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HomeMy WebLinkAboutCOI - Sanchez Concrete Construction, Inc. - Expires 2024-02-11ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYV) ~ 9/25/2023 ~ 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 ~2~l~cT Daniel Brock Sierra Oak Insurance Services PHONE I FAX 9700 Business Park Drive Suite 105 IAJC No Ext): 916-364-7380 /Ale Nol: 916-364-7381 Sacramento CA 95827 i~AJ~ss: certs@slerraoakinc.com INSURER(Sl AFFORDING COVERAGE NAIC# License#: OC97528 INSURER A: Wesco Insurance Company 25011 INSURED SANCCON-02 INSURER B: Security National Insurance Co 19879 Sanchez Concrete Construction, Inc. INSURERC: 2747 Aiello Dr Unit A San Jose CA 95111 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1142523660 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN"D WVD POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYl A X COMMERCIAL GENERAL LIABILITY y WPP1406850-07 2/11/2023 2/11/2024 EACH OCCURRENCE $1,000,000 1 CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED $100,000 PREMISES /Ea occurrence\ MED EXP (Any one person) $5,000 - PERSONAL & ADV INJURY $1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 =l 0 PRO-DLoc PRODUCTS -COMP/OP AGG $2,000,000 POLICY JECT OTHER: Employee Benefits $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ /Ea accidentl - ANY AUTO BODILY INJURY (Per person) $ -OWNED ~ SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ -HIRED ~ NON-OWNED rp~~~;c~~t~AMAGE $ -AUTOS ONLY ~ AUTOS ONLY $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ - EXCESSLIAB CLAIMS-MADE AGGREGATE $ □ED I I RETENTION$ $ B WORKERS COMPENSATION SWC1459692 10/1/2023 10/1/2024 X I ~f:TUTE I I OTH- ER AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ~ N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schodule, may be attached If more space Is roqulred) City of Gilroy, its Officers, Officials, Representative, Agents, Employees and Volunteers are named additional Insured for all liability arising out ofthe operations by or on behalf of the named insured if required by contract per attached endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy Public Works Departments ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Division 7351 Rosanna Street ;;:rf;;Z GIiroy CA 95020 USA I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WPP1406850-07 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanization(s) Location(s) Of Covered Operations Any person or organization with whom or with which you All locations at which you are performing operations for have agreed in writing in a contract or agreement that any person or organization with whom or with which you such person(s) or organization\s) shall be included as have agreed in writing in a contract or agreement that an additional insured on your po icy. such person(s) or organizaHon)s) shall be included as an additional insured on your po icy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; In the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the exten1 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 additional exclusion applies: This insurance does not apply to "bodily injury" or "property damage" occurring after; 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of !he covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organi2ation other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -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 Lim its of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: WPP1406850-07 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s} Or Location And Description Of Completed Organization(s} Operations Any person or organization with whom or with which you All locations at which you are performing operations for have agreed in writing in a contract or agreement that any person or organization with whom or with which you such person(s) or organization(s) shall be Included as an have agreed in writing in a contract or agreement that additional insured on your policy. such person{s) or organization{s) shall be included as an additional insured on your policy. This insurance also does not apply to any structure with an intended occupancy of a private residence, not including apartments. lnformatiOn required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 Ill -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 less. This endorsement shall not increase the applicable Lim its of Insurance shown in the Deel arations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1