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HomeMy WebLinkAboutMartin & Chapman InsuranceOP ID: CO CERTIFICATE OF LIABILITY INSURANCE D02/15ATE /2017 Y) 02/15/2017 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 PIASC Insurance Services, Inc. REEI�_- Lic.# 0747420 P.O. Box 910936i] c? Los Angeles, CA 90091-0936 ,G Pauline B. Ornelas, CIC Martin &ChamL1L INSURED p Attn: Scott Martin 1951 Wright Circle Anaheim, CA 92806-6028 ,VIM IMI I NAME: Cristina Ontiveros aHONti F.�, 323-728-9500 I rFerM_ tum, 323-248-9930 rnyuur.en MARTIN2 CUSTOMER ID INSURERIS) AFFORDING COVERAGE NAI INSURER A:The Hanover Insurance Group 36064 INSURER B: Preferred Employers Ins. Co. 10900 INSURER D: rnVERAGES CERTIFICATE NUMBER: REVISION NUMBER: vTHIS 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 ADDL SUER ICY EFF P LTCY E7(♦'' LIMITS 7R TYPE OF INSURANCE POLICY NUMBER M1DD/YYYY MAID.D/YYYY GENERAL LIABILITY City of San Luis Obispo Attn. City Clerk 990 Palm Street AUTHORIZED REPRESENTATIVE San Luis Obispo, CA 93401 EACH OCCURRENCE $ 1,000,00 A X 1 COMMERCIAL GENERAL LIABILITY �I 9012496 06 02/18/2017 02/18/2018 -DAMA EE Y (5 REN PREMISES jEa occurrence $ 1,000,00 MED EXP (Anyoneperson) $ 10,00 CLAIMS -MADE IX1 OCCUR pZH3 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 dX GL BROAD FORM END GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ _ 2,000,00 X POLICY 1" PRO LOC 1 —1 IEmpl. Ben $ 1,000,00 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) A X ANY AUTO AW3 9033498 06 02/18/2017 02/18/2018 BODILY INJURY (Per person) $ I ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (PER ACCIDENT) X NON -OWNED AUTOS $ UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 3,000,00EXCESS AGGREGATE $ T LIAB CLAIMS -MADE IUH3 8989976 06 02/18/2017 02/18/2018 ---- DEDUCTIBLE $ $ X i RETENTION $ 0 I WORKERS COMPENSATION _ X WC STATU- OTH- B AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WKN 122873-13 06/01/2016 06/01/2017 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A -PROOF OF COVERAGE ONLY" EL DISEASE - EA EMPLOYE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E_LDISEASE-POLICY LIMIT $ 1,000,00 A Errors & OmissionsZH3 9012496 06 02/18/2017 02/18/2018 lEach Occu 1,000,00 IDed. $25,000 i'l—SPECIAL FORM" Ann.Aggre 2,000,00 DESCRIPTION OF OPERATIONS ! LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate holder is named ADDITIONAL INSURED with respects to services provided and/or performed by the Named Insured. CERTIFICATE HOLDER CANCELLATION CITYSL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of San Luis Obispo Attn. City Clerk 990 Palm Street AUTHORIZED REPRESENTATIVE San Luis Obispo, CA 93401 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD N W ZEL Q Lu LL w l� 419.CN r C)m wo CO • o v 0 gp, x Q w w o —i cv U W `v LUILLJ u Lk- o V) OP ID: CO DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 02/15/2017 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 RFCE1 V� NAME: Cristina Ontiveros PIASC Insurance Services, Inc. PHONE FAX Lic.# 0747420 vc o� =a 323-728-9500 Arc N,I.. 323-248-9930 P.O. Box 910936 �� 2 # pREW: cristina@plasc.oro Los Angeles, CA 90091-0936 PRODUCER MARTIN2 Pauline B. Ornelas, CIC 0Tp>N INSURED Martin & Chapman Com 4" ` "' ' `"+`'' "` INSURERA:The Hanover Insurance Group 36064 Attn: Scott Martin INSURER B: Preferred Employers Ins. Co. 10900 1951 Wright Circle INSURER C : Anaheim, CA 92806-6028 INSURER P INSURER E: INSURER F: nr_ n rir,r n TM ■tt rexcoo. R5=VISI(,1N fit IMRRR V 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. ADDL I= — POLICY NUMBER MMIDO EFF__ —POLICY MMMO FSP LIMITS NSR TYPE OF INSURANCE LTR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE GENERAL LIABILITY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of San Luis Obispo EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY ZH3 9012496 06 02/18/2017 02/18/2018 p�ES[ a r<en� $ 1,000,00 MED EXP Any one person) $ 10,00 CLAIMS -MADE L—XI� OCCUR PERSONAL & ADV INJURY $ 1,000,00 I $ 2,000,0011 ^2,000,00 X GL BROAD FORM END GENERAL AGGREGATE GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG III $ 11 Em I. Ben X POLICY PRD LOC I $ 1,000,00 A AUTOMOBILE LIABILITY X ANY AUTO AW3 9033498 06 02/18/2017 02/18/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ _ SCHEDULED AUTOS X HIRED AUTOS PROPERTY DAMAGE (PERACCIDENT) $ $ X NON -OWNED AUTOS $ _i X UMBRELLA LIAB I X OCCUR EACH OCCURRENCE $ 3,000,00 11) AGGREGATE $ A — _ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE UH3 8989976 06 02/18/2017 02/18/2018 $ $ X RETENTION $ 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Yf N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F7N (Mandatory in NH) N I A WKN 122873-13 06/01/2016 ""PROOF OF COVERAGE ONLY" 06/01/2017 X WC STATU- I JOTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 ELL DISEASE - POLICY LIMIT $ 1,000,00( If yes, describe under DESCRIPTION OF OPERATIONS below A (Errors & Omissions (ZH3 9012496 06 02/18/2017 02/18/2018 Each Occu 1,000,00 IDed. $25,000 `SPECIAL FORM` Ann.Aggre 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named ADDITIONAL INSURED with respects to services provided and/or performed by the Named Insured. rrnri rtr nr� uh, ncr7 f_Atdf_FI I ATinm CITYSLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of San Luis Obispo Attn. City Clerk 990 Palm Street AUTHORIZED REPRESENTATIVE San Luis Obispo, CA 93401 U 1985-2UU9 AUUKU GUKF'UKA I IUN. All rlgntS reservea. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: CO CERTIFICATE OF LIABILITY INSURANCE D05131ATE /2 01 6 Y) 05/31 /2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PIASC Insurance Services, Inc. Lic.# 0747420 NAME: Cristina Ontiveros PHONE 323-728-9500 F' 323-248-9930 (,vc, No,.t;$()L- I/UC Nos P.O. Box 910936 AIN Los Angeles, CA 90091-0936 �N 13 2Q I� Pauline B. Ornelas, CIC EMAIL PROOUCER ristlila iasc.erg _CUSTQ� Hlp &MARTIN2 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Martin & Chapman Company INSURERA:The Hanover Insurance Group A k✓ J 36064 Attn: Scott Martin 1951 Wright Circle Anaheim, CA 92806-6028 INSURER B: Preferred Employers Ins. Co. A4,- XV 10900 INSURERC: -- ti _ $ 10,00 INSURER D INSURER E: INSURER F: $ 1,000,00 GENERAL AGGREGATE COVERAGES CERTIFICATE NUMBER; 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. tLT R ADDIISTYPE OF INSURANCE INSR LU O POLICY NUMBER MM EFF POLICY LTR LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X GENERAL LIABILITY ZH3 9012496 05 02/18/2016 02/18/2017 _ E ka p PREMISESS (Ea occurocwrrenos $ 1,000,00 _COMMERCIAL CLAIMS -MADE OCCUR MED EXP. (Arly.one porsprl) _ $ 10,00 H_ PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,0011 x GL BROAD FORM END I l GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X1 POLICY n PRO Lor. $ 1,000,00 Em I. Ben AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 A X ANY AUTO AW3 9033498 05 02/18/2016 102118/2017 (Ea accident) BODILY INJURY (Per person) I $ ALL OWNED AUTOS $ BODILY INJURY (Per accident) SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (PER ACCIDENT) $ X NON -OWNED AUTOS $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,00 AGGREGATE $ A EXCESS LIAB CLAIMS -MADE UH3 8989976 05 02/18/2016 02/18/2077 - DEDUCTIBLE $ $ X RETENTION $ 0 _ WORKERS COMPENSATION X T C Al TS i Fr AND EMPLOYERS' LIABILITY YIN B ANY PROPRIETOR/PARTNER/EXECUTIVE WKN 122873-13 06/01/2016 06/01/2017 E. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA **PROOF OF COVERAGE ONLY* - $ 1,000,00 E.L. DISEASE - EA EMPLOYE If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 1,000,00 A 1Errors & Omissions ZH3 9012496 05 1 02/18/2016 02/18/2017 1 Each Occu 1,000,00 IDed. $25,000 "*SPECIAL FORM*** Ann.Aggre 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) -Certificate holder is named ADDITIONAL INSURED with respects to services provided and/or performed by the Named Insured. CERTIFICATE HOLDER CANCELLATION CITYSL1 City of San Luis Obispo Attn. City Clerk 990 Palm Street San Luis Obispo, CA 93401 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: CO CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDIIIYYYY) 0.02/29/2016 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 02!2912016 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAraE: Cristina Ontiveros PIASC Insurance Services, Inc. Llc.# 0747420 PrI°NE 323-728-9500 323-248 9930 xtL' _ +� Hsi=�_�_' P.O. Box 910936 AD Q.- cristina@piasc.Org Los Angeles, CA 90091-0936 Pauline B. Ornelas, CICcusgp.16WX..1MARTIN2 nkdffal%,t--- ' - --- ---- -- - -� g INSURED Martin 8r Chapman Company INSURER(S) AFFORDING COVERAGE I NAIC # INSURERA:The Hanover_ Insurance Group jC"1ir !36064 Attn: Scott Martin INSURER B :Preferred Ernploy�rs_lns. Co. \J10900 - --- 1951 Wright Circle � Anaheim, CA 92806-6028 Irsau c INSURER D.: ! _ — t _ INSURER E I PERSONAL & ADV INJURY S INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADOL'SUDR I TR i TYPE OF INSURANCE POLICYNU6IBER POLICY EFF POLICY EXP LMM1DDfltiYY] IhiM1i±DDffYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S - - 1,000,00 - A X COMMERCIAL GENERAL LIABILITY H3 9012496 05 02/18/2016 02/18/2017 DAMS E'Tc R`F.NTED EMISE� Eeuocyrr r )$ 1,000,00 _ CLAIMS -MADE ^ 1 OCCUR MED EXP1,Myc lersim $ 10,00 TI I PERSONAL & ADV INJURY S 1,000.,00 X GL BROAD FORM END I GENERAL AGGREGATE _ 3 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY" PRo• 7 Loc Empl. Ben $ 1,000,00 AUTOMOBILE LIABILITY f COMBINED SINGLE LIMIT $ 1+00©,00 A X ANY AUTO JAW3 9033498 05 Ea accidenl) 0211812016 02118!2017 + I BODILY INJURY (Per person) $ I ALL OWNED AUTOS BODILY INJURY (Per accident 15 SCHEDULED AUTOS X HIRED AUTOS PROPERTY DAMAGE $ (PER ACCIDENT) FX NON -OWNED AUTOS $ ;$ I- X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 3,000,00 EXCESS LIAB CLAIMS -MADE A - - UH3 8989976 05 jI ^ AGGREGATE i S 02/18/2016 02/18/2017 - DEDUCTIBLE X I RETENTION S 0 WORKERS COMPENSATION X 1 C STAT . t ER I B AND EMPLOYERS' LIABILITY YIN I ANY PROPRIETORIPARTNER/EXECUTIVEj� EXCLUDED? NIA WKN 122873-12 — ` 06/0112015 06/01/2016 E,L EACH ACCIDENT $ - 1,000,00 OFFICERIMEMBER E n (Mandatory In NH) ('"PROOF OF COVERAGE ONLY` E.L DISEASE - EA EMPLOVEJ S 1,000,00 If yyes, describe under DESCRIPTION OF OPERATIONS below I ` E.L. DISEASE •POLICY LIMIT S 1,000,00 A (Errors & Omissions iZH3 9012496 05 02/18/2016 02/18/2017 lEach Occu 1,000,00 IDed. $25,000 "'SPECIAL FORM" i IAnn.Aggre 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace is required) Certificate holder is named ADDITIONAL INSURED with respects to services ;provided and/or performed by the Named Insured. CERTIFICATE HOLDER CANCELLATION CITYSL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN �Elv�l% ACCO DANCE WITH THE POLICY PROVISIONS. City of San Luis Obispo Attn. City Clerk APR G I 990 Palm Street 201 AUTHOR( ED REPRESENTATIVE San Luis Obispo, CA 93401 I - -J ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD Goodwin, Heather From: Kristin Martin <Kristin@martinchapman.com> Sent: Thursday, April 21, 2016 8:35 AM To: Goodwin, Heather Subject: Insurance Certificate Attachments: SLO_COI.pdf Dear Heather— Please find attached Martin & Chapman Co.'s COI per your request on 4/8/16. Have a great day! Thanks, Kristin Martin McGlone Martin & Chapman Co. (Off on Mondays) kristinra,martinchanman.com 714-939-9866 Ext. 216 www.martinchar)man.com Follow us: MOW A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's CQm SO Member Center: Lou In 'Swan Up Need Coverage? How Does Your Insurer Rate? State Insurance Information Find insurers by state or coverage type - (Enter a Company Name �.,., �} Select a State v Consumer �Ho lme Terms to Know I Why a Best's Rating is Important I Contact Us ® Life & Retirement O Health & Disability G Car & Home (:) Other Life Events Hanover Insurance Company (a member or Hanover Insurance Grp Prop & Cas Cos) AM Beat #: 02225 NAIC * 22292 FEIN* 17.912p1►215 Address: 440 Lincoln Street Phone: 508-853-7200 Worcester, MA 01653-0002 Fax: 508-855-6417 UNITED STATES Web: www hanover com Best's Ratings Vrew Darin tm Financial Strength Rating: A Outlook: Stable Effective Date: May 22, 2015 (Affirmed ) Financial Size Category: XV (Z2 Billion or greater) Licensing: The company is licensed in the District Of Columbia and all states Top Line(s) of Business (based upon Direct Premiums writer) 1 Commercial Multiple Peril view +rr ) 2 Inland Marine (v.m Derhilion ) 3 Other Liability (Claims -made) mlL. Derr on ) 4 Other Liability (Occurrence) rywm Rt:nninon ) 5 Homeowners Multiple Peril mew oerirtltlen > Top State(s) of Business (based upon Direct Premiums Written) 1 New York 2 California 3 New Jersey 4 Texas 5 Massachusetts Visit our News Room for the latest News and Press Releases for this company and its A M Best Group 8 Prinl this Paoe Need More information? 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Best I Site Mae I Privacy Policy I Security I Terms of Use I L=19! Licensing Copyright © 2016 A.M. Best Company, Inc. and/or its affiliates ALL RIGHTS RESERVED http://www3 . ambest.com/consumers/CompanyProfile.aspx?BL=3 6&ambnum=002225 &P... 4/27/2016 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's j `w- '� kmUf���+ �e +~ 80' Member Center: Loa Ind Sion Up Need Coverage? How Hoes Your Insurer Rate? State Insurance information Find insurers by state or coverage lyre - Enter a canwny Nemo = Sdacl a State w Consumer Home I Terms to Know I Why a Best's Rating is Important I Contact Us 'i , Life & Retirement O Health & Disability Q Car & Home () Other Life Events Preferred Employers Insurance Company (a member of W R Berkley Insurance Group) AM Best121911 NAIC#:10900 FEINk 91-1874671 Address: 1455 Frazee Road Suite 1000 San Diego, CA 92108 UNITED STATES Best's Ratings Vlew Dakmton Financial