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Marathon Engineering - Insurance CertificateClient#: 64826 MAREN2 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE //15/15/ /DD/YYY1) TYPE OF INSURANCE 1 1 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 NAOMNT CT Maria Jebb Gulfshore Insurance - Naples ac° N :239 435 -7120 239 213 -7720 ac No 4100 Goodlette Road North E-MAIL ADDRESS: mjebb @gulfshoreinsurance.com Naples, FL 34103 -3303 DAI�AA� T RENTED PREMISEES Ea occurrence $100I 000 239 261 -3646 INSURER(S) AFFORDING COVERAGE NAIC 9 INSURER A: Amerisure Mutual Insurance Comp INSURED Marathon Engineering Corporation INSURER B GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X Ea LOC PRODUCTS - COMP /OP AGG $2,000,000 dba: Gold Medal Safety Padding INSURER C : • AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS Drive Oth Car 5615 2nd Street West INSURER D: CA20956220003 1/24/2016 01/24/2017 Lehigh Acres, FL 33971 INSURER E: X BODILYINJURY(Perperson) $ INSURER F: $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE IIN RL SVIUINU POLICY NUMBER MWDDY EFF MMIDDY EXP LIMITS • GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR CPP20956230003 1/24/2016 01/24/2017 EACH OCCURRENCE $1,000,000 DAI�AA� T RENTED PREMISEES Ea occurrence $100I 000 MED EXP (Anyone person) s5,000. PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X Ea LOC PRODUCTS - COMP /OP AGG $2,000,000 $ • AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS Drive Oth Car CA20956220003 1/24/2016 01/24/2017 COMBINED SINGLE LIMIT Ea accident) 1,000,000 X BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accdent $ X $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE CU20956240003 1/24/2016 01124/201 EACH OCCURRENCE s5,000,000 AGGREGATE $5.000.000 DED I X I RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC205943107 1/19/2016 01/19/2017 X WCSTATU- OTH- E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE Fi ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S952148/M952066 MJE Client#: 64826 MAREN2 A(rUKU,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/19/2016 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 Ileu of such endomement(s). PRODUCER Gulfshore Insurance - Naples 4100 Goodlette Road North Naples, FL 34103 -3303 10TACT Marla Jebb PHONE , 239 435 -7120 ac No 239 213 -7720 ADo ESS: mjebb@gulfshoreinsurance.com INSURE S) AFFORDING COVERAGE NAIC # 239 261 -3646 INSURED Marathon Engineering Corporation INSURER A: Amerisure Mutual Insurance Comp INSURER B: X INSURER C: 1$100.000 dba: Gold Medal Safety Padding INSURER D: $5.000 5615 2nd Street West INSURER E: 1$1.000,,066 Lehigh Acres, FL 33971 INSURER F: GENERAL AGGREGATE $1.000000 - -- - - -- - -- ' - — • -- °•- -- RC V 101UIY IYUMCtK: 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 ADDLSUB LTR TYPE OF INS_ URANCE I SR WVD POLICY NUMBER POLICY F MWDDY Y LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR CPP20956230003 1/24/2016 01/24/2017 EACH OCCURRENCE $1 000 000 X DAMAGE T R NT ante 1$100.000 MED EXP (Any one person $5.000 PERSONAL & ADV INJURY _ 1$1.000,,066 GENERAL AGGREGATE $1.000000 GEN'L AGGREGATE' LIMIT APPLIES PER POLICY X PRO- CT LOC PRODUCTS - COMP /OP AGG $2P0001000 $ A AUTOMOBILE L44BILrnr ANY AUTO ALL OWNED SCHEDULED UTOS AUTOS IRED AUTOS X AUTOS Oth Car CA20956220003 1/24/2016 01/24/201 COMBINED SINGLE LIMIT Ea accident . 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ It'irive PROPERTY DAMAGE Per accident $ $ A A► UMBRELLA LM EXCESS LIAR v OCCUR CLAIMS -MADE N/A CU20956240003 WC205943107 1/24/2016 1/19/2016 01/24/201 01/19/201 EACH OCCURRENCE s5,000,000 AGGREGATE $5 OOO 000 DE D X RETENTION $O WORKERS LI AnON HaAND:EMPLOYERS' LIABILRY ICEWMEMBERR EXXCLUDED? ECUTIVE I Mandatory In and If yes, describe under DESCRIPTION OF OPERATIONS below we sTATU- oTH X $ E.L. EACH ACCIDENT $1,000,000 EJ_ DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Project: City of Gilroy, Gilroy, CA City of Gilroy, CA Is Included as Additional Insured on a primary and noncontributory basis with regards to General Liability Only as required by contract per CG7048 0913, includes ongoing and completed operations, Waiver of Subrogation per CG70491109. Certificate Holder is included as Additional Insured In regards to Auto Liability only as required by contract per form CA7171 0508, including Waiver of (See Attached. Descriptions) CCDTIGIf�A'TC un� non -- -- 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 r� i ©1988 -2010 ACORD CORPORATION- All rlrvhta row'. A AVUKU Z5 (ZU10105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S952955/M952066 MJE Client#: 64826 MAREN2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) TYPE OF INSURANCE 1/1512016 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 Maria Jebb Gulfshore Insurance - Naples ac °N ; .239 435 -7120 FAx ac, N.l: 239 213 -7720 4100 Goodlette Road North E-MAIL ADDRESS: mjebb @gulfshoreinsurance.com Naples, FL 34103 -3303 DAry�A�E TO RENTED PREMISES Ea occurrence $100,000 239 261 -3646 INSURE S) AFFORDING COVERAGE NAIC # INSURER A: Amerisure Mutual Insurance Comp INSURED Marathon Engineering Corporation INSURER B GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7X PRO LOC JECT PRODUCTS - COMP /OP AGG $2,000,000 dba: Gold Medal Safety Padding INSURER C : A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS Drive Oth Car 5615 2nd Street West INSURER D: CA20956220003 1/24/2016 01/24/201 Lehigh Acres, FL 33971 INSURER E: X BODILY INJURY (Per person) $ INSURER F: $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 INSR SUB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MWDD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR CPP20956230003 1/24/2016 01/24/2017. EACH OCCURRENCE $1,000,000 DAry�A�E TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7X PRO LOC JECT PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS Drive Oth Car CA20956220003 1/24/2016 01/24/201 COMBINED SINGLE LIMIT Es accident 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) P t id ( ) $ X X PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE CU20956240003 1/24/2016 01/241201 EACH OCCURRENCE s5,000,000 AGGREGATE $5,000,000 DED I X I RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC205943107 1/19/2016 01/19/201 X WCSTATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - E4 EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS? VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Gilroy Police Department City of Gilroy, its officers, officials and employees are included as Additional Insured on a primary and noncontributory basis with regards to General Liability Only as required by contract per form CG7048 0913, includes ongoing and completed operations, Waiver of Subrogation per form CG7049 1109. Certificate Holder is included as Additional Insured in regards to Auto Liability only as required by contract per form CA7171 0508, including Waiver of Subrogation. Waiver of Subrogation in (See Attached Descriptions) City of Gilroy, it officers, officials and employees 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 All riahts reserved. ACORD 25 (2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S952150IM952066 MJE �?�,,: .' �• p q �„ •. .. .,�i ""Yzx e {i: .;:u a l .., r _iia - :?l ly.r t_ ���J '.•.::s,;� �, � IF, ,i: a xG. ';',:iJ t '.::' 7d �,.: e t _�.i'. "I , � r r:sl�u �: :%9'. "' Ek :a_'.� a5,^ei., `Y � c.. 7i . °'; �?:i. r+,"_. rw, � _ -�a'�r ,_ �? .r ``i ? = =�`i�l'�a,. 1 I�� .9.�L, llkl' `� ,�,u'��r ,>:� �� .,•!�f ;?:_.. ,f �, ���� e �� �r : ;�,��,,� �J„ � u ��,�, ���t� 1,•. 'C� � M�I I�.'q� :'��" �? �•'t�� +l III... ' ;r.l Y w i U °�i�.: h `?.uil F, ,r��2` i.��C 9s � �� ��n�.. �, . x,, _, .� f�•• � �.� AEI, �:. � DESGRIPTI;ON;S,. Continued from, Pa e�1;. .,.�� .r �h � � �r.� ><�. �. i";. t.�"5,C'.°«�«s'..�:.�..i"ta��,K �ie:.,4;:�C��m�u!��ii. 4� Jrlrlu.zu:'.�.L°_Tw3� uF�'�,;a:..'°i x.. � � °�r�lla.i.... :.:.: .u�. F... I!.I,�:: :;}l7�wa �9 �r:. aA�' ��u?4t- ,W1t�:Ckw,i.,u?'ru:�:a.Jxu�a a}1..w...v'�..1,'.r�»- .:�:'u.. �:`•r�.w#r� .. ",...�.� ..w.a.��Jzt�Y'•a..c; °wt Subrogation. Waiver of Subrogation in regards to Workers Compensation only as required by contract per form WC000313 0484 and WC040306 0484 (CA). Umbrella Follows form. These statements are subject to policy terms and conditions; where required by written contract. 4 SAGITTA 25.3 (20101051 2 of 2 #S952955/M952066 DESCRIPTIONS (Continued from °Page 1) regards to Workers Compensation only as required by contract per form WC000313 0484 and WC040306 0484 (CA). Umbrella Follows form. These statements are subject to policy terms and conditions; where required by written contract. SAGITTA 253 (2010105) 2 Of 2 #S952150/M952066