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HomeMy WebLinkAboutCOI - Recology South Valley - Expires 2024-10-01CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/2/2N THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR 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 Beecher Carlson Insurance Services 21650 Oxnard Street, Suite 1600 Woodland Hills, CA 91367 www.beechercarlson.com INSURED Recology South Valley 1351 Pacheco Pass Highway Gilroy CA 95020 COVERAGES CERTIFICATE NUMBER CONTACT NAME: Beecher Carlson Insurance Services PHONE _(A/C No, Exf: 404-460-1400 E-MAIL ADDRESS: FAX (A/C, No): INSURER(S) AFFORDING COVERAGE INSURERA: ACE American Insurance Company INSURER B : Indian Harbor Insurance Company NAIC # 22667 36940 INSURER C: XL Specialty Insurance Company 37885 INSURER D INSURER E : INSURER F: See ADDITIONAL REMARKS SCHEDULE i vvvv is, IlV iI.JIVIY 1`1VIVILGr\. 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 SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A i ✓ COMMERCIAL GENERAL LIABILITY LCLAIMS -MADE 1 ,/I OCCUR SIR: CLAIMS-MADE 0 ✓ XSL G27631976 10/1/2023 10/1/2024 EACH OCCURRENCE $ 1,500,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,500,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,500,000 GEN'L / AGGREGATE POLICY p OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000000 $ A AUTOMOBILE ✓ _ _ ✓ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY Ded: $1,000 0 01 SCHEDULED AUTOS NON -OWNED AUTOS ONLY ✓ ISA H08871796 10/1/2023 10/1/2024 (o COMBINED INGI-E LIMIT $2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Auto Physical Damage $Self Insured B C ✓ UMBRELLA LIAB EXCESS LIAB / OCCUR CLAIMS -MADE RES5000612-03 10/1/2023 10/1/2024 EACH OCCURRENCE $ 3,000,QOQ AGGREGATE $ 3,000,000 DED TRETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AN YP R O P R I E TO R/PA RT N E R/E X E C U T I V E OFFICER/MEMBEREXCLUDED? LJ (Mandatory le NH) If yes, describe under N/A RWE5000442-09 SIR: $2,000,000 10/1/2023 10/1/2024 ✓ STATUTE OTH- ER E.L.EACH ACCIDF_NT $2,000,000 $ 2,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ 2,000,000 F Umbrella/Excess Liability (See ADDITIONAL REMARKS SCHEDULE) VARIOUS 10/1/2023 10/1/2024 Ea. Occ./Aggregate $25,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) If additional insured (ADDL INSR) and/or subrogation waived (SUBR WVD) boxes are checked, applicable blanket policy endorsements apply in favor of the DESIGNATED ENTITY where required by written contract, but only as respects liability arising out of work performed by or on behalf of the insured. Additional Condition(s) as required by written contract: Primary/Non-Contributory status (GL/AL); Policy provisions include 30 days notice of cancellation (10 days for non-payment of premium) to first named insured. Copies of said notices will be provided to certificate holder. DESIGNATED ENTITY: City of Gilroy and its Directors, officers, and employees CANCELLATION City of Gilroy City Administrator 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 ✓Jecertie Caltocut Jfj4rt alwe S'(.wlce , .e.ee Beecher Carlson Insurance Services, LLC © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 76656121 123-24 Liability +$25M XS I Robert Schwartz 110/2/2023 11.33 )52 PM (PST) I Page 1 of 2 A p® AGENCY Beecher Carlson Insurance Services POLICY NUMBER AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE CARRIER ADDITIONAL REMARKS NAIC CODE NAMED INSURED Recology South Valley 1351 Pacheco Pass Highway Gilroy CA 95020 Page EFFECTIVE DATE: 10/01/2023 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) ADDITIONAL INTEREST: City of Gilroy City Administrator SCHEDULE OF PARTICIPATION: LAYER CARRIER NAIC # POLICY NUMBER PARTICIPATION Umbrella `Primary Lloyd's of London (Hiscox) N/A B0180PN2300870 $5M excess of underlying Excess Liability 1st Excess Lloyds of London (QBE/MAP/Inigo) N/A B0180PN2305961 $7.5M excess of $10M 2nd Excess Lloyds of London (Convex) N/A B0180PN2305975 $2.5M excess of $17.5M 3rd Excess 50% 50% Columbia Casualty Insurance Co. (CNA) Endurance Specialty Insurance Ltd. (Sompo) 31127 N/A 7034711677 EXC30001913803 $10M excess of $20M ADDITIONAL NOTES: ACORD 101 2008/01 ( 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 76656121 123-24 Liability +$25M XS I Robert Schwartz 110/2/2023 11:33:52 PM (PST) I Page 2 of 2