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Mission Control Company - Insurance CertificateMISSCON-01 LUCILA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/31 /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, certa)n'policie_s may require an endorsement. A statement on this certificate does not confer rights to the - certificate holder in lieu of such endorsement(s). PRODUCER License #_'0504035, I CONTACT NAME: Nancy L. Hillman, CISR - - Pacific Diversified Insurance, Inc., PHONE FAX 150051Conc6rd Circle; SLrite'110 I (A/C, No. Ext): (ac. No):E-M- -- - - 408-842-2131 I ADDRESS: nhillman@pdins.com Morgan Hill, CA 95037 - I INSURER(S) AFFORDING COVERAGE NAIC # I INSURER A: Republic Indemnity of America INSURED INSURER B : II Mission Controls Company INSURER C : Frank Kretz 305 Mayock Rd., Unit H INSURER D : Gilroy, CA 95020 I INSURERE: 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. INSR TYPE OF INSURANCE ADDL SUER LTR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MWDD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I $ CLAIMS OCCUR DAMAGE TO I -MADE PREMISES (EaENTED occurrence) $ _ MED EXP (Any -one person) - Is - _ _ . - - - I' _ _-I. PERSONAL & ADV INJURY. I' : GEN'LAGGREGATE;LIMIT APPLIES PER: GENERAL AGGREGATE _. - $- - — --- - -- - ----- . OLICY 0-' `P ;..' .,..-`' F CT :.' LOC JE --- --- - - - . _ ... _PRODUCTS -. COMP/OP AGG $ _.__._.... — ' - OTHER - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT' (Ea accident) AUTO BODILY INJURY (Per person) g - . __ ...-... .. ... _ALL OWNED SAC'ANY HEDULED AUTOS UTOS BODILY INJURY. (Per accident) S HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) Is UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED RETENTION $ $- WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 147153-18 N / A STATUTE ER 03/31/2017 03/31/2018 E.L. EACH ACCIDENT $ 1,000,0001 OFFICER/MEMBER EXCLUDED? (Mandatory. in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,0001 If yyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) * a 10 day cancellation clause applies to Non -Payment of premium. CERTIFICATE HOLDER City of Gilroy Attn: D. Aldridge 7351 Rosanna Street Gilroy, CA 95020 CANCELLATION 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 ACORD 25 (2014101) ©19s8-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �`� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Yl'YY) 7/11/2013 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 onfer rights to'th8� certificate holder in lieu of such endorsements .. the terms and conditions of thepolicy,,certain olicies ma require an endorsement., A statement on this certificate does not c PROD I CONTACT Heidi H011man C J 01, Mana ement' Inc PHONE ,. (585) 546-3747 . FAX o)• (585)424-2798 First. Niagara, Risk 'Management, . N 777-- Canal View Boulevard- ADD heidi . holiman@fnsm: coin Suite 100 PRODUCER ,00132875 u Rochester NY 14 623 INSURER(S) AFFORDING COVERAGE NAIL # INSURED INSURERA:Federal Insurance Company 20281' INSURER B National Union Fire Ins Co of 19445 Mission Controls Company, Inc DBA MCC I INSURERC:Lloyds of London 15792 305 Maycok Road IINSURERD: Unit H I INSURER E : Gilroy CA 95020 IINSURERF: COVERAGES' CERTIFICATE NUMBER-13-14 master 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. iLTR TYPE OF INSURANCE NSR SWVD POLICY NUMBER (UBR MM/DD//YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE Is 1,000,0001 X GENERAL LIABILITY1,000,0001 DAMAGE TO RENTED $ COMMERCIAL Pi; CLAIMS MADE OCCUR 35893096 6/30/2013 6/30/2014 PREMISES (Ea occurrence) 'I MED EXP (Any one person) $ 10 , 600 PERSONAL &ADV INJURY I $ 1, 000 j000 GENERAL AGGREGATE Is 2 , 000, 000,'' AP IPRODUCTS COMP/OPAGG I $ 2,000,666] ".LE ' - POICYXRO- x LOC -- CT U LITY_ _ AUTOMOBILE LIABI COMBINED SINGLE LIMIT $ - Q00 , 000I `. X ANY AUTO ;,; - - - (Ea accident) - .. BODILY INJURY,(Per.person) I $ . , .._1, A . '', ALL OWNED AUTOS 73558072 6/30/2013 6/30/2014 I 'BODILY INJURY (Per accident) I $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON -OWNED ALTOS I Is I Is X UMBRELLA LIAB I X I OCCUR EACH OCCURRENCE $ 1 , 000 , 000 EXCESS LIAB I —jl CLAIMS -MADE AGGREGATE $ 1, 000, 000 DEDUCTIBLE $ B RETENTION $ EBU031731004 6/30/2013 6/30/2014 1$ WO 2KERS.COMPENSATION WC STATU- OER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT I $ N/A OFFICERIMEMBER EXCLUDED? I (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE' $ If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT I $ C Professional ESA00031694 6/30/2013 6/30/2014 Aggregate $1, 000, 000 Liability Deductible $15, 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Gilroy is an additional insured including completed operations under the General Liability policy only in regard to work performed by the insured for City of Gilroy as per Federal Insurance additional insured form 80-02-2653.. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <<;IW .. City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. Attn: D. Aldridge 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95020 Bruce Rogers/HHOLLM " ` 7- ACORD 26 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD Liability Insurance Endorsement Policy Period JUKE 30, 2013 TO DUNE 30, 2014 Effective Date JUNE 30, 2013 Policy Number 3589-30-96 EUC Insured MISSION CONTROLS COMPANY INC DBA MCC Name of Company FEDERAL INSURANCE COMPANY Date Issued JULY 11, 2013 ................................. This Endorsement applies to the following forms: GENERAL LIABILITY Under Who Is An Insured, the following provision is added: Who Is An Insured Scheduled Person Or Subject to all of the terms and conditions of this insurance, any person or organization shown in the Organization Schedule, acting pursuant to a written contract or agreement between you and such person or organization, is an insured; but they are insureds only with respect to liability arising out of your operations, or your premises, if you are obligated, pursuant to such contract or agreement, to provide them with such insurance as is afforded by this policy. However, no such person or organization is an insured with respect to any: assumption of liability by them in a contract or agreement. This limitation does not apply to the liability for damages for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. damages arising out of their sole negligence. Schedule PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT TO WRITTEN CONTRACT OR AGREEMENT BETWEEN YOU AND SUCH PERSON OR ORGANIZATION, TO PROVIDE WrM SUCH INSURANCE AS IS AFFORDED BY THIS POLICY; BUT THEY ARE INSUREDS ONLY IF AND TO THE MINIMUM EXTENT THAT SUCH CONTRACT OR AGREEMENT REQUIRES THE PERSON OR ORGANIZATION TO BE AFFORDED STATUS AS AN INSURED. HOWEVER, NO PERSON OR ORGANIZATION IS AN INSURED UNDER THIS PROVISION WHO IS MORE SPECIFICALLY DESCRIBED UNDER ANY Reference Cop t�y Liability Insurance Additional Insured - Scheduled Person Or Organza i n continued Form 80-02-2367 (Rev. 8-04) Endorsement Page 1 Liability Endorsement (continued) Liability Insurance Form 80-02-2367 (Rev. 8-04) OTHER PROVISION OF THE WHO IS AN INSURED SECTION OF THIS POLICY (REGARDLESS OF ANY LIMITATION APPLICABLE THERETO). FRESH EXPRESS INCORPORATED 950 BLANCO ROAD (93901), P.O. BOX 80599, SALINAS, CA 93912 ATTN: LEGAL DEPARTMENT FRESH EXPRESS ITS PARENT, SUBSIDIARIES, AND CORPORATE AFFILIATES ARE ADDITIONAL INSURED. All other terms and conditions remain unchanged. Authorized Representative Reference Copy Additional Insured - Scheduled Person Or Organization Endorsement last page Page 2