
OFPICREPM IEMB REXCLUDERD E'! CUTIVE
(Mandator, In NH)
Ilya, deeoibe unaer
NIA
N
E.L. EACH ACCIDENT
$ 1000000
E.L.DISEASE-EAEMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$100D000
DESCRIPTIONOPOPERATIONSbebe
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Additional Insured in favor of The City of Gilroy (on all policies except Workers' Compensation/EL) where and to the extent required by written contract.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
12686314
MAY 3 0 2323
AUTHORIZED REPRESENTATIVE
The City of Gilroy
7351 Roseanne St
Gilroy CA 95020
GILROYCIIYCLERK'S OFFICE
Mm
MY . CJ ILV 1 VI VJ) 1 ne AUUKU name ano logo are registered marKs of AGUHU
May 1, 2023
Re: Quanta Services and all Subsidiaries
Renewal Certificate of Insurance
Dear Certificate Holder:
Enclosed for your records you will find the renewal Certificate of Insurance for Quanta Services
and its Subsidiaries.
To expedite the delivery of future renewal certificates, we are collecting email addresses for all
certificate holders. Please note that if no email address is on file, we will continue to mail a
certificate of insurance to the mailing address on file.
If you wish to receive E-mail version of renewal certificates going forward, please send the
email address at which you would like to receive your certificate as well as the Certificate
Holder number (see below for directions on how to locate this information) to the following
email address:
Houston-QuantaECertDelivery@lockton.com
Certificate Holder #
WICATE MOLDER The Certificate Holder number is
12345678 the 8 digit number directly above
the Certificate Holder name and
12345678 address in the bottom left corner
SAMPLE of your enclosed COI.
123 Main Street
Anywhere AL 12345
:ORZ 25 00161031
Regards,
Amy Barnett