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Capitol Builders Hardware, Inc. - Insurance CertificateCAPIT15 OP ID: MM ,d►coR °% CERTIFICATE OF LIABILITY INSURANCE `14.� DATE {MM /DD/YYYY) F 09/21/2016 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 Beach 8 O'Neill Insurance License #OE22542 7520 Greenback Ln Citrus Heights, CA 95610 NAME: CONTACT Chris O'Neill PH ONE 916- 676 -0$44 Fafc No : 916 - 676 -0860 A/C No Ext E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Co 41297 EACH OCCURRENCE INSURED Capitol Builders Hardware, Inc INSURERS: Zurich American Ins Co 16535 DBA Capitol Door Service 4699 24th St. INSURER C: MED EXP (Any one person) $ excluded Sacramento, CA 95822 INSURER D; $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO � LOC JECT OTHER: GENERAL AGGREGATE Is 2,000,00 INSURER E: $ 2,000,00 INSURER F: $ B nnv owr_=a Lit 111,11121=12 RFVISION NLIMBER- 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 ADDLSUBR POLICY NUMBER POLICY EFF MMIDD/YY YY POLICY EXP MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X BCS0035645 10!01/2016 10/01/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO Rr:NTE5-- PREMISES fEa. occurrence $ 100,00 MED EXP (Any one person) $ excluded PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO � LOC JECT OTHER: GENERAL AGGREGATE Is 2,000,00 PRODUCTS - COMP /OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS P AUTOS BAP 0156994 -00 10/01/2016 1010112017 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 . BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ F@ROPERTY DAMAGE Peraccident $ A UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS -MADE LS0100678 10101/2016 10/01/2017 EACH OCCURRENCE $ 5,000,00 X AGGREGATE $ 5,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS- LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A C 0156995-00 10/01/2016 10!01/2017 X PER 077 STATUTE ER E.L. EACH ACCIDENT is 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) Re: Gilroy Police Facility in Gilroy, CA / City of Gilroy, its officers and employees are named as addiltonal Insured per endorsement CG2010 0704 & C 03 0704 11F0TI1=IltATF WAI n;:P CANCELLATION ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 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 Gilroy 7351 Rosanna St. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY DUMBER: BCS0035645 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations ANY PERSON OR ORGANIZATION WHEN YOU AND ALL LOCATIONS SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE "OCCURRENCE" TO WHICH THIS INSURANCE APPLIES, THAT SUCH .PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same,projecf. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page i of 1 13 POLICY NUMBER: BCS0035645 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or 0 anization s : Location And Description Of Completed Operations ANY PERSON OR ORGANIZATIi.DW WHEN YOU AND ALL LOCATIONS SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR`•AGREEMENT, EXECUTED PRIOR TO THE "OCCURRENCE" TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY- Information required to coffi fete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 O ISO Properties, Inc., 2004 Page 1 of 1 ❑ CAPIT15 OP ID: MM .ACORO° CERTIFICATE OF LIABILITY INSURANCE kx�" DATE(MM/DD/YYYY) 09121 /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 terns 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 Beach & O'Neill Insurance License #0E22542 7520 Greenback Ln Citrus Heights, CA 95610 NA0MNE CT Chris O'Neill PHONE FAX aC No EXt : 916 -676 -0844 A/c No : 916 -676 -0860 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Co 41297 INSURED Capitol Builders Hardware, Inc INSURER B:Zurich American Ins Co 16535 DBA Capitol Door Service 4699 24th St. INSURER C: CLAIMS -MADE OCCUR X Sacramento, CA 95822 INSURER D: 10/01/2017 DAMAGE T PREMISES Ea occurrence $ 100,00 INSURER E: MED EXP (Any one person) INSURER F: L_nvCrseGES CERTIEICATF MIIMRFR, REVISION NUMBER: 2 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. INS TYPE OF INSURANCE City Of Gilroy POLICY NUMBER POLICY EFF MM/DD/YYYY POLI CY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00C. CLAIMS -MADE OCCUR X BCS0035645 10/0112016 10/01/2017 DAMAGE T PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ excluded PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY JE� 7 LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO BAP 0156994 -00 10101/2016 10/01/2017 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS DAMAGE PROPERTY accident) $ UMBRELLA UA13 X OCCUR EACH OCCURRENCE $ 5,000,00 X AGGREGATE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE XLS0100578 10/0112016 10101/2017 DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y C 0156995-00 1010112016 10101/2017 X PER 0TH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEEI $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - .POLICY LIMIT $ 1,000,001 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: Service Agreement Police Department ADA doors / City of Gilroy, its officers, officials and employees are named as additional insured per endorsement CG2010 0704 & CG2037 0704. CERTIFICATE HOLDER CANCELLATION ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 26 (20`14/01) The ACORD name and logo are registered marks of ACORD 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 Gilroy Its Officers, Officials and Employees 7351 Rosanna St. AUTHORIZED REPRESENTATIVE Gilrov, CA 95020 ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 26 (20`14/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BCS0035645 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations ANY PERSON OR ORGANIZATION WHEN YOU AND ALL LOCATIONS SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE "OCCURRENCE" TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or In part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 13 POLICY NUMBER: BCS0035645 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or O aniation s : Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHEN YOU AND ALL LOCATIONS SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR "AGRERM T, EXECUTED PRIOR TO THE "OCCURRENCE" TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Information required to corn lete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule; but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 O ISO Properties, Inc., 2004 Page 1 of 1 12 CAPITI5 OP ID: MM '41 °R °' CERTIFICATE OF LIABILITY INSURANCE °A�`mM'° °"""'' 01/05/2016 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. endorsemen s . PRODUCER Beach & O'Neill Insurance License #OE22542 CONTACT NAME: PHONE aC No: 7520 Greenback Ln Citrus Heights, CA 95610 EMAIL ADDRESS: .10/01/2015 10/0112016 EACH OCCURRENCE INSURER(S) AFFORDING COVERAGE NAIC # INSURER A.: Scottsdale Insurance Co 41297 $ Excludedl INSURED Capitol Builders Hardware Inc. DBA Capitol Door Service 4699 24th St. INSURER B: Natlonwlde Mutual Ins Co 23787 INSURER C : Berkshire Hathaway Homestate 20044 INSURERD : GE N'L AGGREGATE LIMIT APPLIES PER: POLICY X 1 JPERCOT- LOC Sacramento, CA 95822 INSURER .E : Ded $ 5,00 INSURER F : .AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COVERAGES CERTIFICATE NUMBER- RFVISInN NtIMRFR- 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 TYPE OF INSURANCE IN= POLICY NUMBER POLICY EFF POLICY EXP - LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X BCS0033399 .10/01/2015 10/0112016 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ Excludedl PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,060,00 GE N'L AGGREGATE LIMIT APPLIES PER: POLICY X 1 JPERCOT- LOC PRODUCTS - COMP /OP AGG $ 2,000,00 Ded $ 5,00 B .AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ACP7835802033 10/01/2015 10/0112016 COMBI ED IN LE LIMIT Ea accident 1,000,000 X BODILYINJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDENT $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE LS0097899 1010112015 10/01/2016 EACH OCCURRENCE $ S,000,OO X AGGREGATE $ 5,000,00 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY P ) y� ANY PROPRIMB RlPXCLUD /EXECUTIVE OFFICERfMEMBER EXCLUDED (Mandatory In NH Hye s,desoribe under DESCRIPTIONOFOPERATIONSbelow NIA CAWC606669 70/0112015 10/01/2016 X WCSTATU- 0TH- Y11$ E.L..EACHACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: Gilroy Police Facility in Gilroy, CA / City of Gilroy, its officers and employees are named as addiitonal insured per endorsement CG2010 0413 CG2037 0413. City of Gilroy 7351 Rosanna St. Gilroy, CA 95020 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 -2010 ACORD CORPORATION. All ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BCS0033399 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section If — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on you_ r behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 0413 C Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured 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 2 of 2 C Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: BCS0033399 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS 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) Location And Description Of Completed Operations Any person or organization where required by written contract 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the . following is added to Section III Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured 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. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 CAPITA S OP ID: MM 144C CERTIFICATE OF LIABILITY INSURANCE DA 09/30/14 1 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 Phone: 916- 676 -08 44 Beach & O'Neill Insurance Fax: 916 =676 -0860 License #OE22542 7520 Greenback Ln Citrus Heights, CA 95610 NCAAME `T A/c° NNE., Ext : FAX No AoD IRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Ironshore Specialty Ins Co. 25445 10/01/14 _ INSURED Capitol Builders Hardware, Inc INSURER B: Nationwide Mutual Ins Co 23787 INSURER C: Navigators Specialty Ins Co 36056 4699 24th St. Sacramento, CA 95822 INSURER D: Cypress Insurance Company 10855 INSURER E: INSURER F $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC —. %. nA# -=O reorleureTC wIMRCO• 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR ILTR TYPE OF INSURANCE ADD POLICY NUMBER MWDD EFF MPOM POLICY EXP' - LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FK OCCUR X AGS0055301 10/01/14 _ 10101/15 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 50,00 MED EXP (Anyone person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP /OP AGG $ 2,000,000 Ded $ 5'00 B AUTOMOBILE LAsury X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ACP7825802033 10101114 10101M5 Es accidentSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident _ _ $ $ C UMBRELLA LWB EXCESS LIAB X OCCUR CLAIMS -MADE SF14EXC7936871C 10101114 10/01/15 EACH OCCURRENCE $ 5,000.00 X AGGREGATE $ 51000,00 DED .. RETENTION$.. — - $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECU I IVE YEN OFFICERNEMBER EXCLUDED? (Mandatory In NH), It yes, describe under DESCRIPTION OF OPERATIONS below N/A 3300067745 -141 10/01/14 10/01115 X WC STATU= LIM TO 0 R - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - .POLICY LIMIT $ 1,000:00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, IF more space is required) Gilroy Policy Facility, 7301 Hanna St., Gilroy, CA / City of Gilroy, its officers & employees are named as additional insureds per endorsement CG2010 0704 k CG2037 0704. f-c0T1C1#- ,rc unl nco CONCFLI: OTICN U 1935 -ZUIU AGUKD GUKPUKACIUN. AN ngnDs reserves. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED AN ACCORDANCE_ WITH THE POLICY PROVISIONS. City of Gilroy 7351 Rosanna St Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE U 1935 -ZUIU AGUKD GUKPUKACIUN. AN ngnDs reserves. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AGS0055301 COMMERCIAL GENERAL LIABILITY CG2010:07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE. PART SCHEULE Name Of Additional Insured Persons) Or Or anazation s : Locations Of Covered O erations Additional Insureds shown in a written contract, or written Any location. agreement that includes primary and .non- oontributory wording. The inclusion of one or more Insured under the terms of this endorsement does not increase our limits of liability;. All other terms and conditions remain unchanged. Information required tozom lete:this Schedule if notzhown above, will belshown_in:the :Declarations. __... A. SECTION II — WHO is AN INSURED is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage." or "personal and advertising injury" caused, in whole or impart, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance: of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to "the insurance afforded to these additional `insureds; the following additional exclusions apply: This insurance does not apply to "bodily: injury or "property damage" occurring after:. 7. All work, including materials, parts, :or equipment furnished in ;connection with such work, on the project (other than service, maintenance or repairs) :to be;, performed :. by or on behalf of the additional insureds) at the location of the covered operations has been completed; or 2. That portion of "your .work" out of which the injury or damage arises . has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal asa part of the;same project.. CG 2010:07 04 © ISO Properties, Inc., 2004 Page 1, of `1 ❑ POLICY NUMBER: AGS0055301 COMMERCIAL GENERAL LIABILITY CG 20.37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance: provided under the:following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional: Insured Person(s) Or Organization(s). Location And Description Of:Corn leted_O erations: Additional Insureds shown, in a written contract, or by-this policy for benefit of written agreement that includes primary :and he add tionalensured does. not appl rucfureho non- contributory wording where required. 'property damage to any building, sit appurtenant structure intended to be occupied as The inclusion of one or more Insured under the terms of a 'private residence'. The term "private residence" includes single family homes or residences, this endorsement does not increase our limits of multi-family, homes or residences. liability. All other terms and conditions remain unchanged. Information required to com lete.this Schedule if not.shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to Liability for "bodily injury" or "property damage" caused, in whole orin part, by "your work" at the. location designated and :described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 =37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 13 CERTIFICATE OF LIABILITY INSURANCE OP ID MM F DATE(MMIDDIYYYY) 09/30/13 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 Beach & O'Neill Insurance License #OE22542 NAME: - I PHONE FAX AIC, No, Ext : (AIC, No): ADDRESS: 7520 Greenback Ln VKUUUUtK CUSTOMERIDM CAPITI5 Citrus heights CA' 95610 INSURERS) AFFORDING COVERAGE NAIC #. Phone : 916 - 67 6 - 0 844 Fax : 916 - 67 6 - 0 8 6 0 INSURED INSURER A: Ironshore Specialty Ins Co. 25445 INSURER B: Depositors Insurance Company 42587 Capitol Builders Hardware, Inc dba Ca itol Door Service 4699 Ca St. Sacramento CA 95822 INSURER C: Navigators specialty Ins Co 36056 ' INSURERD: Everest National Ins Co 10120 INSURER E : ' I Ded INSURER F �A AUTOMOBILE COVERAGES CERTIFICATE NUMBER: I 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. ' LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51 OCCUR X AGS0055300 10/01/13 10/01/14 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $50,000 MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ][' PRO LOC JECT_ . PRODUCTS - COMP /OP AGG $ 2, GOO, 006 Ded $$51000 B AUTOMOBILE LIABILITY— ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACP7815802033 10/01/13 10/01/14 COMBINED SINGLE LIMIT (Ea accident) $ 1, O 0 () , O O () X BODILY INJURY(Per,person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SF13EXC793687IC 10/01/13 10/01/14 EACH OCCURRENCE s5,000,000 X AGGREGATE $5,000,000 DEDUCTIBLE RETENTION $ $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below. N/A 7600005896131 10/01/13 10/01/14 X WC LIMIT 'T'_ R TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1, 0 0 0 , 0 0 0 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Gilroy Policy Facility, 7301 Hanna St., Gilroy, CA / City of Gilro , its officers & employees are named as additional insureds per endorsement G2010 0704 &'CG2037•'0704'. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna St. 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 ©1 ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD All riahts reserved. POLICY'NUMBER: AGS0055300 COMMERCIAL GENERAL.LIABILITY CG 20-10,67 04 THIS, ENDORSEMENT CHANGES THE POLICY. PLEASE READ 1T CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES -OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies, insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE:PART SCHEDULE Name.Of Additional Insured Person(s) Or Or anizatior s : Locations Of Cove red'O perations City. of Gilroy, its officers & employees Gilroy Policy Facility, 7351 Rosanna St. 7301 Hanna St. Gilroy, CA 95020, Gilroy, CA Information required tozom letethis 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 the person(s) or organization(s) shown in the .Schedule, but -only With respect to liability -for "bodily ;injury ", "property damage" or "personal ;and `:advertising injury " caused, in= whole,or in part, by: 1. -Your acts or �omissionsi or 2. The acts ors omissions lof,thos6 . acting on your behalf, in the performance, of your ongoing =operations for the .additional insured(s) at the locations) designated above. B. With respect 'to the insurance afforded' to these 'additional insureds; the following additional exclusions apply: This insurance - -does .not apply to "bodily injury" or "'property °damage" occurring after: 1. All work, including, .;materials, parts ,or equipment furnished in connection with such -work, on the project .(othe( than; service, maintenance or repairs) Ao be,, perform ed by or on behalf of the additional insured(s) at 'the location of the covered ,operations. 'has been completed; or °2.. That portion of "your work" out . of which the injury or damage arises has been put; its intended use by -any person or. organization . other than another contractor or .'subcontractor engaged in performing operations. for; sa principal asaa partofthesame project: M20 10 07:04 © ISO Properties, Inc., 2004 Page 1 of 1 !I POLICY NUMBER: AGS0055300 COMMERCIAL. GEN_ERAL.LIABILITY -CG 20:37:07 04 THIS ENDORSEMENT CHANGES THE'POLICY. PLEASE READ IT CAREFULLY. -ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance. provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or'Or. anization s : _ LocatiomAnd:Description.Of Completed' Operations City of Gilroy, its officers & employees Gilroy Policy Facility 7351 Rosanna St. 7301 Hanna St. Gilroy, CA 95020 Gilroy, CA Information required to complete this Schedule, if not,shown.above, will be shown in the Declarations. Section' If — Who is,-An Insured is ,amended to include .as;an additional insured the persons) or organization(s) shown in the .Schedule, but only with respect to Liability for "bodily injury" or "property, 'dam age" °caused, in whole or in':part, by 'your work" at the. location. designated -and -described in the schedule of 'this endorsement performed for that ;additional insured " and included in the "products- completed operations hazard ". CG 20-37 07 04 ©, ISO Properties, Inc., 2004 Page 1 of 1 ❑