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HomeMy WebLinkAboutCOI - J.S. Cole Inc. - Expires 2024-05-17CURREQU-01 �1 ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI ME BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI-- - 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 endorsement(sl. PRODUCER ii"AMC- unsana YValiace ProCo Insurance Services PHON (AIC, NE A, EXt): (408) 709.1167 910 E Hamilton Ave 0410 ERALEss: drisana.wallace� Campbell, CA 95008 INSURED Curie Equipment, LLCIJ.S. Cole Inc. J.S. Cole Inc. 320 Deer Island Lane Novato, CA 94945 COVERAGES CFRTIFICATF NI IMRFR• RFVISInm idiIMRFR• 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 TYPE OF INSURANCE ADDLSUBft AM POLICY NUMBER POLICY EFF 5/1712023 POLICY EXP_UIL LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR X AES103481209 5/17/2024 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED S 100,000 MED EXP (my one erson S 0 PERSONAL BADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY F PRO- JECT :7 LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS-COMPIOP AGG S 2,000,000 I S OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 BODILY INJURY Per erson S ANY AUTO CF2CA00235-221 9/612022 91612023 BODILY INJURY Per accident S OWNED X SCHEDULED AUTOS ONLY AUTOS PPerOemLan DAMAGE S VWy pp Al)TOS ONLY AUTOSONEV S A UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000 X AGGREGATE S EXCESS LIAB CLAIMS -MADE FXA105313705 5N712023 5/17/2024 DEO I X I RETENTIONS O S 5,000,000 C WORKERS COMPENSATION AND EMPLOYERS Y LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Man datory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA TWC4268737 5I1712023 5/17I2024 X PER OTH- ' ER E.L. EACH ACCIDENT 1,000,000 S E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMB 1,000,000 S D Property 6018120031 511712023 5117/2024 Per Item 750,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy is named as an additional insured on General Liability policy per the attached endorsement. C[F D N - 2 2023 rR ITY CLERK'S OFFICE City of Gilroy Rosanna St. Attn: Public Works Dept. 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 ACORD 25 (2016103) 91988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AES1034812 09 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written Any location where you perform work for such contract with the named insured additional insured Information required to complete this Schedule, if not shown above will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 ACORO" CURREQU-01 CERTIFICATE OF LIABILITY INSURANCE PIHPATRA2 DATE(MMIDDP 5/26/202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI--- 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 endorsement(s). PRODUCER COE"CT Drisana Wallace ProCo Insurance Services PRONE FAX 910 E Hamilton Ave AIC, No, Eal; 408)709-1167 uatD ADDRESS. drisana.wallace@proco.global Campbell, CA 95008 INSURERIS AFFORDING COVERAGE NAILp INsu.ERA: Associated Industries Insurance Company, Inc. 23140 INSURED INSURER B: Everest Indemnity Insurance Company 10851 Currie Equipment, LLC INSURER C:Technolo Insurance Company, Inc 42376 J.S. Cole Inc. 20478 320 Deer Island Lane INSURER D: National Fire Insurance Co of Hartford Novato, CA 94945 INSURER E: INSURER F: HOLDER.' COVERAGES CERTIFICATF NIIMRFR• RFVISInM NI IMRFR- 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 rypE OF INSURANCE ADDL INSD SUER MD POLICY NUMBER POLICY EFF POLICYEXP LIMBS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X AES103481209 5/17/2023 5/17/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED Me occumancel $ 100,00PREMISES MED EXP An one erson 0 PERSONAL S ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JPET LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 S OTHER: B AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT U S 1,000,000 BODILY INJURY Per erson S ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS CF2CA00235-221 916/2022 9/6/2023 BODILY INJURY Per aedderd S PROPERTY DAMAGE Peracatlent $ Ep Al1T0S ONLY AVTOB ONLY $ A UMBRELLA LIAR X OCCUR EACH OCCURRENCE 51000,000 X AGGREGATE S EXCESS LIAR CLAIMS -MADE EXA105313705 5117/2023 5/17/2024 DED X RETENTION$ D 5,000,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE Y/❑ FFIOERMEMBER EXCLUDED? Mandatory In NH) If Dyes, describe antler DESCRIPTION OF OPERATIONS below NIA TWC4266737 511712023 5I1712024 X PER OTH- E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 D Properly 6018120031 511712023 5117/2024 Per Item 750,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be artached It more space is required) City of Gilroy, its officers, officials and employees are named as an additional insured on General Liability policy per the attached endorsement. M(3G GOWMD JUN - 2 2023 CERTIFICATE HOLDER CANCELLATION GILROY CITY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy 7351 Rosanna St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE � ^ I/k " . ACORD 25 (2016103) © 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AES1034812 09 COMMERCIAL GENERAL LIABILITY = CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written Any location where you perform work for such contract with the named insured additional insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1