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Active Sports Club - Insurance CertfiicateClient #: 442416 ACTIVACQUI1 ACORDTM CERTIFICATE OF LIABILITY INSURANCE [DATE(MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12/22/2017 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Rose King Marsh & McLennan Agency LLC PHONE 858- 587 -7521 FAX 858 - 909 -7530 AMA Lo, Ext : A/C, No Marsh & McLennan Ins. Agency LLC ADDRESS: rose.king @marshmma.com PO Box 85638 12/31/2017 12/31 1201 EACH OCCURRENCE INSURER(S) AFFORDING COVERAGE NAIC # San Diego, CA 92186 18058 Philadelphia Indemni Insurance Co. INSURERA: Indemnity INSURED INSURER B : Everest National Insurance Company 10120 Active Wellness, LLC; Active Aquisition MED EXP (Any one person) $5,000 Partners LLC dba Active Sports Clubs INSURER C: 1200 Clay Street, Ste 100 INSURER D PERSONAL & ADV INJURY Oakland, CA 94612 INSURER E INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER: 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD/YYW LIMITS A X COMMERCIAL GENERAL LIABILITY X PHPK1752695 12/31/2017 12/31 1201 EACH OCCURRENCE $1,000,000 CLAIMS -MADE 4 OCCUR PREMISESOEaoccu ence $300,000 X MED EXP (Any one person) $5,000 BI /PD Ded:25000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO - POLICY JECT X LOC PRODUCTS - COMP /OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY PHPK1752695 12/31/2017 12/31/2018 COMBINED SINGLE LIMIT Ea acc ident $ 1 , 000 , 000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR PHUB611277 12/31/2017 12/31/201 EACH OCCURRENCE $10,000,000 AGGREGATE $1 0,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE -- OFFICER/MEMBER EXCLUDED? N/A CA10002071171 12131/2017 12/31/201 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,0_0_0,000 _ E.L. DISEASE - EA EMPLOYEE -- $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 A Professional PHPK1752695 12/31/2017 12/31/2018 $1,000,000 Each Claim Liability $1,000,000 Aggregated Occurence Form DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 ACORD 25 (2016/03) 1 Of 1 #S3187524/M3187439 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 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WSGCL INSURED: Active Wellness, LLC; Active Aquisition POLICY #: PHPK1752695 POLICY PERIOD: 12/31/2017 TO 12/3112018 COMMERCIAL GINERAL LIABILITY 013 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY', U :2 z&IIIIIIIII k111, 911111111 11111111***19111111111 This andorsement modifies insurance providod lodfir the (01kpMag; COMMERGAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name,01 Additional insured Person(s) OF OrgaplizationLa) City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020-0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement Iffformatlan raquired 6D minplet)a this Schedule, if not shown abow, yvill be shown in the Dedaraflons. Sootion 11 — Who to An Insuired is amended to in- cJuds as an addWwal Insured the person(p) ororgwi- zaflon(s) shoom in he Schedule, but oirity vkh re"ct to liabirity for "bodily injury", 'property damage' or "pemwal and advorhsOg injury' caused, in whote, of io part, by youir OCOS of OMIWOnS or 11he 06b or oMt&- sine of thaw ac on your b"* In this pedurman m of your ongoing op am or 8. In ownecdon with your promises owed by or roaW to you. CG 2426 07 04 @ W PMPOM68, Im, 2DO4 Page 1 of I Client#: 26916 ACTIACQU ACORDTM CERTIFICATE OF LIABILITY INSURANCE M /DD/ YYYY) DATE (MM/DDI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3/03 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 Rose King Marsh & McLennan Agency LLC PHONE FAX IC, No, EXt : 888- 587 -7521 A/C, No ; 858- 909 -9840 Marsh & McLennan Ins Agency LLC E -MAIL rose.n barne ki andbarne ADDRESS: g@ Y y tom PO Box 85638; CA Lic #OH18131 3103/2017 12/31/2017 San Diego, CA 92186 INSURER(S) AFFORDING COVERAGE NAIC# CLAIMS -MADE I OCCUR INSURER A: Philadelphia Indemnity Insuranc 18058 INSURED INSURER B: Everest National Insurance Comp 10120 Active Wellness, LLC; Active Acquisition X MED EXP (Any one person) Partners LLC dba Active Sports Clubs INSURER C : BI /PD Ded:25000 1200 Clay Street, Ste 100 INSURER D: Oakland, CA 94612 INSURER E: 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY X PHPK1618549 