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HomeMy WebLinkAboutCOI - ZOLL Data Systems, Inc. - Expires 2024-07-01lt\tt ~ -~ ® CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/00/YYYY) ACC,RC> ~ 06/28/2023 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 CONTACT Aon Risk services Northeast, Inc. NAME: Stamford CT office ftc:'."No. Ext): (866) 283-7122 I r.e~. No.): (800) 363-0105 1600 summer Street E-MAIL Stamford CT 06907-4907 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Tokio Marine America Insurance company 10945 ZOLL Data systems Inc. INSURER 8: Trans Pacific Ins Co 41238 11802 Ridge Parkway INSURER C: Sompo America Fire & Marine Insurance co 38997 #400 Broomfield CO 80021 USA INSURER D: Mitsui Sumitomo Insurance USA Inc. 22551 INSURER E: Sompo America Insurance company 11126 ~ ~ 'E Q) :E ... Q) "O 0 J: INSURER F: COVERAGES CERTIFICATE NUMBER: 570100340094 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. Limits shown are as requested 'Lrii TYPE OF INSURANCE """' :SUtlH POLICY NUMBER cMM1°0□1Yvvv1 (MMmDivvv'v LIMITS INSD WVD B X COMMERCIAL GENERAL LIABILITY CLLb40'1/tlUUtl 07 /UJ./ LULj U//UJ./LUL4 EACH OCCURRENCE $1,000,000 -:=J CLAIMS-MADE 0occuR U1'M1'\.>t TO HtN I tu $100,000 PREMISES (Ea occurrence) -MED EXP (Any one person) $5,000 f---PERSONAL & ADV INJURY $1,000,000 -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 H □PRO-□LDC excluded POLICY JECT PRODUCTS · COMP/OP AGG OTHER: A AUTOMOBILE LIABILITY CA6409761-06 07/01/2023 07/01/2024 COMBINED SINGLE LIMIT $1,000,000 IEa accident\ ,...__ BODILY INJURY ( Per person) X ANY AUTO ,...__ ~ SCHEDULED BODILY INJURY (Per accident) OWNED AUTOS ,...._ AUTOS ONLY ,...__ NON-OWNED PROPERTY DAMAGE HIRED AUTOS (Per accident) ~ ONLY ,...__ AUTOS ONLY D UMBRELLA LIAS H OCCUR EXS5200217 07/01/2023 07/01/2024 EACH OCCURRENCE $15,000,000 -AGGREGATE $15,000,000 X EXCESS LIAS CLAIMS-MADE DEDI I RETENTION C WORKERS COMPENSATION AND JCD40122WO 07/01/2023 07/01/2024 X I PER STATUTE I IOTH-EMPLOYERS' LIABILITY YIN AOS ER C ANY PROPRIETOR/ PARTNER I EXECUTIVE ~ JCR40013NO 07/01/2023 07/01/2024 E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) WI E.L. DISEASE-EA EMPLOYEE $1,000,000 st CJ) 0 0 st (') 0 0 * * ;; r--l() 0 z Q) iii ~ 'f Q) (.) ~~it~f/f[~~ tnFdt'PERATIONS below E.L. DISEASE-POLICY LIMIT $1,000, 000 : -~ DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) a -t:-j ~ ~-The City of Gilroy, its officers, officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. --== =---I ar-.: 2; ~ CERTIFICATE HOLDER CANCELLATION ~ r-----------------------------r---------------------------------,,.,11!~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ~ City of Gilroy 7351 Rosanna stre Gilroy CA 95020 U ACORD 25 (2016/03) ~t~c\i-·c,:□W[§IID JU~ --7 2023 EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ::""-: POLICY PROVISIONS. ~ AUTHORIZED REPRESENTATIVE ~ ~~g~~~f-..... L'lr-~ 1 •m ""' '..~:.,.-~~ ''Q ,wrr,u I ,Ill ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0. § co ;; IX) ~ "' 8 "' 0 8 0 0 8 0 0 _____,, AC:C>Re>® I,,_.._....--AGENCY AGENCY CUSTOMER ID: 570000083508 LOC#: ADDITIONAL REMARKS SCHEDULE NAMED INSURED Aon Risk Services Northeast, Inc. ZOLL Data systems Inc. POLICY NUMBER See Certificate Number: 570100340094 CARRIER I NAICCODE see certificate Number: 570100340094 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER($) AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER Page_ of_ ADDITIONAL POLICIES lf a policy below does nol include limit information, refer to the corresponding policy on the ACORD I certificate form for policy limits. INSR POLICY POLICY ADDL SUHR POLICY NUMBER EFFECTIVE EXPIRATION LIMITS LTR TYPE OF INSURANCE INSD WVD DATE DATE (MM/DD/YYYY) (MM/IJD/YYYY) EXCESS LIABILITY E UUX40172U0 07/01/2023 07/01/2024 Aggregate $10,000,000 Each $10,000,000 Occurrence ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD