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HomeMy WebLinkAboutCOI - Precision Heavy Haul, Inc. - Expires 2024-07-01?5260028002 >® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 06/26/2023 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(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 endorsement(s). PRODUCER 1-801-505-6500 CONTACT Jennifer Stires NAME: Brown & Brown Inc. r.~~NJ0 0_.1• 801-505-6500 IFAX IA/C Nol: 801-505-6501 E-MAIL jennifer.stires@bbrown.com 257 East 200 South ADDRESS: suite 700 INSURER/SI AFFORDING COVERAGE NAIC# Salt Lake City, UT 84111 INSURER A : GENERAL SECURITY NATL INS CO 39322 INSURED INSURER B: PA Manufacturers Assoc Ins. /Gen Sec Ind1 IQ.2262 Precision Heavy Haul, Inc. INSURER c : OLD REPUBLIC UNION INS CO 31143 PO Box 797 INSURER D: PENNSYLVANIA MANUFACTURERS ASSOC INS 12262 INSURER E: Tolleson, AZ 85353 INSURERF: COVERAGES CERTIFICATE NUMBER: 69062905 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 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ,.,on 1 .. n,n POLICY NUMBER IMM/00/YYYYI IMM/DD/YYYY\ LIMITS A X COMMERCIAL GENERAL LIABILITY GL-000012-02 07/01/23 07/01/24 EACH OCCURRENCE $1,000,000 -0 CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED r--PREMISES (Ea occurrence I $100,000 r--MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 r--GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 H □PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ B AUTOMOBILE LIABILITY 1523011027994/XA00016401 07/01/23 07/01/24 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accldentl r--X ANY AUTO BODILY INJURY (Per person) $ -OWNED -SCHEDULED BODILY INJURY (Per accident) $ -AUTOS ONLY -AUTOS HIRED NON-OWNED ;p~~~~:J;;;,fiAMAGE $ -AUTOS ONLY -AUTOS ONLY $ C UMBRELLA LIAB M OCCUR ORANXS000485-02 07 /01/23 07/01/24 EACH OCCURRENCE $4,000,000 X EXCESS LtAB CLAIMS-MADE AGGREGATE $ 4,000,000 OED I I RETENTION$ $ WORKERS COMPENSATION 2023011027994 07/01/23 07/01/24 x I mTUTE 1 I OTH-D AND EMPLOYERS' LIABILITY ER Y/N ANYPROPRIETOR/PARTNERIEXECUTIVE ~ N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below C Riggers Liability ORANIM000468-01 07/01/23 07/01/24 $10,000 Ded 5,000,000 C Cargo ORANIM000468-01 07/01/23 07/01/24 $10,000 Ded 5,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required I ~@~nw~ID) CERTIFICATE HOLDER CANCELLATION JUL -7 2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 I ACORD 25 (2016/03) JStires 69062905 GILROY CITY CLERK'S OFFICE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE OSA ~ © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -m ~ I-L-"'' 1-L-o "' ,_ '-0 00 0 "' ~