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HomeMy WebLinkAboutCOI - Sedgwick LP and Subsidiaries - Expires 2024-05-01-- , ® A� D CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/02/2023 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 `MARSH USA LLC. 6410. Poplar Ave Suite 540 Memphis, TN 38119 CN101395638--GAWU-23-24 CONTACT Karen Angus NAME: g PHONE (901) 684 3725 FAX (A/C. No. Ext):(A/c, No): E-MAILDSS: k.angts@marsh.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hartford Fire Insurance Co 19682 INSURED Sedgwick LP and Subsidiaries 8125 Sedgwick Way Memphis, TN 38125 INSURER B : Hartford Underwriters Insurance Company 30104 INSURER C : Twin City Fire Insurance Co 29459 INSURER D : Everest National Insurance Co 10120 INSURER E : Hartford Insurance Company of the Midwest 37478 INSURER F : Hartford Accident & Indemnity Co. 22357 CERTIFICATE NUMBER: ATL-005079443-10 REVISION NUMBER: 0 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 LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY 20CSEC75302 09/30/2023 05101/2024 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 2,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ A B AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED x SCHEDULED AUTOS NON -OWNED AUTOS ONLY 20CSEC75305 AOS 20CSEC75307 HI 09/30/2023 09/30/2023 05/01/2024 05/01/2024 COMBINED SINGLE LIMIT (Ea accident) $ .2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA LIAB EXCESS LIAB X O OCCUR CLAIMS -MADE XC5EX01904-231 09/30/2023 0510112024 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENT ON $10,000 F C E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 20WNC75300 (AOS) 20WBRC75301 (MA, WI) 20 WN C75308 (AK,ID,MT,MN) 09/30/2023 09/30/2023 09/30/2023 05101/2024 0510112024 0510112024 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF GILROY IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION CITY OF GILROY 7351 ROSANNA STREET GILROY, CA 95020 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 ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD On Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. if you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@inarsh.com and include the following: — Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operation , Marsh USA, LLC A bustness of Marsh McLennan 0373-01-00-0004358-0002-0009767