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HomeMy WebLinkAboutInsurance Certificate: Shelzi Enterprises, Inc.Rr.FI FNT-01 BLOOSIGIAN T �►Corrv° CERTIFICATE OF LIABILITY INSURANCE DATE(1121120YY_YYj f2a25 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(s). PRODUCER License # OE02096 D!Buduo & DeFendis Insurance Brokers, LLC 6873 N. West Ave, Ste 101 Fresno, CA 93711 CONTACT Blair Loosigian ME: ...,_ __..._. PHONE FAX f" No, Extl: {Alc, Noj: ni R1ESs.. blair.loosigian@dibu.com INSURERiS1 AFFORDING COVERAGE NAIC A INSURER A.Fireman's Fund Insurance Co. � 21873 _ _ INSURED INSURER B.American Automobile Insurance Co 21849 INSURERC:Znat Insurance Company 30120 Scelzi Enterprises, Inc. INSURER 0: 2286 E. Date Ave. Fresno, CA 93706 INSURER E : INSURER F rnVFPAn99 C.1=RTIF1rATF N111KARIPP- 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 TYPEOFfNSURANCE ADDL5USR POLICY NUMBER POLICY EFF POLICY EXP LIMITSLTR A X COMMERCtAL GENERAL LIABILITY cI Alkas I1ADE X OCCUR X USCO15795240 5/1/2024 5/1/2025 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED £MISES Ea octanece 104,000 M£D EXP An oneerson $ 5,000 GENL X AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ LOC JECT OTHER: PERSONAL_&ADVINJURY $ 1,000,000 GENERAL AGGREGATE 21000,000 PRODUCTS-COMPIOPAGG $ 2,000,000 $ B AUTOMOBILE LIABILITY - X ANY AUTO OWNED F SCHEOULED AUTOS ONLY AUTOS AUTOS ONLY AIOrTNOS ONLY X SCV0097492401 5/1/2024 5/1/2025 COMBINED SINGLE LIMIT $ 1 �000,000 BODILY SNJURY,(Per erson S BODILY INJURY Peraccident $ PROPERTY DAMAGE er acddeMl $ A X UMBRELLALIAB Excess Line X OCCUR CLAIMS-h(ADE USCO1183324U 5/1/2024 511/2025 EACH OCCURRENCE $ 10,000,000 AGGREGATE 1 10,000,000 D£D RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNEWEXECUTIVE YIN 01= FICERIMF�MBER EXCLUDED? andatory nNH) Ifs bounder OndescnRIPTIONOFOPERATIONSbekw N 7 A M1225508 3/1/2025 W112026 X STA E OHN - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 S B B Garage & Dealers Physical Damage SCV0097492401 SCV0097492401 5/1/2024 5/1/2024 W112025 511/2025 Comp/Coll $500 Ded Comp/Coll $500 Ded 6,000,000 6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addidonal Remarks Schedule, may be attached If more space Is requiredd►► City, its officers, agents, volunteers and employees are named as additional Insured with respect to General Liabliity per attached form CG71930319 and Aut Liabitity per attached form CA7018t014. Contractors Insurance coverage will be primary insurance with respect to City, its officers, agents, Volunteers and employees per attached form CG71930319 (General Liabitlty) and CA71060717 (Auto Liability) and any insurance or self-insurance maintained by the City wit be in excess of Contractors Insurance and not contributory with it. Contractor will furnish certificates of insurance and endorsements to City prior to City s execution of this Agreement. CERTIFICATE i-Inl nFR CANCELLATION �IIj�111111111Ijljil�llilljjji�Iji�Ijlltli�lllull�Ijll�lillij'll "**'**`*"**'*'**********SNGLP 936 Tray 1 : Piece 180 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 180 1 SP 0.690 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Si AUTHORIZED REPRESENTATIVE Ashland OR 97520-1814 "4 � ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Afflanz @ MultiCover® - Without Medical Payments - CG 7193 03 19 Policy Amendment(s) Commercial General Liability Coverage Form Your Commercial General Liability Coverage Form is revised as follows: 1. Broadened Named Insured A. SECTION II - WHO IS AN INSURED, item 3., is deleted and replaced by the following: 3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if: a. There is no other similar insurance available to that organization; and b. The first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization; and c. That organization is incorporated or organized under the laws of the United States of America. However: (1) Coverage under this provision 3 is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; and (2) Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization; and (3) Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. B. SECTION II -WHO IS AN INSURED, the last paragraph, is deleted and replaced by the following: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not shown as a Named Insured in the Declarations. However, this does not apply to a limited liability company that meets all of the conditions in Section II - Who Is An Insured, item 3., above. 2. Additional Insured If an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 2. Additional Insured does not apply to such person or organization. SECTION II - WHO IS AN INSURED, subsection 2.e., is added as follows: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is legally obligated to pay for bodily injury, property damage or personal and advertising injury caused by your acts or omissions. With respect to the insurance afforded to such additional insured, all of the following additional provisions apply: (1) You have agreed in a written insured contract that such person or organization be added as an additional insured under this policy; (2) The bodily injury, property damage or personal and advertising injury for which said person or organization is legally obligated to pay occurs subsequent to the execution of such insured contract; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the insured contract; (4) The insurance afforded to such additional insured only applies to the extent permitted by law; CG 7193 03 19 Copyrtght V 2019 Aleanz Global Rirks US Insurance Company. A I rights resecved. Includes copyrighted material of Insurance Services Ofhca, Inc.. with As percussion. Page 1 of 7 Afflanz ili (5) Such person or organization is an additional insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d) The maintenance, operation or use by you of equipment leased to you by such person or organization; (e) Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the products -completed operations hazard; or (f) Their liability as a grantor of a franchise to you. (6) This insurance does not apply to bodily Injury, property damage, personal and advertising injury, occurrence or offense: (a) Which takes place at a particular premises after you cease to be a tenant of that premises; (b) Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of your work out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project; or (d) Which takes place after the expiration of any equipment lease to which (4)(d) above applies; (7) With respect to architects, engineers or surveyors, coverage does not apply to bodily injury, property damage or personal and advertising injury arising out of the rendering or failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (b) Supervisory, inspection, architectural, or engineering services. These exclusions apply even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal or advertising injury, involved the rendering of or the failure to render any professional services by or for you. 3. Additional Insured - Vendors If an Additional Insured Vendors endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 3. Additional Insured - Vendors does not apply to that person or organization. Unless the products -completed operations hazard is excluded from this policy, SECTION 11 - WHO IS AN INSURED, item 21 is added as follows: f. Any vendor of yours is included as an additional insured, but only with respect to bodily injury or property damage caused by your products which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: CG 71 93 03 14 Copyright ® 2019 Manz Global Rlsks US Insurance Company. AR rights reserved. Includes copyrighted material of Insurance Services Office. Inc., with its permission, Page 2 of 7 Afflanz @ (1) The insurance afforded such 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 contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless 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 by the vendor in full compliance with the manufacturer's written instructions 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 liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (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; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or agreement; and (4) The insurance afforded to such vendor only applies to the extent permitted by law. 4. Additional Insured - Limited Primary and Noncontributory Provision The following is added as a second paragraph to Section IV Conditions, Condition 4. Other Insurance, following paragraph b.(2): However, if you have added any person, organization or vendor of yours as an additional insured to this policy by way of this MultiCover<9 endorsement and have agreed in a written insured contract that this insurance is primary and non-contributory with other insurance available to that additional insured, this insurance is primary and we will not seek contribution from such additional insured's other insurance, provided that the additional insured is a Named Insured under such other insurance. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8., is deleted and replaced by the following: 8. Transfer of Rights of Recovery Against Others to Us and Blanket Waiver of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. b. If required by a written insured contract executed prior to the occurrence or offense, we waive any right of recovery we may have against any person or organization named in such insured contract, because of payments we make for injury or damage arising out of your operations or your work for that person or organization. CG 7193 03 19 Copyright ® 2019 Manz Global Risks US Insurance Crvnpany. AN rights reserved. Includes copyrighted material of Insurance Services Office, Inc., Wth 43 permission. page 3 of 7 Afflanz ili 6. Cancellation - 90 Days Common Policy Conditions endorsement IL0017, A. Cancellation, item 2.b. is deleted and replaced by the following: b. 90 days before the effective date of cancellation if we cancel for any other reason. 7. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added as an additional Condition: Liberalization If we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. 8. Fire, Explosion, Sprinkler Leakage, or Lightning Legal Liability Coverage A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the last paragraph, is deleted and replaced by the following: Exclusions c. through n, do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while: 1. Rented to you; 2. Temporarily occupied by you with the permission of the owner; or 3. Managed by you under a written agreement with the owner. A separate limit of insurance applies to this coverage as described in Section III - LIMITS OF INSURANCE, B. SECTION III -LIMITS OF INSURANCE, item 6., is deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented To You Limit shown in the Declarations, for property damage to any one premises while rented to you, or in the case of damage by fire, explosion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of: a. $1,000,000 Any One Premises; or b. The Damage To Premises Rented To You Limit shown in the Declarations. C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, b. Excess Insurance, (1)(a), items (i) and (iii), are deleted and replaced by the following: (i) That is Fire, Explosion, Sprinkler Leakage or Lightning insurance for premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner; or D. SECTION V - DEFINITIONS, 9. Insured Contract, item a., is deleted and replaced by the following: (a) A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner, is not an insured contract; 9. Damage to Invitees' Automobiles from Falling Trees or Tree Limbs -Limited Coverage CG 71 93 03 19 CopyrlgM Q 2019 Manz Global Risks US Insurance Company AM rights reserved. indudes copyrighted material of Insurance Services Office, Inc., with its pema sslon. Page 4 of 7 C. Additional Insured Coverage and Waiver of Subrogation 1. Form CA0001 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added as item e.; and form CA0020 (if attached to this policy), Section 11 — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured; the following is added as item g.: Any person or organization with respect to the operation, maintenance, or use, of a covered auto, provided that you and such person or organization have agreed under an expressed provision in a written insured contract or written agreement, or a written permit issued to you by a governmental or public authority, to add such person, organization, or governmental or public authority to this policy as an insured. However, such person or organization is an insured: (1) Only with respect to the operation, maintenance, or use, of a covered auto; and (2) Only for bodily injury or property damage caused by an accident which takes place after: (a) You executed the insured contract or written agreement; or (b) The permit has been issued to you. 2. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, A. Loss Conditions, item 5.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, A. Loss Conditions, item 6.; the following is added: Waiver of Subrogation If required by a: a. Written insured contract or written agreement executed prior to the accident; or b. Written permit issued to you by a governmental or public authority prior to the accident; we waive any right of recovery we may have against any person or organization named in such contract, agreement or permit, because of payments we make for injury or damage arising out of the ownership, maintenance or use of a covered auto. D. Auto Medical Payments - Increased Limit For each covered auto described in the Declarations or shown in the Schedule as having Auto Medical Payments Coverage, the Medical Payments Limit of Insurance for those autos is revised to the greater of: 1. $5,000; or 2. The limit shown in the Declarations. E. Hired Auto Physical Damage Coverage and Loss of Use Expenses Hired Auto Physical Damage Coverage CA7018 10-14 Page 2 of 10 Copyright ©2014 Allianz Global Risks U5 Insurance Company. 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