3103/2017 12/31/2017 EACH OCCURRENCE $110001000 CLAIMS -MADE I OCCUR PREMISES Ea occur ante $300,000 X MED EXP (Any one person) $ 5,000 BI /PD Ded:25000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 ECOT X LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY PHPK1618549 3/03/2017 12/31/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 1 BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR PHUB574669 3/03/2017 12/31/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN] N/A CA10002071161 12/31/2016 12/31/2017 P X ER OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 A Professional PHPK1618549 3/03/2017 12/31/2017 $1,000,000 Each Claim Liability $1,000,000 Aggregate Occurence Form DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement HULUt_H. City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 ACORD 25 (2014/01) 1 of 1 #S1139298/M1139243 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 r�OyQ- lra . �ir,T�c ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LOPG INSURED: Active Wellness, LLC; Active Acquisition POLICY #: PHPK1618549 POLICY PERIOD: 03/03/2017 TO 12/31/2017 d611EFiiCLN►►tc 6M ERAL,UAB1LffY Cd2A0700 Name OtA+dWaral InuaW Persants City of Gilroy, its officers, officials and employees . 7351 Rosanna Street Gilroy, CA 95020 -0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement In rriailan, 6 I6D COM th4s.Schsdiule It nod 0v413 axi 6e4 wwn in ft Ded4rWbas, S6c6 M U.- WM b, Mi'InesiusW is omreriditi to 6%. =clltda � an ed�toala! Ia�ut�d pdarscn�a� oe•cugar�- zation(s) sholAiva to 1 scfisd le; duty with nab Ilah r flan- or. .' "per54 a1 ; I an irti -w gpigoo - In who* or dmmiIor or ft 60W or o - "; of t}eere'adlltag on yewr r�1la - IY. In Ove perknrranc a of yournniaing iomv; or B. In b6nruedon ytiw wised :cundd by or nanted:gce;yoa CO 20,2607 04 . 0 18+0 FImpefflip, Jnp..: 2004 Page 1 cIF I Client #: 26916 ACTIACQU ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12/20/2016 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 CONTACT Rose King Barney & Barney, A Marsh & PHONE g58- 587 -7521 858- 909 -9840 Ext A/c, No McLennan Ins Agy LLC E-MAIL ADDRESS: rose - king @barneyandbarney.com PO Box 85638; CA Lic #OH18131 03103/201 San Diego, CA 92186 INSURER(S) AFFORDING COVERAGE NAIC q INSURER A: Philadelphia Indemnity Insuranc 18058 INSURED INSURER B: Everest National Insurance Comp 10120 Active Wellness, LLC; Active Acquisition CLAIMS -MADE � OCCUR Partners, LLC dba Active Sports Clubs INSURER C: 1200 Clay Street, Ste 100 INSURER D PERSONAL & ADV INJURY $1,000,000 Oakland, CA 94612 INSURER E: 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE ADDLSUBR WVD POLICY NUMBER MM /DDY/YEYrr POLICY LIMITS A GENERAL LIABILITY X PHPK1459522 3/03/2016 03103/201 $1,000,000 X COMMERCIAL GENERAL LIABILITY pEACH�OEC'CrURRENCE PREMISES EaE�urrrrence $ 30O 000 CLAIMS -MADE � OCCUR MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 X BI /PD Ded:25000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY JE 0. X LOC $ A AUTOMOBILE LIABILITY PHPK1459522 3/03/2016 03/03/201 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccident $ A X UMBRELLA LIAR X OCCUR PHUB531624 3/03/2016 03/03/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION$10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN N/A CA10002071161 12/3112016 12131/201 X I WCSTATU- 0TH- IQEY LIMITS E.L. EACH ACCIDENT $11,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 A Professional PHPK1459522 3/03/2016 03/03/201 $1,000,000 Each Claim Liability $1,000,000 Aggregate Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 ACORD 25 (2010/05) 1 Of 1 #S10385811M1038565 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 6?dv- yn . el,no @ 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LOPG INSURED: Active Wellness, LLC; Active Acquisition POLICY #: PHPK1459522 POLICY PERIOD: 03/0312016 TO 03/03/2017 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ i CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement moMes:lnsumnoe pmWded under ptffoiWng: COMMERCIAL, GENERAL LIABILITY COVERAGE PART SCHEDULE City of Gilroy; its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement Seeu`On 11— Who Is An InstmW is amended fa m- Wuf = an addlibrial Inumd die pereon(s) ororgesd- >-1160*) 0own_in the S'eheduie. but only with reWW in 6ebll* for Uclibr Info . 'prtlRarty damaW or VeMmal and edvefthg i*rf cdund. In vrtt * or 6r pa'% by yaw' acts ororriMbone or dre mW or orris+ slave of tlim adbv an yourbOvIft A. In gte pedionnance of ymtr Ong opet a rmF or E. In ownedSon *0 yon prernbes owned by or rented to yoarL CO 20 29 07 04 0 184 PWrtle9. Inc.. 20144 Page 1 of I Client#: 26916 ACTIACQU ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM)DD/YYYY) 02/26/2016 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 Barney & Barney, A Marsh & NAME: Rose King PHONE 858 -587 -7521 858- 909 -9840 AI No Erd : A/C No McLennan Ins Agy LLC PO Box.85638; CA Lic #OH18131 San Diego, CA 92186 E-MAIL rose.kin barne andbarne com ADDRESS: g� y . y• INSURER(S) AFFORDING_ COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insuranc 18058 INSURED INSURER B: Everest_ Nation_ I Insurance Comp 10120 Active Wellness, LLC; Active Acquisition Partners, LLC dba Active Sports Clubs 1200 Clay Street, Ste 100 Oakland, CA 94612 INSURERC: INSURER D: INSURER E: INSURER F: $300 000 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 CONTRACTOR 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.. IN gR LTR TYPE OF INSURANCE ADD[ IN SR SUB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMID LIMITS A GENERAL LIABILITY X PHPK1459522 D310312016 03/031201 $1,000,000 X COMMERCIAL GENERAL LIABILITY pEAACMHpGOECCCUR��RENCE PREMISES EsE.iRince $300 000 CLAIMS MADE OCCUR MED EXP (Any one rson) $5 000 PERSONAL & ADV INJURY I $1 000 000 X BI /PD Ded:25000 GENERALAGGREGATE $2,000 000 GEN'LAGGREGATE'LIMITAPPLIESPER: PRODUCTS- COMP /OPAGG $2,000000 POLICY PRO X LOC $ A AUTOMOBILE LIABILITY P 2._ 13[0. COMBINED SI_G_LE LIMIT O O X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per aceideM HIRED AUTOS NON-OWNED AUTOS 5 A X UMBRELLA LIAB X OCCUR PHUBS31624 3/03120161 03103/201 EACH OCCURRENCE $16,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $10000 $ B WORKERS COMP SA 7n 1 N. AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 7 NIA CA10002071151 2/31/2015 12/31/201 X WC sTATU- oTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under DESCRIP_TION'.OEOPERATIONS below El. DISEASE - POLICY LIMIT s1 OOO OOO A Professional PHPK1459622 0310112016 631031201 $1,000,000 Each Claim Liability $1,000,000 Aggregate Claims Made DESCRIPTION of OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, Its Officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN officials and employees ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy, CA 95020 -0000 AUTHORIZED REPRESENTATIVE 6?60- yn - e&r20 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S673273/M673207 KINR INSURED: Active Wellness, LLC; Active Acquisition POLICY M PHPK1459522 POLICY PERIOD: 03/03/2016 TO 03/03/2017 COMMERCIAL' GF IERAL UABILITY W lt21F 07 04. THIS, ENDORSEMENT C.HAINIGES, THE POUCY PLEASE READ ff CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This w*r M0Mw 1nsV.ranq pmri W folllaw�ln 66AAMER.GlA[. C,EWERAL LIAHILIIY COVER—AGE PART SCHEDULE City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement 8"M 11-6 Vft b � hAftsf C8`'ArlrB dW 1D, R1- �cdude_si en i 1neumd ftfman(e) oral �p�sj a�iciri3>I In tFle`�ch'edule� tm�_rt+n9�`rit` to Be�t�r for 'badib►.iry",.'prrtjr one or "person ®I, �md; �OverrliaBtp Ir��ny{ s:8u68d. hi ailhoCe pr F�a.P -art. bS+' eEx9droalntSS6at9:olF11� ecla or otrl slon6;of Bpose aarw yoiurbl; H: In' aor>wec�an vtA�t` pirilrs®s ;anfrtted b�►'oir : *.. CS 2624 0 W 0160 Pra�rc1K -.Ift Pa@e 1 of I- Client#: 26916 ACTIACQU ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 2/25/2016 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 Barney & Barney, A Marsh & McLennan Ins Agy LLC San Box 85638; 92 86 #OH18131 San Diego, CA 92186 NAME: Rose King PHti N ; Ext): 058-587-7521 aC No : 858- 909 -9840 E-MAIL RSS: rOSe.king@barneYandbarney.COm INSURER(S) AFFORDING COVERAGE NAIC S INSURERA: Philadelphia Indemnity Insuranc 18058 INSURED INSURER B: Everest National Insurance Comp 10120 Active Acquisition Partners LLC 1200 Clay Street, Ste 100 Oakland, CA 94612 INSURERC: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR INSURERD: INSURER E: INSURER F : PR EM SES ERENTED . I a occurrence $360,000 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. LTR TYPE OF INSURANCE INDRL SUER POLICY NUMBER POLICY . EFF MMOIVDP LIMITS A GENERAL LIABILITY X PHPK1459522 3/0312016 031031201 EACH OCCURRENCE $1,000,006 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR PR EM SES ERENTED . I a occurrence $360,000 MED EXP (Any one person) $6,066 PERSONAL & ADV INJURY $1 000 000 X BUPD Ded:25000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG s2,000,000 POLICY PE X 7 I LOC $ A AUTOMOBILE LIABILITY PHPK1459522 310312016 03/031201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LAB X OCCUR PHUBS31624 3/03/2016 03/031201 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED . X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? � NIA CA10002071151 2131/201512/31/201 X WC STATU- OTH -' E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yyea„ describe under DESCRIPTIONOFOPERATIONSbelow E.L. DISEASE - POLICY`LIMIT -- $1,000,OOQ_ A Professional PHPKI469622 0310312016 03/031201 $1,000,000 Each Claim Liability $1,000,000 Aggregate Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarlra Schedule, H more space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional Insured, per the attached endorsement City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 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 t::5;P6s— )n • epN rw CORPORATION_ All rinhts rebrtarvafl ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S671438/M671399 LOPG INSURED: Active Acquisition Partners LLC POLICY #: PHPK1459522 POLICY PERIOD: 03/03/2016 TO 03/0312017 CIMMERCU4L G NEW.JUABILRY 01320 '26 07 oa THIS ERDORSEMgNr CHANGES THE POLICY. PLEASE READ It CAREFMLY. ADDMONAL INSURED DESIGNATED PERSON OR ORGANIZATION TFils wtdoOer *b moMes twurarice pWdetl unit ft'ta1wr1drw 60MWE RQM4 GMEPM UAB- IMY; COVERAGE 'PART SCF MOILE City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement .460M a V t0 k� Ah 'ir18Y0f6� i8 ?;erlta3,ndbd 10 irk dude,? a an l:Insured 'd pemn(t) arorge iiilan i atli:yui In .ft kheW bad ardy lift n m icy► iar 'fit �� -f ► da' =W w "paf?�tal a� adva#�edeg It11�' caueea9, ,tn voQroba> ao- Io port. y eate_: aOM wwo=Wor the aft ar a s8ona.,;trf' aq�.am yourba�ll A In ?-to pe&rmancs ofiatr >ongoing ape,ridonac ar B.. In oarua3 vn nfines :owned by. br . refrted tm.YgA Cdr 26 B 0 08 0 160 F'rolPe W Inc:, 2604 I 1 or t Clipnt#• 2R91R OCTIOCOII ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 12/23/2015 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 Barney $r Barney, A Marsh & NAME: Rose King H/ N E,t .858 -58T -7521 F arc No): 858- 909 -9840 McLennan Ins Agy LLC 18131 PO Box 85638; CA Lic #01-118131 San Diego, CA 92186 E -MAIL ose. bame andbame r kin ADDRESS: g� .com Y Y INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Philadelphia Indemnity Insuranc 18058 INSURED INSURERS: Everest National Insurance Comp 10120 . Active Wellness, LLC;Active Acquisition Partners LLC DBA Active Sports Clubs PO Box 2358 INSURER C: INSURER D : San Francisco, CA 94126 INSURER E MED EXP (Any one person) INSURER F: PERSONAL & ADV INJURY 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 CONTRACTOR 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 NSR WVD POLICY NUMBER MM/DD MWDDMW LIMITS A GENERAL LIABILITY X PHPK1301971 3/03/2015 103103/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR PREMISE S Ea oacu Dnoe $300,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 X BI /PD Ded:25000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 —1 POLICY J Cj X LOC $ A AUTOMOBILE LIABILITY PHPK1301971 __- 3/03/2015 03/03/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS J $ 1 A X UMBRELLA LIAB X OCCUR PHUB491722 3/03/2015 03/03/201 Q EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 _ riEXCESS LAB CLAIMS -MADE DED I X RETENTION $10000 is B WORKERS COMPENSATION AND EMPLOYE RS' (ABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? FN N / A CA1 0002071151 12/3112015 12/311201 X WCSTATU- 01 E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) if DESCRIPTION OF.OPERATIONS. below E.L. DISEASE - POLICY LIMIT $1,000,000 A !Professional PHPK1301971 0310312015 03/031201 $1,000,000 Each Claim Liability $1,000,000 Aggregate Claims Made DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD m, Additional Remarks Schedule, irmore space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, Its Officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN officials and employees ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy, CA 95020 -0000 AUTHORIZED REPRESENTATIVE Q6t, >n - ei,r o ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S612563/M612511 MITK INSURED: Active Wellness, LLC;ActiveAcquisiton POLICY #: PHPK1301971 POLICY PERIOD: 03/03/2015 TO 03/03/2016 d. =M.ERCIA!_ GMERA,L LM LffY QG 2Q ?A '67 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEA READ rr CARE1IFULLY. ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION ertdowareerit .mOM049:kwumnceproAdW under#leeftbl Vw M RCK.._GENERAl. Lil SIMYiCOVERAGE PART II CHML.E City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement .8ndo" rt a = vow k An 1lnstaed K'* On' M- died 10: bra. d� n en i inwred'il, pe=s (e ).`orw9e - xapon(4) ih6i ii. h ft fish e, YV1111 '"PerwIl'9111 � ;@dVo1 4� WWI i�t1 � ifl �(pp116 b8 OWL. . j4ittr 6( E9' w 0M'iIi &%b df im � Or cka� B1D116.0t 6DBe" CQ1 b�l Wlk A In'Sue ptaorae of �autror>�cing oaffimr�:aa L In. oo oit "WIh *e p*hWili bWeled bit or �errbed p y±M CS 20 26117 04 0 1$Q RWp.r0w Inc.. 20M Aar I of 1 Client #: 26916 ACTIACQU ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) TYPE OF INSURANCE 3/03/2015 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 NAM Rose King Barney 8r Barney, A Marsh & McLennan PHONE Ax E =t :858 57 -7521 ,/c No : 8S8- 909 -9840 Agency LLC Company, CA License #0H18131 E-MAIL ADDRESS: rose.king @barneyandbarney.com P.O. Box 85638 AMA T RENTED REM, S Ea occurrence $100,000 San Diego, CA 92186 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insuranc 18058 INSURED INSURER B: Everest National Insurance Comp 10120 Active Acquisition Partners LLC Active Sports Clubs INSURERC: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PO Box 2358 INSURER D: 3/03/2015 INSURER E: COMBINED SINGLE LIMIT Ea accident San Francisco, CA 94126 X BODILY INJURY (Per person) $ 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM /DDrMY LIMITS • GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X PHPK1301971 3/03/2015 03/03/2016 EACH OCCURRENCE $1,000,000 AMA T RENTED REM, S Ea occurrence $100,000 MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY r7 PROT- X LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ • AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PHPK1301971 3/03/2015 03/03/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB491722 3/03/2015 03/031201 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED X RETENTION $$1O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? F_N1 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A CA10002071142 12/3112014 12131/201 X WC STATU- OTH- 91 E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000, O00 E.L. DISEASE - POLICY LIMIT $1,000,000 A Professional Liab Claims Made PHPK1301971 3/0312015 03/03/2016 $1,000,000 Each Claim $1,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, its officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN officials and employees ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy, CA 95020 -0000 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S316038/M316000 MITK INSURED: Active Acquisition Partners LLC POLICY #: PHPK1301971 POLICY PERIOD: 03/03/201,5 TO 03103/2016 COMMERCIAL (GENERAL LIABILITY (�G 20 26.07 {14 'HIS ENDORSEMENT ORANGES THE POLICY. PLEASE READ IT CAREFULI-Y. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This widorsernenl modifies Insurance pmided u1dertt►e follovWng: COMMERCIAL GENERAL UABILITY covERAOE PART 0 City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 -0000 SCHEDULE Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employeesare named as an additional insured, per the attached endorsement Seellon U — Who Is An Inswed is amended: to in.. ejuda as an ad'dkionall Insured dss persons.}`orflrgenl- zayaa (s) shown In the Schadule. b A tutly vAh rasped la Ietai6tyr fair 'bolt Gam'. 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