Strength Rating: A+ Outlook: Stable Effective Date: February 26, 2016 (Affirmed ) Financial Size Category: XV ($2 Billion or greater) Licensing: The company is licensed in Arizona, California, Nevada and Oregon Top Line(s) of Business (based upon Direct Premiums Written) 1 Workers' Compensation (v_n. ua!14GIInrr ) Top State(s) of Business (based upon Direct Premiums Written) 1 California Phone: 619-688-3900 Fax:619-71 M694 Web: www-oeiwc com Visit our NewsRoom for the latest News and Press lieleagas for this company and its A M Best Group Terms of Use ng P_nnt9htgtaa$ Need More information? Purchase an insurer report, complete with rating history, market share and a list of competitive insurers for $ 9,95. View Sample Report All information provided on the A M Best website, including but not limited to text, data, ratings, reports, images, photos, graphics, and charts is owned by or licensed to A M Best Company and is protected by United States copyright laws and international treaty provisions. A M. Best and its licensors retain all copyright and other proprietary rights to the website content. Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A M Best Company. All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited By logging into Best's Member Center or accessing this site, you accept and agree to be bound by our complete Terms of Use. Customer Sorvlce Product Support I Member Canter l Contac! info lCarea About A M. Best i e Ma l Privacv Pgl Necurity Terms of Use j Legal & L0nging Copyright © 2016 A M Best Company, Inc and/or its affiliates ALL RIGHTS RESERVED http://www3.ambest.com/consumers/CompanyProfile.aspx?BL=36&ambnum=012191 &P... 4/27/2016 ,;, City Administration �r............ 990 Palm Street, San Luis Obispo, CA 93401-3249 805.781 7114 sIocity org April 8, 2016 Scott Martin Martin & Chapman Company 1951 Wright Circe Anaheim, CA 92806-6028 Subject: Expired Insurance Certificates for Martin & Chapman Company Dear Mr. Martin: Our records indicate the following insurance coverage(s) will expire as of the referenced date below. According to the contract, you must maintain insurance coverage throughout the term of the contract. We would greatly appreciate your prompt attention to this matter as we have several contracts with your business. Worker's Comp/Emp. Liability: Expiration date: 06/01/2016 Other Liability: Expiration date: 02/18/2016 The documents may be emailed in advance to hgoodwin0),slocity.org and then hard copies mailed. All documents should be sent to: City of San Luis Obispo Attn: City Clerk's Office 990 Palm Street San Luis Obispo, CA 93401 If you have any questions, please phone me at (805) 781-7103. Our fax number is (805) 781-7109. Sincerely, Heather Goodwin Deputy City Clerk OP ID: CO CERTIFICATE OF LIABILITY INSURANCE D02/16ATE /2016 Y) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 02/16/2016 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT T Cristina Ontiveros PIASC Insurance Services, Inc. ". Lic.