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Mark Thomas & Company - Insurance CertificateAC ®K 1 0 �� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 9/15/2017 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Asero Insurance Services 200 N Almaden Blvd 3rd Floor San Jose, CA 95110 www aseroms com License No OA91339 NAME: Asero Insurance Services PHONEo 866 966 -8928 FAX No 408- 271 -1802 EMAIL ADDRESS. certsinaseroins com INSURERS AFFORDING COVERAGE NAIC # INSURER A : Travelers Property Casualty Co of Amer 25674 INSURED Mark Thomas & Company, Inc 2290 North First Street, Suite 304 San Jose CA 95131 INSURER B Travelers Indemnity Company of CT 25682 INSURER C. INSURER D: 9/15/2017 INSURER E: EACH OCCURRENCE INSURER F COVERAGES CERTIFICATE NUMBER: 37738213 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 LTR TYPE OF INSURANCE JNSD ADDLSUBRI POLICY NUMBER Ml DD/YYYY MMIDD P LIMITS B ✓ COMMERCUILGENERALUABILITY �/ 6$0 2H548914 9/15/2017 9115 /201$ EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2.000,000 POLICY ECT F--/] LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER B AUTOMOBILELIABILITY ✓ BA- 61-1189707 9/15/2017 9/15/2018 EOMaBIINdEoDtSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per ecatlent $ HIRED NON -OWNED ✓ AUTOS ONLY Of ONLY Comp/Coll Ded $1,000 $ A ✓ UMBRELLA LIA& ,/ OCCUR CUP- 9EO95562 9/15/2017 9/15/2018 . EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE DED I _RETENTION$ _ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE —1 OFFICERIMEMBER EXCLUDED? NIA XJUB4342T25017 9/15/2017 9/15/2018 �/ STATUTE ER - 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 I I I I I E L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) Service Agreement City of Gilroy On -Call Engineering Services City of Gilroy, its officers, officials and employees NOTE 30 DAYS NOTICE OF CANCELLATION WILL BE GIVEN EXCEPT 10 DAYS FOR-NON-PAYMENT City of Gilroy 7351 Rosanna Street 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. AUTHORRED REPRESENTATNE Joe Longwello ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 37738213 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 1 of 8 AGENCY CUSTOMER ID: MARKT -1 LOC #: A O ADDITIONAL REMARKS SCHEDULE Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Company, Inc 2290 North First Street, Suite 304 San Jose CA 95131 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Gilroy ADDRESS: 7351 Rosanna Street Gilroy CA 95020 General Liability / Waiver of Subrogation / Primary & Non - Contributory as required by written contract per form CG D3 81 09 07 Commercial Auto Liability Additional Insured / Waiver of Subrogation as required by written contract per form CA T3 53 02 15 Workers' Compensation Waiver of Subrogation as required by written contract per form WC 99 03 76 (A) -001 General Liabilty Additional Insured per form CG D3 82 09 07 General Liability 30 day notice of cancellation per form IL T4 00 12 09 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 37738213 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 2 of 8 POLICY NUMBER 680- 21-1548914 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 09/15/2017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION (S): CITY OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED 7351 ROSANNA ST GILROY, CA 95020 PROJECT /LOCATION OF COVERED OPERATIONS: SERVICE AGREEMENT: CITY OF GILROY ON -CALL ENGINEERING SERVICES PROVISIONS A. The following_ is added to WHO IS AN INSURED (Section 11): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for "bod- ily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily in jury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services ". e. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing Insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of Insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance In COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 © 2007 The Travelers Companies, Inc Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily Injury" or "property damage" for which coverage Is sought occurs; and (2) The "personal injury" for which coverage Is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance" for such addi- tional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional in- sured when the additional insured Is also an addi- tional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the pro- ject, or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with that additional insured entered Into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal in- jury" offense Is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include the person or organization shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily Injury" and "property damage" oc- curs, and the "personal injury" is caused by an of- fense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement Is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc CG D3 82 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission Policy No. 680- 21-1548914 ISSUE DATE: 9/15/2017 THIS ENDORSEMENT CHANGES THE P OLICY. PLEASE READ IT CAREFULLY. DESIGNATED EN' nTY - NOTICE OF CANCELLATIONMONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 NONRENEWAL: PERSON OR ORGANIZATION: CITY OF GILROY 7351 RDSAIM ST GILROY, I.A 95020 ADDRESS: PROVISIONS: Number of Days Notice of Nonrenewal: A. If we cancel this policy for any statutorily permit- ted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail_notioe of cancel- lation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation In the schedule above before the effective date of can- cellation. B. If we decide to not renew this policy for any statu- torily permitted reason, and a number of days is shown for nonrenewal in the schedule above, we will mail notice of