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HomeMy WebLinkAbout15- EsGil (Cavignac & Associates) Certificate of InsuranceCAVIGNAC r. -I ASSOCIATES INSURANCE BROKERS License No. OA99520 450 B Street, Suite 1800 San Diego, CA 92101-8005 Tel. 619.234.6848 e Fax 619.234.1239 e Web www.cavignac.com City of Bozeman ATTN: Building Division P.O. Box 1230 Bozeman, MT, 59771 Sep 01, 2015 Re: EsGil Corporation To Whom It May Concern: Enclosed is a certificate of insurance, as requested. If you have questions or require changes, _ please contact our office via email (certificates@cavignac.com) or fax (619-234-1239). Please include a copy of the certificate with your request or reference ID number 330039. Sincerely, Cavignac & Associates Certificate Department certificates@cavignac.com 619-234-1239 (fax) cc: Karen Ross (kross@esgil.com) EsGil Corporation - Certificate of Insurance Page 1 of 3 / i ® A`� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/1/2015 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 Certificate Department NAME: P PHONE FAX 619-234-8601 C o Ext): 619-234-6848 A1C No: Cavignac & Associates 450 B Street, Suite 1800 San Diego, CA 92101-8005 ADDRESS: Icertificates@cavignac.com INSURERS AFFORDING COVERAGE NAIC# License No. OA99520 INSURER A 9/1/2015 INSURED INSURER B: TRAVELERS IND CO OF CT 25682 INSURER c:13EAZLEY INS CO INC 37540 EsGil Corporation 9320 Chesapeake Drive, #208 San Diego, CA 92123 United States INSURER D: INSURER E: INSURER F: CLAIMS -MADE X� OCCUR COVERAGES CERTIFICATE NUMBER: 210358 REVISION NUMBER:330039 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER EFF MMIDDY POLICY MM D/YYYY LIMITS B GENERAL LIABILITY 6801052T972 9/1/2015 9/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 X Separation of Insureds X GENERAL AGGREGATE $ 2,000,000 X Contractual Liability GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible $ 0 1-1 POLICY X PEo LOC A AUTOMOBILE LIABILITY BA6663MO34 9/1/2015 9/1/2016 MBINED Ea..MontSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS 1HIREDAUTOS - PROPERTY DAMAGE $ Per accident NON -OWNED AUTOS A X UMBRELLA LIAB X OCCUR CUPOF316016 9/1/2015 9/1/2016 EACH OCCURRENCE $ S'000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ NIL $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N UB067ST169 9/1/2015 9/1/2016 XI TORY WCSLATU- OIMITS E H- -' ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT $ 1, 000,000 OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1, 000, 000 E.L. DISEASE -POLICY LIMIT 1 $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below C Professional Liability V15WOKlSI001 9/1/2015 9/1/2016 Each Claim $1,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured coverage applies to General Liability for City of Bozeman, its officers, officials, employees, agents and volunteers per policy form. Prof. Liab. - Claims made, defense costs included within limit. CERTIFICATE HOLDER CANCELLATION City of Bozeman P.O. Box 1230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Bozeman, MT 59771 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN United States ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jeffrey W. Cavignac I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD EXIGIS - CAVIGNAC & ASSOCIATES 330039 Page 2 of 3 POLICY NUMBER: 6801052T972 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part, but only with respect to liability for "bodily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf. a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the '.products -completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided to the additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services". f. The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits shown in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance". But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or organization entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and C. Before the end of the policy period. © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 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