# 0747420 - '' PHONE 323-728-9500 FA% c No.Irxl) _ _ _ (AJC, NI):'323-248-9930 P.O. Box 910936 AorARss cristine iasc,o _. rg Los Angeles, CA 90091-0936 ® Pauline B. Ornelas, CIC FEB 2 2 2016 .. PRODUCER CUSTOM ( _MARTIN2 INSURED Martin & Chapman Company INSURER($) AFFORDING COVERAGE _ _ NAIC N INSURERA:The Hanover Insurance Group— 36064 Attn: Scott Martin INSURER B: Preferred Empip fyers Ins. CO. 44- \A/ 10900 " 1951 Wright Circle Anaheim, CA 92806-6028 INSURER C : INSURER D INSURER E: INSURER F: rC)VF:PAt'9FS CERTIFICATE NUMBER: 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. TYPE OF INSURANCE POLICY NUMBER MIODNYYY ly MJDD 'L M POLICY EFF POLICY EX LIMITS GENERAL LIABILITY EACH OCCURRENCE i 1,000,00 A X COMMERCIAL GENERAL LIABILITY H3 9012496 05 02/1812016 02/18/2017 OAMAG( _ TO RENTED PREMISE �Ea occvrran- $ _ 1,000,00 I CLAIMS -MADE 1x1 OCCUR MED EXP (Any one person) S 10,00 PERSONAL & ADV INJURY $ 1,000:00 X GL BROAD FORM END GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS _ COMP/OP AGG $ �2,000r0" XA POLICY F-1PRO• I LOC Empl. Ben $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT � $ 1,000,00 A ' X ANY AUTO IAW3 9033498 05 02/18/2016 (Ea accident) 02/18/2017 - -, BODILY INJURY (Per person) $ _ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS (PROPERTY DAMAGE $ X HIRED AUTOS PER ACCIDENT) X NON -OWNED AUTOS �� $ F iX UMBRELLA LIAR X OCCUR I EACH OCCURRENCE $ 3,000,0010 EXCESS LIAR CLAIMS -MADE' A UH3 8989976 05 02/18/2016 02/18/2017 AGGREGATE $ �- DEDUCTIBLE ?i R-TFNT!0N S WORKERS COMPENSATION! X _�_ TORY LIMIWC TS O R I B AND EMPLOYERS' LIABILITY Y 1 H ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? ❑N IjWKN 122873-12 06/01/2015 06/01/2016 E L EACH ACCIDENT $ 1,000,Q0 N / A OFFICERWEMBER (Mandatory in NH) �"*PROOF OF COVERAGE ONLY* E.L DISEASE - EA EI`APLOYE� $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below EL, DISEASE -POLICY LIMIT S 1,000,00 A Errors & Omissions 'ZH3 9012496 05 02/18/2016. 02/18/2017 Each Occu 1,000,00 Ded. x25,000"**SPECIAL FORM*** Ann.Aggre 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is named ADDITIONAL INSURED with respects to services provided and/or performed by the Named Insured. Gr -t( I IrIUA I r- rIUL.Ur-M r I�Iv CITYSL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of San Luis Obispo Attn. City Clerk AUTHORIZED REPRESENTATIVE 990 Palm Street San Luis Obispo, CA 93401 ,q.�.s�. ©1988-2009 ACORD CORPORATION. All rlgnts reserves. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best'] -` consumer Insurance Cootof 20 �r� �.- Member Center: Loa In i Sion Need Coverage? How Does Your Insurer Rate? State Insurance Information Find ,nsurers by s^ale or coverage type Enter a Company Name Ftf Select a Stale _ v Consumer Home i Terms to Know I Why a Best's Rating is Important i Contact Us Life & Retirement O Health & Disability Q Car & Home + Other Life Events Hanover Insurance Company (a member or Hanover Insurance Grp Prop & Cas Cos) AM Best if: 02225 NAIC # 22292 FEIN #, 13-5129825 Address: 440 Lincoln Street Worcester, MA 01653-0002 UNITED STATES Best's Ratings View Definition Financial Strength Rating: A Outlook: Stable Effective Date: May 22, 2015 (Affirmed ) Financial Size Category: XV ($2 Billion or greater) Licensing: The company is licensed in the District of Columbia and all states Top Line(s) of Business (based upon Direct Premiums Written) 1 Commercial Multiple Peril (yew narmigio 2 Inland Marine tyrnw Qenmllnn ) 3 Other Liability (Claims -made) my4 par !ine ) 4 Other Liability (Occurrence) omw Lkonitlun ) 5 Homeowners Multiple Peril tVi(tw our iton ) Top State(s) of Business (based upon Direct Premiums Written) 1 New York 2 California 3 New Jersey 4 Texas 5 Massachusetts Phone: 508-853-7200 Fax: 508-855-6417 Web: www.hanovercom 8 Print this Pape Need More information? PurMW an insurer report, complete with rating history, market share and a list of competitive insurers for $ 9,95 View Sample Report Visit our NewsRoom for the latest News and Press Relaasas for this company and its A M Best Group j Terms of Use All information provided on the A M Best website, including but not limited to text, data, ratings, reports, images, photos, graphics, and charts is owned by or licensed to A M Best Company and is protected by United States copyright laws and international treaty provisions A M Best and its licensors retain all copyright and other proprietary rights to the website content - Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A M, Best Company All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited By logging into Best's Member Center or accessing this site, you accept and agree to be bound by our complete Terms of Use. i Carslamer ervtce j Product Su000n Member Center I ConIja In I Careers ul AM. Bes I §ile Mp I Privacy Polity j Security I Terms of Use I LenaI & Lice. s[no i Copyright © 2016 A M Best Company, Inc. and/or its affiliates ALL RIGHTS RESERVED http://www3 . ambest. com/consumers/CompanyProfile. aspx?BL=3 6&ambnum=002225 &P... 3/24/2016 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's �_ _4; 40 f - 1 s_ Member Center Loa In I Sian Need Coverage? How Does Your Insufffrreer Ra111te? State Insurance Information Find insurers by state or coverage type (Enter a Company Name f�f�111it1 Se v Select a Stat Consumer -Ho Jme Terms to Know I Why a Best's Rating is Important I Contact Us (_) Life & Retirement O Health & Disability Q Car & Home ® Other Life Events Preferred Employers Insurance Company (a member of W R Berkley Insurance Group) A,M. Y. 1$1$1 NAIC * 10900 FEIN If 0t-1aNOT1 Address: 1455 Frazee Road Suite 1000 San Diego, CA 92108 UNITED STATES Best's Ratingsylewooflnitton Financial Strength Rating: A+ Outlook: Stable Effective Date: February 26, 2016 (Affirmed ) Financial Size Category: XV ($2 Billion or greater) Licensing: The company is licensed in Arizona, California, Nevada and Oregon Top Line(s) of Business (based upon Direct Premiums Written) 1 Workers' Compensation mow 0arim lon i Top State(s) of Business (based upon Direct Premiums Written) 1 California A Print this pope Phone: 619-686-3900 Fax: 619-718-6694 Web: www oelwc.com Need More information? ur ase an insurer report, complete with AMS R rating history, market share and a list of competitive insurers for $ 9..95 View Semple Room Visit our NewsRoom for the latest News and Press Releases for this company and its AM Best Group. Terms of Use All information provided an the A.M.. Best website, including but not limited to text, data, ratings, reports, images, photos, graphics, and charts is owned by or licensed to A M Best Company and is protected by United States copyright laws and international treaty provisions. A. M. Best and its licensors retain all copyright and other proprietary rights to the website content. Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A M Best Company, All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited By logging into Best's Member Center or accessing this site, you accept and agree to be bound by our complete Terms of Use. Customer Service I Product Supom I Member Cents I Contact Infix I Caresrs AboutA.M. Bss! I site I Prwaav PolicyI Security I Terms of Use I Le -gal _& Lipeflsi, Copyright © 2016 A M. 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