the nonrenewal to the person or organization shown In the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for nonrenewal In the schedule above be- fore the expiration date. IL T4 0012 09 02009 The Travelers Indemnity Company page 1 Of 1 Policy No BA- 61­1189707 Insured Mark Thomas & Company Inc COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered" Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II = COW ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- - efed "autos" you own* (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 0 2015 The Travelers Indemnity Company All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc with Its permission 37738213 1 MARKT -1 1 17/18 Master Certificate I Stephanie Schaller 1 9/15/2017 10:21:21 AM (PDT) I Page 4 of 8 COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11— COVERED AUTOS LIABILITY COVERAGE. Any "employee" of yours is an "Insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (1) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit ". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, Including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO = LIMITED WORLDWIDE COW "suit ", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS. addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the Insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses hibits the transaction of business with or (b) This Insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, _ "auto" that you lease, hire, rent or borrow contingent or on any other basis without a driver for a penod of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees ", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company All rights reserved CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc with its permission 37738213 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 5 of 8 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE - However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident'. I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE_ COVER- AGE We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto" This coverage applies only in the event of a total theft of your covered "auto" No deductibles apply to this Personal Property coverage K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy, b. The airbags are not covered under any war- ranty, and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident' or 'loss" ap- plies only when the "accident' or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident' or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident' parel and other personal property which is: or "loss ", provided that the "accident' or "loss" (1) Owned by an "Insured "; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc with its permission 37738213 1 MARKT -1 1 17/18 Masten Certificate I Stephanie Schellen 1 9/15/2017 10 21 21 AM (PDT) I Page 6 of 8 COMMERCIAL AUTO such contract The waiver applies only to the person or organization designated In such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error In, any Information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal Page 4 of 4 © 2015 The Travelers Indemnity Company All rights reserved. Includes copyrighted material of Insurance Services Office, Inc with Its permission 37738213 1 MAAKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21.21 AM (PDT) I Page 7 of 8 CA T3 53 02 15 Al TR A,s��� ®S WORKERS COMPENSATION /�!/ I� AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (XJUB- 4342T25 -0 -17) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 3 .0 % of the Califomia workers' compensation pre- mium. Schedule Person or Organization I Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09/15/2017 Policy No. XJUB4342T25017 Endorsement No. Insured Mark Thomas & Company, Inc Premium Insurance Company Countersigned by DATE OF ISSUE: 09 -15 -17 ST ASSIGN: Page 1 of 1 37738213 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10.21:21 AM (PDT) I Page 8 of 8 ,4coRE)i CERTIFICATE OF LIABILITY INSURANCE lilh.� DATE (MM/DD/YYYY) 1 9/15/2017 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 rights to the certificate holder In lieu of such endorsement(s). PRODUCER Asero Insurance Services 200 N. Almaden Blvd 3rd Floor San Jose, CA 95110 www.aseroins.com License No OA91339 NAME: CONTACT Asero Insurance Services PNCON o 866 - 966 -8928 ac No): 408- 271 -1802 E -MAIL ADDRESS' certsL&aseroins com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co of Amer 25674 INSURED Mark Thomas & Company Inc 2290 North First Street, Suite 304 San Jose CA 95131 INSURER e: Travelers Indemnity Company of CT 25682 INSURER C: INSURER D: 9/15/2017 INSURER E EACH OCCURRENCE INSURER F. COVERAGES CFRTIFICATF NIIMRFR- z77zaIV� RFVISION NIIMRFR- 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 ADDL 1= SUER WVD POLICY NUMBER POLICY MMIDD YY LIMITS B ,/ COMMERCIAL GENERAL LIABILITY ,� 680- 21-1548914 9/15/2017 9/15/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE F-11 OCCUR DAMAGE TO RENTEU_ PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10.000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE $ 2,000,000 PRO- POLICY Z JECT 7-1] LOC PRODUCTS - COMP /OP AGG $ 2,000,000 I $ OTHER B AUTOMOBILE LIABILITY BA- 61­1189707 9/15/2017 9/15/2018 Ea BNEDSINGLELIMIT $ 1000000 ✓ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PROP DAMAGE $ HIRED A UTOS ONLY ✓ AUTOS ONLY Comp/Coll Ded $1,000 Is A �/ UMBRELLA UA13 V OCCUR CUP- 9EO95562 9/15/2017 9/15/2018 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 EXCESS LAB CLAIMS -MADE DED I I RETENTION $ 7 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIE-rOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? NIA XJUB4342T25017 9/15/2017 9/15/2018 V/ I STATUTE ERH E L EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEEI s 1,000,000 (Mandatory in NH) If Yes, descnbe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) SJ- 15106, Monterey Utilities City of Gilroy, its officers and employees NOTE 30 DAYS NOTICE OF CANCELLATION WILL BE GIVEN EXCEPT 10 DAYS FOR NON - PAYMENT. 