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HomeMy WebLinkAboutCOI - EF&S Concrete, Inc. - Expires 2023-07-13-,® CERTIFICATE OF LIABILITY INSURANCE I DA TE (MM/DDIYYYY) -06/13/2023 ~ THIS CERTIFICATE 15 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 15 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 Heather Wagner NAME: Hunter Insurance Services, Inc ;it)gN~o Ext\: (619) 713-1034 I r.ifc Nol: (619) 713-1034 8277 La Mesa Blvd E-MAIL heather@hunteronline.com ADDRESS: INSURERCSI AFFORDING COVERAGE NAIC# La Mesa CA 91942 INSURER A: Colony Insurance Company 39993 INSURED INSURER B: Infinity Select Insurance Company 20260 E F & S Concrete Inc INSURERC: 8352 Church St. Ste #F1 INSURERD: INSURERE: Gilroy CA 95020 INSURERF: COVERAGES CERTIFICATE NUMBER: 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 ,.,~n '"",n POLICY NUMBER fMM/DDNYYY\ fMM/DDNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -~ CLAIMS-MADE [X] OCCUR UAMAbt: ',Ytt:NTt:D PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) s 5,000 -A y 600GL017739502 7/13/2022 7/13/2023 PERSONAL & ADV INJURY $ 1,000,000 -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000 ~ [Xj PRO-Owe $ 2,000,000 POLICY JECT PRODUCTS -COMP/OP AGG OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 /Ea accidentl -ANY AUTO BODILY INJURY (Per person) $ -OWNED X SCHEDULED B 504610144582001 4/21/2023 4/21/2024 BODILY INJURY (Per accidenl) $ AUTOS ONLY f--~gm~WNED HIRED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident) f--f--$ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ f--EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION w(\~~~fl~j~ I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE □ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under -DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERA TIO NS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy, its officers, officials and employees are named additional insured, per attached endorsement. > , ,__. -,--, nn nr;:::J ~ CERTIFICATE HOLDER • ·-.\1...S~LSU \!/ l.=>L!;:.I CA NC ELLA TION ! ~ JUL -7 2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ( ~ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy :W CITY CLERK'S OFFICE ACCORDANCE WITH THE POLICY PROVISIONS. ', .·. its officers, officials and enipleyee_ AUTHORIZED REPRESENTATIVE 7351 Rosanna St. ~ GILROY CA 95020 I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD