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CIM Air - Insurance Certificater ACORD CERTIFICATE OF LIABILITY INSURANCE INSR TYPE OF INSURANCE - - - 05/05/2015 PRODUCER Ferrante Insurance.Services Inc. THIS CERTIFICATE IS ISSUED AS ,A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE NOT. AMEND, EXTEND- OR 3018 Willow Pass Road _DOES ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Suite 100 Concord CA 94519- 03/28/2016 / / INSURED INSURERA:U.S. Specialty Insurance Company INSURER B: CIM Air, Incorporated INSURERC: 50 Aviation Way #2 INSURER D: $ 1,000,000 INSURER E: Watsonville CA 95076— CnVFRA[;FS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED., NOTWITHSTANDING ANY REOUIRE,MENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATELHATSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE - - - POLICY NUMBER POLICY EFFECTIVE DATE MMID POLICY EXPIRATION DATE MMMD/YY UMW P, GENERAL LIABILITY X- .. COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_1 OCCUR U15AC66663 -00 03/28/2015 / / 03/28/2016 / / EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY %8r LOC PRODUCTS - COMP /OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per, person) . $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR 0 CLAIMS MADE DEDUCTIBLE RETENTION $ / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ $ $ COMPENSATION AND EEMPLOYERLIABITY ORLER TORY LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENTISPEC1AL PROVISIONS The City of Gilroy, its officers and employees to be named as additional insured per attached endorsement form CG 20 10 07 04. v_n 4 Irrwn IQ nvwGR. I n I AUUIITUNAL INSUKEU' INSURER LETTER: L P11V6CLL %I.IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT City of Gilroy FAILURE TO DO SO SHALL IMPOSE NO OBLI N OR W181LITY OF KIND UPON THE 7351 Rosanna St INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Gilroy CA 95020- AGUKU Z5-5 (7187) © ACORD CORPORATION 1988 fjT,r INS025S (9910).02 ELECTRONIC LASER FORMS, INC. - (800)327 -0545 Page 102 POLICY NUMBER: U15AC86663 -00 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 for whom you are performing operations during the policy period when you and such person or organization have agreed in writing in a contract or agreement 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 project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 ACORD. CERTIFICATE OF LIABILITY INSURANCE 0A� TYPE OF INSURANCE 03/28/20.14 PRODUCER Ferrante Insurance Services, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF .INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3018 Willow Pass Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Suite 100 Concord CA 94519 - 03/28/2015 / / INSURED INSURERA:Intl Ins of Hannover Plc INSURERS: CIM Air, Incorporated INSURER C: 50 Aviation Way #2 INSURER D: $ 1,000,000 INSURER E: Watsonville CA 95076— CAVFRAGFA 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIM POLICY EXPIRATION DATE (MMMDrrn '�, LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY, CLAIMS MADE II OCCUR HAN 002021 14 03/28/2014 / / 03/28/2015 / / EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any onefite) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL SADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECOT LOC PRODUCTS - COMP /OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON- OWNEDAUTOS / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ R PROPERTY DAMAGE (Per accident) $: GARAGE LIABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR❑ CLAIMS MADE DEDUCTIBLE RETENTION $ / / / / EACH OCCURRENCE $ AGGREGATE $ $ WORKERS EMPLOYERS* LIABILITY ON AND / / / / TORY LIMITS. JOT E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE 13- E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLE $!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Gilroy, its officers and employees as additional insureds on the Commercial Liability insurance policy per attached endorsement. VCR I IrIVM 1. C 0VLVCR I n I AOUITIONAL INSURED; INSURER LETTER:_ %.AN%.CLLAI TUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT City of Gilroy FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 7351 Rosanna St INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Gilr2X CA 95020 - ACORD 25-S (7197) `© ACORD CDR PO TION 1988 INS025S (991o).o2 ELECTRONIC LASER FORMS, INC..- (800)327 -0545 Page 1 of 2 POLICY NUMBER: HAN 002021 14 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Gilroy, its officers and employees 7351 Rosanna St Gilroy, CA 95020 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended, to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily in- jury" 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 site 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 10 01 Copyright ISO Properties, Inc., 2000 Page 1 of 1 ❑