113.�a1�Nf��A -2 . NI R-I -t.l Cl ty of Gilroy 7351 Rosanna Street Gilroy CA 95020 ACORD 25 (2016/03) 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 Joe Longwello _ M 1988 -2015 ACORD CORPORATION_ All riahls rasarvarl The ACORD name and logo are registered marks of ACORD 37738212 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 1 of 10 AGENCY CUSTOMER ID: MARKTA LOC #: _--­4 a ACOPR o ADDITIONAL REMARKS SCHEDULE Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Companyy, Inc 2290 North First Street, 5I. 304 San Jose CA 95131 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE. ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certifi cate of Liability (03/16) HOLDER: City of Gilroy ADDRESS: 7351 Rosanna Street Gilroy CA 95020 General Liability Additional Insured / Waiver of Subrogation / Primary & Non - Contributory as required by written contract per form CG D3 81 09 07 Commercial Auto Liability Additional Insured / Waiver of Subrogation as required by written contract per form CA T3 53 02 15 Workers' Compensation Waiver of Subrogation as required by written contract per form WC 99 03 76 (A) -001 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 37738212 I MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 2 of 10 ACO L- --- AGENCY CUSTOMER ID: MARKT -1 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Company Inc 2290 North First Street, Suite 304 San Jose CA 95131 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Gilroy ADDRESS: 7351 Rosanna Street Gilroy CA 95020 THIS PAGE INTENTIONALLY LEFT BLANK A6UKU IU7 (ZUUZU /U7) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 37738212 1 MARKT -1 1 17/18 Master Certificate I Stephanie Schaller 1 9/15/2017 10 21 21 AM (PDT) I Page 3 of 10 Insured: Mark Thomas & Company, Inc. Policy : 680- 2H548914 Commercial General Liability CG D3 81 09 07 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLREASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following COMMERICAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section 1I): Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part but only with respect to liability for "bodily injury", "property damage ", or "personal injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf. a. In the performance of your ongoing operations b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard" Such person or organization does not qualify as an additional insured for "bodily injury ", "property damage ", or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided for such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services ". f. The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits showing in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part. - B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIAIBLITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such .additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance ".'But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others To Us in COMMERICAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage ", or "personal injury: arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or 37738212 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10.21 21 AM (PDT) I Page 4 of 10 organization entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. D. The following definition as added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract Commercial General Liability CG D3 81 09 07 Page 2 of 2 or agreement under which you are require to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and C. Before the end of the policy period. 37738212 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10:21.21 AM (PDT) I Page 5 of 10 Policy No BA- 61­1189707 Insured Mark Thomas & Company Inc COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11— COVERED AUTOS LIABILITY COVERAGE Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section IIL C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE- An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "e-m- employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS. b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own- (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc with its permission 37738212 1 MARKT -1 1 17/18 Master Certificate I Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 6 of 10 COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit "' related to the conduct of your busi- brought outside the United States of ness America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada covered "auto ". (I) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set - tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS bons. LIABILITY COVERAGE (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent in your business or your personal affairs' (iii) We may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit ". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover We do not have to furnish sured" pays with our consent, but these bonds only up to the limit described in Para - 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "s "suit ", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees ", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 0 2015 The Travelers Indemnity Company All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc with Its permission 37738212 1 MARKT -1 1 17/18 Master Certificate 1 Stephanie Scheller 1 9/15/2017 10 21 21 AM (PDT) I Page 7 of 10 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident' I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES — INCREASED LIMIT _ The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for 'loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured "; and COMMERCIAL AUTO (2) In or on your covered "auto ". This coverage applies only in the event of a total theft of your covered "auto ". No deductibles apply to this Personal Property coverage K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated We will pay up to a maximum of $1,000 for any one 'loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident' or 'loss" ap- plies only when the "accident' or 'loss" is known to: (a) You (if you are an individual), (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization), or (e) Any "employee" authorized by you to give no- tice of the "accident' or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS. S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex= tent required of you by a written contract signed and executed prior to any "accident' or "loss ", provided that the "accident' or "loss" arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc with its permission 37738212 1 MARKT -1 1 17/18 Mastex Certificate I Stephanie Schellex 1 9/15/2017 10 21 21 AM (PDT) I Page 6 of 10 COMMERCIAL AUTO such contract The waiver applies only to the person or organization designated In such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal. Page 4 of 4 © 2015 The Travelers Indemnity Company All rights reserved. Includes copyrighted material of Insurance Services Office, Inc with Its permission 37738212 1 MARKT -1 1 17/18 Master Centificate I Stephanie Schellex 1 9/15/2017 10 21:21 AM (PDT) I Page 9 of 10 CA T3 53 0215 Al ®����e ® S WORKERS COMPENSATION IT G iT AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY URTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: (XJUB- 4342T25 -0 -17) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 3 .0 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09/15/2017 Policy No. XJUB4342T25017 Endorsement No. Insured Mark Thomas & Company, Inc. Premium Insurance Company Countersigned by DATE OF ISSUE: 09 -15 -17 ST ASSIGN: 37738212 1 MART -1 1 17/18 Master Certificate I Stephanie Schaller 1 9/15/2017 10 21 21 AM (PDT) I Page 10 of 10 Page 1 of 1 ' - A� R° ® CERTIFICATE OF LIABILITY INSURANCE DATE (MMDD /YYYY) 6/28/2017 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, 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 —_ _- _ _ _ _ Dealey, Renton & Associates P. O. Box 12675 Oakland, CA 94604 -2675 NAME. CT " Doris A. Chambers - PHONE 510 465 -3090 - FAX -No E=U (A/C.No- - ADDRESS. dchambers @dealeyrenton com _ INSURERS AFFORDING COVERAGE NAIC # MED EXP (Any one person) $ INSURER XL Specialty Insurance CO. 37885 INSURED MARKTHOMA INSURER B GEN'L INSURER C GENERAL AGGREGATE- -- Mark Thomas & Company, Inc 2290 N. First Street San Jose CA 95131 INSURER D -$ - - - - $ - - INSURER E. LIABILITY ANY AUTO AUTOS NED I AUTOSULED NON -OWNED HIRED AUTOS AUTOS INSURER F - - rnvcoAr•cc rGOTIrIC ATC Mi IMRGI7. 115316912 RFVLCI(1m NI LMRPR- 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 INTR TYPE OF INSURANCE I INSD SWVD I POLICY NUMBER MMDDY/WYY MM DDY/YYYY I LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR - - EACH OCCURRENCE $ A Al I PREM SESO(Ea occu ence) $ MED EXP (Any one person) $ _ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER PRO- POLICY I� PRO a LOC OTHER GENERAL AGGREGATE- -- $- -- PRODUCTS - COMP /OP AGG -I -$ - - - - $ - - AUTOMOBILE LIABILITY ANY AUTO AUTOS NED I AUTOSULED NON -OWNED HIRED AUTOS AUTOS - - - MBINED Ea accdent I L IM $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPER DAMAGE $ $ LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ HUMBRELLA AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ (Mandatory OFFICER/MEMBER NH EXCLUDED If yes, - describe under , DESCRIPTION OF OPERATIONS below NIA . " J STATUTE ERH EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ EL DISEASE -POLICY LIMIT $ A Professional Liability _ - I DPR9915552 7/1/2017 7/1/2018 $2,000,000 Per Claim $2,000,000 Annl Aggregate equired) '_ -' -- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES' (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)'--'- REF: MTC'S Project# CU -16107 — East Luchessa Ave Reconstruction. CERTIFICATE -- - -- _- City of Gilroy PUBLIC WORKS DIVISION 7351 Rosanna Street ----------Gilroy CA 95020 ACORD 25 (2014/01) - CANCELLATION= 3U -Uay NUU /1U Uay for NonF'ay of F'rem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUUTHOORIZE4D REPRESENTATIVE Q __ @ 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/28/2017 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, certain policies may require an endorsement. A statement on this certificate does not confer rights to the - certificate holder in lieu of such endorsements . PRODUCER _ Dealey, Renton & Associates P. O. Box 12675 - Oakland, CA 94604 -2675 CONTACT Doris A. Chambers _ NAME: PHONE 510 465 -3090 FA ' No E -MAIL -ADDRESS, dchambers @dealeyrenton com INSURERS AFFORDING COVERAGE NAIC # CLAIMS -MADE E OCCUR INSURER A XL Specialty Insurance Co. 137885 INSURED MARKTHOMA INSURER B I INSURER C 1 Mark Thomas & Company, Inc. 2290 N. First Street San Jose CA 95131 INSURER D I $ INSURER E INSURER F I+f1VG0ArCC /`CDTICl/`ATC NI 1rA9 =D• 17465AR967 RFVI_CInN NI IMRFR• 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 I INSD ISWVD I POLICY NUMBER MM DIDY/YYYY MM/DD/YYYY I LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE E OCCUR I DAMAGE PREM SESOEa occu ante I $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER PRO- POLICY I ECT :7] LOC GENERAL AGGREGATE $ _ PRODUCTS - COMP /OP AGG _$ OTHER AUTOMOBILE LIABILITY M NE Ea accident) IN LIMI $ BODILY INJURY (Per person) $ ANY AUTO AUTOS