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HomeMy WebLinkAboutZanker Road Resource Management, Ltd. (2)ZANKEROA ACC>RbP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `.... - 6/26/2020 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(les) 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 USI Insurance Services LLC 1039-A N. McDowell Blvd, Petaluma, 94954 707-779-110000 CONTACT NAME: Susan Boutchie PHONE 628-201-9041 FAX AIC No Ext): AIC No rMAILADDREss: susan.boutchie@usi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Starr Surplus Lines Ins. Co. 13604 INSUREDZank 1500 B Road Resource Management, Ltd. 1500 Berger Drive INSURER B : Starr Indemnity and Liability Company 38318 INSURERC: National Union Fire Ins. Co. of Pittsburgh, PA 19445 INSURER D INSURER E: San Jose, CA 95112 INSURER F: COVERAGES CERTIFICATE NUMBER: 15074202 RFVISIr m IJIIMRFI?• Sc hol,,,.. 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. ILTR TYPE OF INSURANCE ANSR DDL INSD SUBR I WVD I POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 1000067024191 07/01/2019 09/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGETO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 25,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: P❑JECT PRO- ❑ LOC GENERAL AGGREGATE $ 2,000,000 GEN'L X PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 10000636742191 07/01/2019 09/01/2020 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY (Per person) $ Ix OWNED SCHEDULEDBODILY AUTOS ONLY AUTOS INJURY Per accident $ ( )HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $1,000 Llab. Ded. $ C UMBRELLALIAB X OCCUR 1000337348191 07/01/2019 09/01/2020 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10,000,000 DED RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A PER I OTH- STATUTE I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CG20150413 RE: Composting and resource management services for Los Altos Hills. Yard Waste Processing. The Town of Los Altos Hills is included as additional insured under General Liability only as respects liability arising out of operations performed at the above listed job per attached endorsement referenced above. Town of Los Altos Hills Jeff Peterson 26379 Fremont Road Los Altos CA 94022 LLH 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 I nu mtrvr<v name ano logo are registerea marKS OT ACOKD V 198E-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) 11111111 $11 III 1111 1E 11111 III 11�1 1111 11111E 1 11111 11III III • CYB01 A27/000044/02I04/0/0/0/0` POLICY NUMBER: 1000067024191 COMMERCIAL GENERAL LIABILITY CG 20 15 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor) Your Products Where Required By Written Contract TBD Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business. However: 1. The insurance afforded to such vendor only applies to the extent permitted by law; and 2. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors, the following additional exclusions apply: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contractor agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Sub -paragraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products, C. With respect to the insurance afforded to these "°°.'"„ uiuuiiiuliuiiiiiiiiiiuiiiiuiliiii'iiuiiiuiiiuuiuiuiuii Page 1 of 2 'CYBO1 A27/000044103/04/010/010' vendors, the following is added to Section III — Limlts Of Insurance: If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page =o,= 111111111111IIIIIIIIIIIiIIIIIIIIUIIIIIIIIIIIBI'IIIIIIIIIIIIIIIIIIIIII CG=.�Po,� USI INSURANCE SERVICES LLC 1039-A N. MCDOWELL BLVD. PETALUMA, CA 94954 707-779-1100 TOWN OF LOS ALTOS HILLS JEFF PETERSON 26379 FREMONT ROAD LOS ALTOS CA 94022 M. Would you like to receive this certificate via email or fax? We offer expedited delivery to better serve our mutual clients. To update the delivery method for revisions to this certificate and for next year's copy, please enter this information in your browser: https://www.cybersure.com/cybersure/forms/iyoc/cdmu.aspx When prompted, enter this information for security purposes: Client ID: ZANKEROA Cert ID: 15074202 Passcode: E7EE6002 Follow the instructions and let us know your delivery preference. You'll receive future copies of this certificate via the method you provide. Thank you for helping us provide certificates to you more quickly. IIIII'lllllllllllllllll11lllllllll1l!IIIIIIIIIIIIIIIIYIIIIIRIIIVIIII v_,......._...