HomeMy WebLinkAboutCOI - Ernie's Mobile Home Transport Inc - Expires 2023-11-02A`ORV CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDIVYYYY)
10/31/2022
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 pollcy(ies) must 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
Cc TA T
NAME:
PHONE (530)365-1009 ac Not: 1330r2e7-7e0e
N En,P.O.
Roberson 6 Sons Insurance Services, Inc.
E-MAIL ADDRESS: ReceP tionist@roberson—ins. cont
Box 491719
INSUREMS) AFFORDING COVERAGE
NAIC #
INSURERA: Kinsale Insurance Company
38920
Redding CA 96049-1719
INSURED
INSURERB:Onited Financial Casualty Company
11770
INSURERC:L10 ds Of London
26077
Ernie's Mobile Home Transport Inc
INSURER 0:
PO Box 1510
INSURER E :
INSURER F:
Marysville CA 95901
COVERAGES CERTIFICATE NUMBER:2022-10-31 MP - 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
LTR
TYPE OF INSURANCE
ADD
R
POLICYNUMBER
MNDY
M�
DY
MMIDDWY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE F0OCCUR
DAMAGETORENTED
PREMISES Ea ovunema
$ 100,000
X
MED EXP(Any one person)
$ Excluded
$1,000 BI S PD Deductibles
X
0100033173-7
11/3/2022
11/3/2023
PERSONAL SADV INJURY
$ 1,000,000
GENLAGGREGATE UMITAPPLIES PER:
GENERALAGGREGATE
S 2,000,000
X POLICY ❑ PRAT 0LOC
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS AUTOS
009772280
11/2/2022
11/2/2023
BODILY INJURY (Per accident)
S
X
PROPERTY DAMAGE
Per accident)
$
HIREDAUTOS X NON -OWNED
AUTOS
$
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
S
WORKERS COMPENSATION
PER OTH-
AND EMPLOYERWLIABILITY YIN
ANY PROPRIETOWPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? ❑NIA
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
Ifyes. deatiUe under
DESCRIPTION OF OPERATIONS lod.
E.L. DISEASE -POLICY LIMIT
I S
C
Motor Truck Cargo
1,11110866A22
11/3/2022
11/3/2023
Uric $100,000
Dedudim. $10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required)
Cargo coverage includes Double -Wide S Triple -Wide Endorsements.
City of Gilroy is named as Additional Insured. Additional Insured applies to General Liability only.
JUL 25 2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Rosanna Street 7351 RosaACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy, CA 95020 IGILROY MY CLERKS OFICE
AUTHORED REPRESENTATIVE
Eric Roberson/MPS
ACORD 25 (2014I01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)