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HomeMy WebLinkAboutCOI - Rana Creek Habitat Restoration - Expires 2024-07-29AW R� p® CERTIFICATE OF LIABILITY INSURANCE 7/28/2023 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 Andreini & Company -San Mateo 220 West 20th Avenue San Mateo CA 94403 INSURED Rana Creek Habitat Restoration 26382 Carmel Rancho Lane, 2nd Floor Carmel CA 93923 COVERAGES RANAC-2 CONTACT NAME: Andreini & Company PHONE (A/c. No. Ext): 650-573-1111 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Evanston Insurance Co INSURER B: Lloyd's of London INSURER C: State Compensation Ins Fund INSURERD: Nationwide Mutual Ins. Co. INSURER E : Evolve Cyber Insurance INSURER F: DATE (MM/DD(YYYY) (A/C, No): 650-378-4361 NAIC ri 35378 35076 23787 CERTIFICATE NUMBER: 1505781830 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'SUBH -_._. _ _ __-.. _-_._._.- - LTR TYPE OF INSURANCE INSD I WVD POLICY NUMBER (MM DD YYYY) (MM DD/YYYY) i LIMITS A X COMMERCIAL GENERAL LIABILITY Y MKLV5ENV103703 7/29/2023 7/29/2024 X j OCCUR D CLAIMS -MADE GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JEcr %! LOC OTHER: AUTOMOBILE LIABILITY X j ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A C.V. A UMBRELLA LIAB X ; EXCESS JAB X OCCUR CLAIMS -MADE ! DED RETENT ON $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below B Professional Liability E Cyber Liability Y/N NIA ACPBA3100464215 11/4/2022 MKLV5EFX100998 930751223 ANE160767523 E5L0039677841 11/4/2023 7/29/2023 7/29/2024 6/1/2023 i 6/1/2024 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 1,000,000 $ 50,000 $ 5,000 $ 1,000,000 $ 2,000,000 $ 2,000,000 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) - BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident), Deductible EACH OCCURRENCE rAGGREGATE X STATUTE I IEERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 $51,000 $ 5,000.000 $ 5,000,000 $ E.L. DISEASE - POLICY LIMIT $ 1,000,000 7/29/2023 7/29/2024 1 Each Claim/Aggregate 1,000,000 6/8/2023 6/8/2024 Each Claim/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Contractors Pollution Liability: Evanston Insurance Co. Policy Number MKLV5ENV103703 Eff. Date: 7/29/2023 to 7/29/2024 Limits: Shared General Aggregate Limit $2,000,000 Ea. Pollution Condition Limit $1,000,000 Ea. Transportation Pollution Condition Limit $1,000,000 Ea. Non -Owned Disposal Site Pollution Condition Limit $1,000,000 Self Insured Retention: $10,000 Each Pollution Condition Policy Basis: Occurrence. See Attached... CERTIFICATE HOLDER City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy CA 95020 CANCELLATION 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 5617: 2 of 4 AGENCY CUSTOMER ID: RANAC-2 LOC #: ACORO® AGENCY Andreini & Company -San Mateo POLICY NUMBER CARRIER ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED Rana Creek Habitat Restoration 26382 Carmel Rancho Lane, 2nd Floor Carmel CA 93923 EFFECTIVE DATE: Page 1 of 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are included as an additional insured, per the attached Endorsement. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 5617: 3 of 4 POLICY NUMBER: MKLV5ENV103703 COMMERCIAL GENERAL LIABILITY CG20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization(s) SCHEDULE Location And Description Of Completed Operations As required by written contract signed by both parties N/A and executed prior to commencement of operations. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section 11I — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is Tess. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 5617: 4 ` of 4