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Home My WebLink AboutCOI - Performance Transport - Expires 2025-01-01 (2)P5260028002 +i Rs,if �. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/26/2023 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($). PRODUCER 1-801-505-6500 Brown & Brown Inc. 257 East 200 South Suite 700 Salt Lake City, UT 84111 CONTACT tlennifer SoreNAME:s PHONE FAX (AIC. No; ExO:-8015056500 (AIC, N): 801-505-6501 SNAIL ADDRESS: jennifer.stiresebbrewn,Com INSURER(S)AFFORDING COVERAGE NAIL # INSURER A : NATIONAL INTERSTATE INS CO 32620 INSURED Performance Transport 11408 Cactus Avenue Bloomington, CA 92316 INSURERS: Upland Specialty Ina Co 16988 INSURER C : VANLINER INS CO 21172 INSURERD: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: 70266477 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 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 yyyp POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY SCG 0000509-06 01/01/24 01/01/25 EACHOCCURRENCE $ 1,000,000 CLAIMS -MADE I X I OCCUR PR PREMISES DAMAGE M(Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEML X AGGREGATE LIMIT APPLIES PER: POLICY C1 YR: I J LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AU7°MOBILELIABILITY X __ ANY AUTO OWNED __._, SCHEDULED AUTOS NON -OWNED AUTOS ONLY SCR 0000509-06 01/01/24 01/01/25 COMBINED SINGLE LIMIT (Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ 13 XLL UMBRELLA LIAB EXCESS LIAB X4 OCCUR CLAIMS -MADE USXTL0517024 01/01/24 01/01/25 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE iNN I OFFICER/MEMBER EXCLUDED? (Mandatory In NH) Ifyes, describe under DESCRIPTION OF OPERATION$ below N NIA SCW 0000509-06 01/01/24 01/01/25 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 A Motor Truck Cargo CRC 5500509-06 01/01/24 01/01/25 S10,000 Ded 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space la required) City of Gilroy is listed as additional insured in regards to the general liability and auto liability policies per the attached .forms. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 USA 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) ,IStires 70266477 O 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD trt O P5260028002 Policy #: SCR0000509-05 COMMERCIAL AUTO NI CA 50 57 06 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSIURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM TRUCKERS COVERAGE FORM MOTOR CARRIEFI COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. Who Is An Insured under COVERED AUTOS LIABILITY COVERAGE is amended to include as an "insured", any person or organization you are required to add as an additional insured on this policy under a written contract, agreement or permit which must be: a. currently in effect or becoming effective during the term of the policy; and b. executed prior to the "bodily injury" or "property damage." The insurance provided to this additional insured is limited as follows: 1. That person or organization is an additional insured only with respect to liability arising out of your operations performed for that additional insured as specified in the written contract, agreement or permit. 2. The limits of insurance applicable to the additional insured are those in written contract, agreement, permit or in the Declarations for this policy, whichever are less. These limits of insurance are inclusive of and not in addition to the Limit of Insurance for Liability Coverage shown in the Declarations. 3. Coverage is not provided for "bodily injury" or "property damage" arising out of the sole negligence of the additional insured. Any coverage provided hereunder will be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary. When this insurance is in excess, we will have no duty to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured against that "suit." If no other insurer defends, we will undertake to do so, but vve will be entitled to the additional insurer's rights against all those other insurers. All other terms and conditions of this policy remain unchanged. NI CA 50 57 06 14 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission. Copyright, Insurance Services Office, Inc. P5260028002 Brown & Brown Inc. 257 East 200 South Suite, 70 Electronic Service Requested MIXES) tADC 950 :I:I9 r9 1 . 1458 MB 0.558 C3tyy oNNrA T 547 GXL.ROY, CA 95.020.6141 EBIX BPO This document was brought to you by CertieicatesNow. - If you have questions re£3arding thq content of this document, please contact - the Producer/Agent listed on the cart f&cate of insurance or the Insured 'listed on the notice of earicellat on/reinstateaoent.- COS The data included in this notice and In the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by CertlflcatesNow - www.ConfirmNet.com - 877.669.8600