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Nova Partners - Insurance CertificateACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 5/10/2016 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 Arthur J. Gallagher & Co. Insurance Brokers of California Inc. LIC #0726293)' 1255 Battery Street, Suite 450 San Francisco CA 94111 CONTACT NAME: Certificate Department PHONE 415 - 391 -1500 FAX .415- 391 -1882 E-MAIL . CertRequests @ajg.com INSURER(S) AFFORDING COVERAGE NAIC e INSURERA:James River Insurance Company 12203 EACH OCCURRENCE INSURED INSURER B: Republic Indemni Company of Ameri 22179 Nova Partners, Inc. 855 El Camino Real #307 INSURER c: Underwriters at Lloyd's London — — -- 15792 $1,000 Palo Alto, CA 94301 INSURER D: $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY 7 LOC 1x] J OTHER: GENERAL AGGREGATE INSURER E: INSURER F: $2,000,000 COVERAGES CFDTIFICATF NIIMRFD- 1622933887 DFVICICVU IUI IMRFD- 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 WDDIYYYY POLICY EXP MWDDNY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE EX OCCUR Y Y 000242449 5/16/2016 5/16/2017 EACH OCCURRENCE $1,000,000 PREMISES Ea occurrence $50,000 ME EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY 7 LOC 1x] J OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AUT8SED AUTODULED HIRED AUTOS X NON -OWNED AUTOS Y Y 000242449 5/16/2016 5/16/2017 Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X Per accident $ 8 A UMBRELLA LIAR EXCESS LIAB I X OCCUR CLAIMS -MADE 000716960 5/16/2016 5/16/2017 EACH OCCURRENCE $4,000,000 64,000,000 X AGGREGATE DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRO PRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 16649911 j 8/1/2015 8/1/2016 X STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE . EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT I $1,000,000 C Professional Liab. i PGIARK0323702 9124/2015 9/24/2016 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: San Ysidro Park Pathway and Lighting project. ADDITIONAL INSURED(S): City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers. a.crc 1 IF n..n I c nvLUCK k AIYI.tLL.A I IUIV 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 ,rte 9. < 9 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: - - - -- --- - - ---- LOC #: -- - AC "R" ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY NAMED INSURED POLICY NUMBER CARRIER I NAIC CODE EFFECTIVE DATE' ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: _ _ _ __ FORM TITLE: GENERAL LIABILITY: `Additional Insured per attached Form CG20100704 CONGO] 'Additional Insured per attached Form CG20370704 {COOP] 'Coverage is Primary 8 Non - Contribulory is required by written contract per attached Form AP5031USO410 'Waiver of Subrogation is required by written contract per attached Form CG24040509 AUTOMOBILE LIABILITY: 'Additional Insured per attached Form AP2126US0108 'Additional Insured per attached Form AP2127US0812 "Waiver of Subrogation is required by written contact per attached Form AP5004USI 106 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Locations Of Covered Operations City of Gilroy, its officers and employees All Operations of Named Insured 7351 Rosanna Street Gilroy, CA 95020 -6141 Information re uired to complete this Schedule if not shown above will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions: or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locations) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: I. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS --- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations City of Gilroy, its officers and employees All Operations of Nained Insured 7351 Rosanna Street Gilroy. CA 95020 -6141 Information re wired to complete this Schedule if not shown above will be shown in the Declarations. Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE= PARTS Name Of Additional Insured Person(s) __ -- Or OQanization(s):-_....__.-- Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this ollc . Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US 04 -10 Page 1 of 1 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Mere required by written contract or written agreement Information required q to complete this Schedule, if not shown above, will be shown In the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 06 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage I Limit of Insurance I I Additional Premium Hired Auto Liability 1 000 000 Included The insurance provided under SECTION 1, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily Injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of `bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing In this endorsement shall Increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- 'employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership orjoint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto" means any "auto" you lease, hire or borrow. This does not include any "auto' you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer" of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON - OWNED AUTO LIABILITY - EXCLUDING LOADING AND UNLOADING This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto ". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of °bodily Injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law: or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION 11— WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b, above. None of the following is an insured: AP2127US 08 -12 Page 1 of 2 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a 'non-owned auto" or any agent or "employee" of any such owner; (5) Any person or organization for the conduct of any current or past partnership or joint venture that Is not shown as a Named Insured in the declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you are a partnership, a 'non-owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PART'S The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, AP5004US 11 -06 Page 1 of 1