COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

DATE (MMIDDIYYYY) AC Ro® CERTIFICATE OF LIABILITY INSURANCE 3 / 3 / 2020 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 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 CONTACT NAME: Shala Pearson Leavitt United Insurance Services , Inc . PHCN o , ( 925 ) 395 -2600 AIC N0 : ( 9251287-0710 CA License # OJ02939 E-MAIL shala -pearson@leavitt . com ADDRESS: 2358 Maritime Dr , Ste 100 INSURER(S) AFFORDING COVERAGE NAIC # Elk Grove CA 95758 INSURER A : Admiral Insurance Company 24856 INSURED INSURER B : Travelers Property Casualty Company . 36161 Walton Engineering , Inc . INSURERC : State Compensation Insurance Fund 35076 P . O . BOX 1025 INSURER D : INSURER E : West Sacramento CA 95691 INSURER F : COVERAGES CERTIFICATE NUMBER: 20 -21 Master 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 NUMBER MM DPOLI CY EFF POLICY EXP LTR DIYYYY MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000 r 000 DAMAGE TO RENTE A CLAIMS-MADE �X OCCUR PREMISES Ea occurrence $ 50 r 000 X Pollution Liability FEIECC1358706 3 / 6 /2020 3 / 6/2021 MED EXP (Any one person) $ 51000 X Professional Liability PERSONAL & ADV INJURY $ 1 , 000 , 000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 21000 , 000 POLICY F�X] JE PRO F�j LOC PRODUCTS - COMP/OP AGG $ 2 , 0001000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000 , 000 Ea accident B X ANYAUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED 8108L785302 3 / 6/2020 3/ 6/2021 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Per accident $ Uninsured motorist combined single $ 11000 , 000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 10 000 000 A X EXCESS LIAR HCLAIMS-MADE AGGREGATE $ 10 , 000 , 000 DED X RETENTIONS 0 FEIEXS1358806 3 / 6/2020 3/6/2021 $ WORKERS COMPENSATIONX PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT $ 1 , 000 , 000 C (Mandatory R EXCLUDED? 9113339 10/ 1 /2019 10/1 / 2020 ( ry in NH) E.L. DISEASE - E4 EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 B Inland Marine QT6608KB16207 3/6/2020 3/ 6/2021 Umit $ 300 , 000 Leased , Borrowed , Rented Deductible $2 r 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Where required by written contract , Certificate Holder is Additional Insured with respects to the General Liability per attached policy endorsement form CG20370704 ; and with respects to the Auto , Additional Insured with Waiver of Subrogation and Primary and Noncontributory clauses apply when required by written contract per attached endorsement forms CAT3530215 and CAT4740216 . General Liability insurance is Primary and Noncontributory where required by written contract per attached endorsement form ECC5480712 . A separate Designated Construction Project General Aggregate Limit applies to each designated construction project of the Named Insured when agreed to and required under written contract per attached endorsement CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE To Whom it May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS . AUTHORIZED REPRESENTATIVE Shala Pearson / SHFRED � © 1988-2014 ACORD CORPORATION . All rights reserved . ACORD 26 (2014/01 ) The ACORD name and logo are registered marks of ACORD INS025 (201401 )