Subject:
Date:
No. of Pages:
Phone:
Sender:
URL:
MAIL DOCUMENT
Certificate of Insurance Delivery by ecertsonline™
THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BY TELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE.
Certificate of Insurance Delivered by ecertsonline™ Insurance Visions, Inc. All rights reserved.
Venbrook Insurance Services
6320 Canoga Avenue, 12th Floor
Woodland Hills, CA 91367
818-598-8900
www.venbrook.com
5/11/2023
City of Redondo Beach
Department of Engineering and
Building Services
Attn: Jeff Townsend
415 Diamond Street
Redondo Beach CA 90277
Yvonne Alfaro
5 Cert No. 74355159 - Certificate of Liability: Jilk
Heavy Construction, Inc. -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
5/11/2023
Venbrook Insurance Services
6320 Canoga Avenue, 12th Floor
Woodland Hills, CA 91367
818-598-8900 818-598-8910
www.venbrook.com CA Lic No. 0D80832
Yvonne Alfaro
Venbrook Insurance Services
Jilk Heavy Construction, Inc.
500 S. Kraemer Blvd., Suite 380
Brea CA 92821
74355159
✓
✓
Insured but only for coverages and limits provided by the policy and the additional insured endorsement.
City of Redondo Beach
Department of Engineering and
Building Services
Attn: Jeff Townsend
415 Diamond Street
Redondo Beach CA 90277
RE: Redondo Beach Pier
Certificate holder is named as Additional Insured's under the General Liability Liability policy if required by written contract with the Named *10 Days Notice of Cancellation for Non-Payment of Premium, 30 Days All Others.
A MLIB-1001348-03 1/1/2023 1/1/2024 1,000,000
50,000
5,000
✓
1,000,000
✓ BFPD/XCU/OCP
2,000,000
✓ Contractual
2,000,000
✓
✓
$25,000 Deductible
B CF2CA00215-231 1/1/2023 1/1/2024 1,000,000
✓
✓ ✓
✓ Comp $2,000 ✓ Coll $2,000
C ✓ OMX10008514607 1/1/2023 1/1/2024 10,000,000
✓ 10,000,000
D T10230132 1/1/2023 1/1/2024 ✓
1,000,000 N
1,000,000
1,000,000
D USL & H /Jones) T10230132 1/1/2023 1/1/2024 Ea. Acc 1M Dis/Empl 1M/1M E Professional Liability B0621PJOHN028823 6/4/2023 6/4/2024 $2,000,000 Per Claim $2,000,000 Aggregate
$25,000 Deductible
Liberty Mutual Insurance Company A XV 23043
Everest National Insurance Company A+ XV 10120
Endurance American Insurance Company A+ XV 10641
StarStone National Insurance Company A- XI 25496
Underwriters at Lloyd's, London (VI) 15642
74355159 | 23/24 GL/AL/EX /WC/PROF | Yvonne Alfaro | 5/11/2023 10:42:27 AM (PST) | Page 1 of 4 Marine Business Owners Policy
Marine General Liability
Section I.
1 1 M-1333-MGL-E031 (03-14)
LIBERTY MUTUAL INSURANCE COMPANY
(A Massachusetts Stock Insurance Company, hereinafter the “Company”) Effective Date:
Policy Number:
Issued To: Jilk Heavy Construction, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED AND WAIVER
OF SUBROGATION ENDORSEMENT
In consideration of the payment of additional premium, the Company agrees with the Named Insured as follows:
1. In events where the Named Insured is required by written contract to include another party as an Additional Insured under this policy, the Company consents to such inclusion, but coverage for such Additional Insured shall only be with respect to liabilities incurred as a result of Covered Operations performed by the Named Insured and such coverage is limited to the indemnity obligations assumed by the Named Insured. Inclusion of an Additional Insured shall not increase the Limits of Liability hereunder.
2. In events where the Named Insured is required by written contract to have its insurer waive subrogation rights against another party, the Company consents to such waiver, but only with respect to Covered Operations performed by the Named Insured.
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
MLIB-1001348-03
01/01/2023
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Marine General Liability
Section I.
1 1 M-1333-MGL-E053 (03-14)
LIBERTY MUTUAL INSURANCE COMPANY
(A Massachusetts Stock Insurance Company, hereinafter the “Company”) Effective Date:
Policy Number:
Issued To: Jilk Heavy Construction, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON CONTRIBUTORY ENDORSEMENT
This endorsement modifies insurance provided under the following:
If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy.
Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis, unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis.
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
MLIB-1001348-03
01/01/2023
74355159 | 23/24 GL/AL/EX /WC/PROF | Yvonne Alfaro | 5/11/2023 10:42:27 AM (PST) | Page 3 of 4
COMMERCIAL AUTO
ECA 04 521 04 14
ECA 04 521 04 14 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – DESIGNATED ORGANIZATION
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
SCHEDULE
Name Of Additional Insured Organization
ALL ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED
TO BE NAMED AS AN ADDITIONAL INSURED ON THIS POLICY WITH REGARD TO THEIR OPERATION, MAINTENANCE, OR USE OF A COVERED "AUTO".
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to the Who Is An Insured B. Is executed after the date of “loss”. paragraph under Section II – Liability Coverage: This paragraph does not apply if:
1. The terms and conditions of the written
“insured contract” had been agreed upon prior
to the “accident” or “loss”; and
2. The organization shown in the Schedule with respect
to the operation, maintenance, or use of a covered
"auto" if you are required to add such organization to
this policy as an additional insured in order to comply with the terms of a written "insured contract" or written agreement. This does not apply when such contract
or agreement:
A.
You can definitively establish that the terms
and conditions of the written “insured contract”
ultimately executed are the same as those
which had been agreed upon prior to the
“accident” or “loss”. Involves the owner or anyone else from whom you hire or borrow a covered “auto” unless it is a
“trailer” connected to a covered “auto” you own; or
INSURED COPY
Jilk Heavy Construction, Inc.
CF2CA00215-231
74355159 | 23/24 GL/AL/EX /WC/PROF | Yvonne Alfaro | 5/11/2023 10:42:27 AM (PST) | Page 4 of 4