OWNED AUTOSULED HIREDAUTOS AUTOS F11 NON -OWNED BODILY INJURY (Per accident) S P O cdent DAMAGE $ $ LIAB I OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE HUMBRELLA AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ (Mandatory OFFICER/MEMBER NH EXCLUDED NIA A PER I STATUTE ERH E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ -• - - E L b1SE SE - POLICY LIMIT '$ ' If es,"descdbe under DESCRIPTION OF OPERATIONS below - —' -A Professional Liability DPR9915552 7/112017 7/1/2018 1$2,000,000 — Per Claim $2,000,000 And Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLE$ (ACORD 101, Additional Remarks Schedule, "may be attached if more space is required) -- REF. MTC's #Project# CU -16108 —Sewer Trunk line Improvement KATE HOLDER Clty of Gilroy 7451 Rosanna Street Gilroy CA 95020 GANGtLLATIUN_ OV -Uay rvvLa I u Uay iur i wnray ur rrem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION - DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988 -2014 ACORD CORPORATION. All rights reserved. .ACORD.25!(2014/01.) The,ACORD,name and (logo are registered marks of ACORD AC®® OI2 � CERTIFICATE OF LIABILITY INSURANCE - DATE (MMIDD/YYYI� 6/28/2017 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, 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 - Dealey, Renton 8i Associates P. O. Boz 12675 Oakland, CA 94604 -2675 NAME: Dons A. Chambers - - - - - - - PHA HONE Fxt) 510 465 -3090 - ADDRESS dchambers @dealeyrenton.com INSURER(S) AFFORDING COVERAGE NAIC # - PERSONAL & ADV INJURY INSURER A:XL Specialty Insurance Co. - I37885- GENERAL AGGREGATE - - INSURED MARKTHOMA INSURER B. I $ - - -- INSURER C $ - - - Mark Thomas & Company, Inc. 2290 N. First Street San Jose CA 95131 INSURER D INSURER E Ea accident I INSURER F BODILY INJURY (Per person) $ rK% %1r0AriLC RFRTIFICATF KII IMRFR• 83601408 RFVI__Qinm All IMRFR- 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 I INSDLISWVD POLICY NUMBER 1 JMMOILDSgtlF I IM0Mr6D=J I LIMITS . COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7 OCCUR EACH OCCURRENCE $ 'A ' A PREMISES Ea GES( RENTED I occurrence $ MED EXP (Any one person) I $ PERSONAL & ADV INJURY $ — GEN'L AGGREGATE LIMIT API PLIES PER PRO- POLICY ECT LOC OTHER GENERAL AGGREGATE - - $ - PRODUCTS - COMP /OP AGG I $ - - -- -- - - — -- - --I• $ - - - AUTOMOBILE LIABILITY ANY AUTO AUT OWNED SCHEDULED NON -OWNED HIRED AUTOS AUTOS _P� - - Ea accident I BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Is UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE I $ AGGREGATE $ DED RETENTION $ $ -- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If es; descnbe tinder' DESCRIPTION OF OPERATIONS below NIA I _ PER 0TH - STATUTE I ER EL EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ - - - — EL DISEASE - POLICY LIMIT $ A Professional Liability DPR9915552 - 7/1/2017 7/1/2018 1$2,000,000 1$2,000,000 ' Per Claim Annl Aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) MTC#SJ- 15106, Monterey Utilities CERTIFICATE HOLDER - City of Gilroy 7351 Rosanna Street Gilroy CA 95020 - CANCELLATION SU uay U uay Tor Nonray oT rrem 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 ©1988-2014ACORDICORP.ORATION_ Allwiahts• reserved ACORD 25 (2014/01) The ACORD name and logo are registered- marks,of ACORD ,d►coRV® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/15/2016 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate -does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Asero Insurance Services 200 N. Almaden Blvd. 3rd Floor San Jose, CA 95110 CONTACT NAME: Asero Insurance Services PHONE 866-966-6928 AX No: 408271 -1802 E-MAIL ADDRESS: Certs seroins.COm INSURER(S) AFFORDING COVERAGE NAIC # 9/15/2016 INSURER A : Travelers Property Casual I ty Cc of Amer 25674 www.aseroilns.com License No. OA91339 INSURED Mark Thomas & Company, Inc. 2290 North First Street, uite 304 INSURER B: Travelers Indemnity Company of CT 25682 INSURER C MED.EXP (Any one person) 1 INSURERD : San Jose CA 95131 INSURER E : $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY ❑ JPERCOT- 7 LOC OTHER: INSURER F : $ 2,000,000 PRODUCTS - COMP/OP AGG COVERAGES CERTIFICATE NUMBER: 31788393 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_DOC_UMENT 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 L TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A �/ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR ✓ 68041-1548914 9/15/2016 9/15/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO (EaEo�rrrence ) $ 1,000,000 MED.EXP (Any one person) $ 10,066 PERSONAL & ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY ❑ JPERCOT- 7 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000;000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED ..AUTOS ONLY AUTOS AUTOS ONLY Y ✓ AUTOS NON-OWNED 500 Com D . ✓ 1 000 Coll Ded. ✓ BA- 6H189707 9/15/2016 9/15/2017- OMBINEDitSINGLE LIMIT $ 1000000 ✓ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ✓ PeOPEF7Y DAMAGE $ ✓ $ A ,� UMBRELLA LIAB EXCESS LIAR ✓ OCCUR CLAIMS -MADE CUP009E095562 9/15/2016 9/15/2017 EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBEREXCLUDED?. (Mandatory 'In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA XJUB4342T25016 9/15/2016 '9/15/2017 ✓ STAT TE ERH E.L. EACH ACCIDENT '$ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 OOO OOO E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Service Agreement City of Gilroy On -Call Engineering Services City of Gilroy, its officers, officials and employees NOTE: 30 DAYS NOTICE OF CANCELLATION WILL BE GIVEN EXCEPT 10 DAYS FOR NON - PAYMENT. GtKIIr'IGAIt MULUGK UANGCLLAIIUN City of Gilroy 7351 Rosanna Street Gilroy CA 95020 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c7--- ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 31788393 1 MARKT -1 1 16 -17 Master Certificate I Stephanie �SCheller 1 9/15/2016 3:58:48 PM (PDT) I Page 1 of 8 ACOREP L---- AGENCY CUSTOMER ID: MARKT -1 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Asero.lnsurance _Senrices NAKED-INSURED Mark Thomas & Company, Inc. 2290 North First Street, Suite 304 San Jose CA 95131 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Gilroy ADDRESS: 7351 Rosanna Street Gilroy CA 95020 General Liability Additional Insured per form CG D3 82 09 07 General Liability 30 Day Notice of Cancellation per form IL T4 00 12 09 Commercial Auto Liability Additional Insured / Waiver of Subrogation as required by written contract per form CA T3 53 03 10 Workers' Compensation Waiver of Subrogation as required by written contract per form WC 00 03 13 (00) The ACORD name and logo are registered marks of ACORD 31788393 1 MARRT -1 1 16 -17 Master certificate I Stephanie Scheller 1 9/15/2016 3:58:48 PM (PDT) I Page 2 of 8 ATTACHMENT POLICY NUMBER: 680- 2H548914 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 09/15/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION (S): CITY OF GILROY, ITS OFFICERS, OFFICIALS AND EMPLOYEES ARE NAND AS ADDITIONAL INSURED 7351 ROSANNA ST GILROY, CA 95020 PROJECT /LOCATION OF COVERED OPERATIONS: SERVICE AGREEMENT: CITY OF GILROY ON —CALL ENGINEERING SERVICES PROVISIONS A. The following is added to WHO IS AN INSURED (Section II): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for "bod- ily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products - completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services ". e. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- lions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section 1V): However, if you specifically agree in a "contract or agreement requiring insurance" that, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 0 2007 The Travelers Companies, Inc. Pagel of 2 Includes the copyrighted material of Insurance Services Office; Inc., with its permission COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a .named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance" for such addi- tional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional in- sured when the additional insured is also an addi- tional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the pro- ject or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage occurs, or the "personal in- jury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include the person or organization shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs, and the "personal injury" is caused by an of- fense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 82 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission POLICY NO. 680-21-1548914 ISSUE DATE: 9/15/2016 THIS ENDORSEMENT CHANGES THE P OLICY. PLEASE READ IT CAREFULLY. DESIGNATED EN, nTY - NOTICE OF CANCELLATION /NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHED n c CANCELLATION: Plumber of Days Notice of Cancellation- 30 NONRENEWAL: PERSON OR ORGANIZATION: My or 61my 7351 ADSAUK $T B . CA 95020 PROVISIONS: Number of Days Notice of Nowenr&W: A. If we cancel this policy for any statutory penNt- tad reason other then nonpayment of premium, and a number of days Is shown for cancellation in the schedule above, we will mail notice of cancel- lation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cenceliaiion In the schedule above before the effective date of can - calwon. B. If we decide to not renew this policy for any statu- torily permitted reason, and a number of days Is shown for nonrenewal In the schedule above. we Will mall police of the nonrenewal to the pion or organization shown In the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for nonrenewal In the schedule above be- fore the expiration date. IL T4 0012 09 0 2= The Travelers Inde" CanpaM Page 1 of 1 Policy No: BA- 6H189707 Insured: Mark Thomas & Company, Inc. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLE MENrARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO —. LIMITED WORLDWIDE. COVERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section. II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is- An Insured, of SECTION 11 — Ll- ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who 1s An Insured, of S ECr ION II LIABILITY operating an "auto hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 03 10 © 2010 The Travelers Indemnity Company. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 31788393 1 MARKT -1 1 16 -17 Master Certificate I Stephanie Scheller 1 9/15/2016 3:58:58 PM (PDT) I Page 3 of 8 COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.5., Other I nsurance, of SEC M ON IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". D. EMPLOYEES AS INSURED The following is added to Paragraph AA, Who Is An Insured, of SECTION 11 — LIABILITY COV- ERAGE:. Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS - .INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 0 — LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a:(4), of SECTION 0 — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph 6.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to.and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease,, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees ", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (1) You must arrange to defend the "in- sured" against; and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (IQ Neither you nor any other involved insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in, defending the "insured" against, or in the settlement of, any claim or "suit ". (Iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to ,which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limit Of Insurance, of SEC- TION II — LIABILITY COVERAGE. (v) We will reimburse the insured for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit ", but only up to and included within the limit described in Para- graph C., Limit Of Insurance, of SECTION II LIABILITY COVER- AGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available Page 2 of 4 ® 2010 The Travelers Indemnity Company. Includes copyrighted material of Insurance Services Office, Inc. with its permission. 31788393 I, MARKT-1 1 16 -17 Master Certificate IStephanie. Scheller 1 9/15/2016 3:.58:48 PM (PDT) I Page 4 of 8 CA T3.53 0310 to the "insured" whether primary, excess contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE —GLASS The following is added to Paragraph D, Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE - INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.6., Loss Of Use Expenses, of SEC- TION III— PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident ". I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a,, Transportation Expenses, of SECTION III PHYSICAL, COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft. of a cov- ered "auto" of the private passenger type. COMMERCIAL AUTO J. PERSONAL EFFECTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION 111 = PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured "; and (2) In or on your covered "auto ". This coverage applies only in the event of a total theft of your covered "auto ". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph 8.3, Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b.. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c, The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss ". L NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A2.a, of SECTION IV- BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is (mown to: (a) You (if you are an individual); (b) A partner (if you are, a partnership); (c) A member (if you are .a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee authorized'by you to give no- tice of the "accident" or "loss". CA T3 53 0310 ® 2010 The Travelers Indemnity Company. Page 3 of 4 Includes copyrighted material of insurance Services Office, Inc. with its permission. 31788393 1 MARKT -1 1 16 -17 Master Certificate I Stephanie Schaller 1 9/15/2016 3:58:98 PM (PDT) I Page 5 of 8 COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss ", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph 6.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV- BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal. Page 4 of 4 © 2010 The Travelers Indemnity Company. Includes copyrighted material of Insurance Services Office, Inc. with its permission. 31788393 1 MARKT -1 1 16 -17 Master Certificate I Stephanie Schaller 1 9/15/2016 3 :58:48 PM (PDT) I Page 6 of 8 CA T3 53 0310 TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00) - POLICY NUMBER: XJUB4342T25016 INSURED: Mark Thomas & Company, Inc. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED sY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAVER DESIGNATED ORGANIZATION: DATE OF ISSUE: 09 -15 -16 ST ASSIGN: 31788393 1 MARKT -1 1 16 -17 Heater Certificate I Stephanie Schaller 1 9/15/2016 3:58:48 PM (PDT) I Page 7 of 8 DATE (MMIDDIYYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE Ill - 6/30/2016 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 NAME: Doris A. Chambers Dealey, Renton & Associates PHONE 510 465 -3090 FAX P. O. BOX 12675 - (A!!C.M Ezt) (N. No): EMAIL deale dchambers renton.com Oakland, CA 94604 -2675 DRESSY dchambers@dealeyrenton.com _ INSURERA:XL Specialty Insurance Co. 37885 INSURED MARKTHOMA INSURER B: Mark Thomas & Company, Inc. INSURERC : 2290 N. First Street San Jose CA 95131 tNSURERD: rnVl=PAnl=Q CERTIFICATE NIIMRFR• 641323776 RFVICInN NIIMRFR- 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 POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MMlDDMYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ PRO- POLICY _ _ JECT 71 LOC PRODUCTS - COMP /OP AGG S OTHER: $ AUTOMOBILE LIABILITY I SINGLE LIMIT (Ea accident) $ ANY AUTO ^BODILY INJURY (Per person) $ AUTS OWNED SCHEDULED BODILY INJURY (Per accident) $ NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident)_ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE_ AGGREGATE $ I DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ - _ If yes, describe under _ DESCRIPTION OF OPERATIONS below_ _ _ — + E.L. DISEASE - POLICY LIMIT $ ` A Professional Liability DPR9806472i 7/1/2016 7/1/2017 $2,000,000 Per Claim $2,000,000 Annl Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REF: MTC's #Project# CU -16108 — Sewer Trunk line Improvement. CERTIFICATE HOLDER CANCELLAI IUN 3U Udy INUL/ 1 U uay lur INunrdy Ol rrern SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7451 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD DATE (MM /DD /YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 6/30/2016 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 NAAME: NME, Doris A. Chambers Dealey, Renton & Associates PHONE FAX 510 465 -3090 P. O. Box 12675 A/C, ft r -XQ' _(AfC No): Oakland, CA 94604 -2675 DDRess: dchambers @dealeyrenton.com COMMERCIAL GENERAL LIABILITY INSURERS AFFORDING COVERAGE _ NAIC 0 INSURERA:XL Specialty Insurance Co. 37885 INSURED MARKTHOMA INSURER B: Mark Thomas & Company, Inc. INSURER C: 2290 N. First Street _ _ San Jose CA 95131 INSURER D POLICY PRO- JECT LOC INSURER E: OTHER: INSURER F: I+llllc r]wl�cC 11C10TIEW1 ATC A11111ADCo. 7 9rl 9,iQRnn Pr: % /ICI(/AI IVI IUrZ9=I7- 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 LTR INSD WVD POLICY EFF POLICY EXP LIMITS POLICY NUMBER MMlDDfYYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ __ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ IN IN LE LIMIT $ AUTOMOBILE LIABILITY Ea accident ANY AUTO BODILY INJURY (Per person) $ ALLOSNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE, $ DED RETENTION $ WORKERS COMPENSATION PER OTH- STATUTE_ AND EMPLOYERS' LIABILITY Y / N _ _ _ER_ ANY PRO PRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA - - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability DPR9806472 7/1/2016 7/1/2017 1$2,000,000 Per Claim $2,000,000 Annl Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MTC #SJ- 15106, Monterey Utilities CEKI IF-ICAIt HULUtK CANCtLLAI IUN Ou Udy IV VI / Iv Udy Ivl IVUl lydy UI r"I CI 11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE e-- ---L Co - lz., ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD A ® DATE (MM /DD YYYY) CERTIFICATE OF LIABILITY INSURANCE F6/130/2016 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 NAME: Doris A. Chambers Dealey, Renton & Associates PHONE 510 465 -3090 FAX P. O. Box 12675 -(A/C. N am? (A/c. No): Oakland, CA 94604 -2675 E DRESS ydchambers @dealeyrenton.com INSURED Mark Thomas & Company, Inc. 2290 N. First Street San Jose CA 95131 MARKTHOMA C: XL SDecialty Insurance Co. 37885 rcorl�l�wrc AnIRADC'o• 1R5d51Rncl; I?G \ /ICI(12J A1111111pr:0. 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 DL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MMIDD/YYYY (MMIDD /YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMP /OP AGG — $ OTHER: $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL SCHEDULED BODILY INJURY (Per accident) $ UTOWNED AUTOS - NON -OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE _ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA - - (Mandatory in NH) - E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability DPR9806472 7/1/2016 7/1/2017 $2,000,000 Per Claim $2,000,000 Annl Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REF: MTC'S Project# CU -16107 — East Luchessa Ave Reconstruction. CERTIFICATE HOLDER GANCtLLAI IUN OU Udy INUM/ IV Udy IUr INUnrdy UI rrern SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUBLIC WORKS DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street 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 ACC)RO® ".`� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYY1) 6/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD_ ER. 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 - Dealey, Renton -& Associates - P. O. Box 12675- . Oakland, CA 946.04 -2675 NAME�T David C Eckman _ VNE.. - .- 510465 -3090- FAx E-MAIL INSURER (S) AFFORDING COVERAGE NAIC # INSURERA:XL Specialty Insurance Co. - 37885 INSURED MARKTHOMA INSURER B: $ INSURER C: CLAIMS -MADE E OCCUR Mark Thomas & Company, Inc. 1960 Zanker Road San Jose, CA 95112 INSURER D 408 453 -5373 INSURER E: $ INSURER F: MED EXP Any one person) $ f nVCQAf_FC r_FRTIF!C_ATF NIIMRFR• 1415496319 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDlYYYY POLICY EXP MMIDD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE E OCCUR DA AGE To RETED FIRM ISES Ea occurrence $ MED EXP Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ - $ PRODUCTS-.COMP /OPAGG $ POLICY E_1 PRO - ❑ LOC JECT - $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGIFIJT Ea accident _ I $ BODILY INJURY (Per person) $ ANY AUTO - AUTOS NED _ SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY'DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION' AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE PER STATUTE ERH E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - .POLICY LIMIT $ - If yes, - describe under DESCRIPTION OF OPERATIONS beiow A Professional Liability DPR9725035 7/1/2015 7/1/2016 $2,000,000 Per Claim $2,000,000 Ann] Aggregate DESCRIPTION OF OPERATIONS .I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MTC#SJ- 15106, Monterey Utilities rFRTIFIrATF Mn1 nFR CANCELLATION 3V UaV IVIJI,/ I UaV IOU IVOnriJV OI r'FUM City of Gilroy 7351 Rosanna Street 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 fEl --.4- e - s,..._ --..^ ©198 &2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Aee✓o�v® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYI� 6/30/2015 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 ' Dealey, Renton & Associates P. O.. Box 12675 Oakland, CA 94.6042675 - CONTACT NAME: David C. Eckman PHONE 510 465 -3090 FAX E-MAIL INSURER (S) AFFORDING COVERAGE NAIC # INSURERA:XL Specialty Insurance Co. 37885 INSURED MARKTHOMA INSURER B: $ INSURER C: CLAIMS -MADE FI OCCUR Mark Thomas & Company, Inc. 1960 Zanker Road San Jose, CA 95112 INSURER D 408 453 -5373 INSURER E: $ INSURER F: MED EXP (Any one person) $ d`nWCDAnCC !`CDTICIPATC kilIURCD• 1d15dgFi31q DCVICInId IJIIMRCI?- 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' INSD WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE FI OCCUR DAMAGE To RENTED PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $- POLICY PRO LOC JECT PRODUCTS - COMP /OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGIT-L—INIM— Ea accident $ "BODILY INJURY (Per person) $ ANY AUTO AUT OWNED SCHEDULE[) BODILY INJURY {Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPER TY'D MAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ tDEC ESS LIAB CLAIMS -MADE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OT H- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ . If -, describe under DESCRIPTION OF OPERATIONS below - ' E.L. DISEASE - POLICY LIMB $ A Professional Liability DPR9725035 7/1/2015 7/1/2016 $2,000,000 Per Claim $2,000,000 Annl Aggregate DESCRIPTION OF OPERATIONS'/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) MTC #SJ- 15106, Monterey Utilities CERTIFICATE HOLDER CANCELLATION su uay IVA. w -1 a uay Tor Nont -ay orerem City of Gilroy 7351 Rosanna Street 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 a, _-L d - ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD