Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2013_PS-1302000 thru PS-1302500_ - PS-1302108

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE DAT 01/3/20 4WY) 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(les)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 r~ certificate holder in lieu of such endorsement(s). 'E PRODUCER CONTACT L Aon Risk Services South, Inc. NAME: Franklin TN Office (AICD N.Ext): (866) 283-7122 AX.No.; 800-363-0105 y 501 Corporate Centre Drive E 2 MAIL o suite 300 ADDRESS: _ Franklin TN 37067 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Greenwich insurance Company 22322 Arcadis U.S, Inc. INSURER B: XL Specialty Insurance Co 37885 630 Plaza Drive suite 200 INSURER C: Highlands Ranch Co 80129 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570052554965 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. Limits shown are as requested INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICYFF POLICY EXP LTR INSR WVD MMIDD MM/DDIYYYY LIMITS A GENERAL LIABILITY GEC0010715112 Ul/U'/ZU'5 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TOENTED $1,000,000 PREMISES Ea occurrence CLAIMS-MADE X❑OCCUR MED EXP(Any one person) $10,000 X Contractual Liability PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,00014, LO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 N POLICY X PEO X LOC o B AUTOMOBILE LIABILITY AECO01075812 01/01/2014 01/01/2015 COMBINED SINGLE LIMIT 'O AOS Ea accident $1,000,000 B X ANY AUTO AECO01719510 01/01/2014 01/01/2015 BODILY INJURY(Per person) O ALL OWNED SCHEDULED MA Z AUTOS AUTOS BODILY INJURY(Per accident) 01 X HIREDAUTOSX NON-OWNED PROPERTYDAMAGE V AUTOS Per accident) w X Property Damage to 0) UMBRELLA LIAB OCCUR EACH OCCURRENCE U EXCESS LIAR CLAIMS-MADE AGGREGATE DED RETENTION B WORKERS COMPENSATION AND RWD943516308 01/01/2014 01/01/2015WC sTATU- OTH- EMPLOYERS'LIABILITY XTORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN All Other States B OFFICERIMEMBER EXCLUDED? N/A RWR943516708 01/01/2014 01/01/2015 E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH)If p/I E.L.DISEASE-EA EMPLOYEE $1,000,000 Dyes,describe underCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DES DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) RE: Project No. GP09BPNA.C178, Remedial System Piping Installation, Installation of AS/SVE conveyance piping. .a2 Ni CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 'y San Joaquin Countyr� Attn: Department of Public Works AUTHORIZED REPRESENTATIVE 1810 East Hazelton Avenue Stockton CA 95201 USA ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD