Loading...
MJR Electric - Insurance CertificateA /"® I7f>a CERTIFICATE OF L_I_ABILIW INSU_ RANCE DATE (MM/DD/YYYY) 10/12/2017 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE P O BOX 328 NAME CT CLIENT CONTACT CENTER A CNNo Ext 888 - 333 -4949 a/c No): 507-446-4664 E-MAIL ADDRESS CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # 08/14/2018 INSURER A. FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC INSURER C: GEN'L �OTHER PO BOX 668 INSURER D: $1,000,000 MORGAN HILL, CA 95038 -0668 INSURER E: $2,000,000 PRODUCTS - COMP /OP AGG INSURER F: COVERAGES CERTIFICATE NUMBER: 207 REVISION NUMBER. 2 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 DL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYV POLICY EXP MMIDD /VYVY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y N 9080246 08/14/2017 08/14/2018 EACH OCCURRENCE $1,000,000 DAM AGE TO RENTED PREMISES Ea ocarrence $100,000 MED EXP (Any one person) EXCLUDED GEN'L �OTHER PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER POLICY [:1 PRO JECT LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY N N 9080246 08/14/2017 08/14/2018 COMBINED SINGLE LIMIT Ea accident) $1,000.000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per aeaden A X UMBRELLA LIAR EXCESS LIAS X OCCUR CLAIMS -MADE N N 9080247 08/14/2017 08/14/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5_,000,000 DED RETENTION WORKERS COMPENSATION EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A PER STATUTE OT H- ER EL EACH ACCIDENT E L DISEASE - EA EMPLOYEE E L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7851 CARMEL ST, GILROY CA 95020 CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 207 2 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 tZ 19BB -2015 ACORD CORPORATION_ All riahts reserved ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD FED COPY POLICY NUMBER, 9030246 COMMERCIAL GENERAL LIABILITY CG 2010 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION Th•s endorsement modifies insurance provided tinder the following. COMMERCIAL GENERAL LIABILITY COVERAGE PAR`; SCHEDULE --------------------------- - - - - -- ---------------------- -- ----- -- ----- -- ----- - ---------------------------- Name Of Additional Insured Person(s) Or Organizations: ';CITY OF GILROY :7351 ROSANNA ST :GILROY CA 95370 Location(s) Of Covered See IL- F- 40-0039 reformation required to compiete this Schedule. if not shown above, wr'l be shown in the Declarations ------------------------ ... ......... ... ..... .....................................°.... ............................... -- ............................................................. A. Section 11 - Who Is An insured is amended to include as an additional insured the person(s) or orgat:t,zafion(s) shown in the Schedule. but only with respect to hability for "bodily injury ", "pro,)erty damage" or "personal and advertising injury" caused. in whole or m part, by, 1. Your acts or omissions, of 2. The acts or omissions of those acting on your behalf; in the per#ormance of your ongoing operations for the additional insured(s) at the location(s) designated above However: 1. The insurance afforded to such additional inv-ured only applies to the extent permitted by lava; and 2, If coverage provided to the additionai insured is required by .a conirat:t or agreement, the insur;arice afforded to such additional insured will not be broader than tnat which you are required by the contract or agreement to provide for such additional insured. MJR ELECTRIC, INC PO BOX 668 MORGAN HILL CA 95038 B. With respect to the ;nsuranco afforded to these additional insureds, the following additional exc:usions ap:,,ly: This insurance does net apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furn :Shed 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 anses has been put to its intended use by any person or organiLation other than another contractor or subcontractor engaged art performing operations for a principal as a part of the same project �4 Insurance Services Office, Inc . 20f 2 Page 1 of 2 CG 20 10 04 13 Policy Number. 9080246 Transaction Effective Date. 10-l'2-2017 FED COPY C. With respect to the insurance afforded to these additional insureds, the following is added to Section It! - Limits Of Insurance: I€ coverage provided to the additionai insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the arnount of Insurance: 1. € Nuired by the contract or agreement; or 2 hvailab;e under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations Page 2 of 2 �D Insurance Serf ices Office, Inc, 2012 CG 20 10 0413 Po:ir_y Number. 9080246; Transaction Effective Date: 10-12 -2017 FED.COPY EXTENSION ENDORSEMENT Extension - CG 20 10 - CITY OF GILROY ANY COVERAGE PROVIDED BY THIS ENDORSEMENT APPLIES ONLY TO ELECTRICAL SERVICE WORK AT 785E CARMEL ST, GILROY CA 85020 OF THE CEP,THOLDER. ADDITIONAL INSUREDS ALSO INCLUDE CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED. IL-F-40-0039 (05 -10) Pohry NumESer• 9080246 Transact*n Effect ;ve Da?e- 10-12-2017 Additional Insured Copy POLICY NUMBER: 9080246 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED v OWNERS, LESSEES -OR CONTRACTORS = SCHEDULED PERSON1 OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional' Insured Person(s) Or Organizations: Location(s) Of Covered Operations CITY OF GILROY See IL_ -F -40 -0039 7351 ROSANNA ST This insurance does not apply to "bodily injury" or GILROY CA 95020 "property damage" occurring after: nformation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An 'Insured is, amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown lin the Schedule, but only exclusions apply: with respect to liability for "bodily injury'; This insurance does not apply to "bodily injury" or "property damage" or "persona[ and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or T. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or performance your ongoing operations for in the erformance of on behalf of the additional insureds at the insured( s) the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the I. The insurance afforded to such additional injury° or damage arises has been put to its insured only applies to the extent permitted by intended use by any person or organization law; and other-than another contractor or subcontractor engaged in performing operations for a 2. If coverage provided to 'the additional insured principal as a_ part of the same project. is required by a contract or agreement, the insurance afforded to such additional insured will not b_ a broader than that which you a_ re required by the contract or agreement to provide for such additional insured. MJR E_LECTR_IC_ INC PO BOX 668 MORGAN HILL CA 95038 © Insurance Services Office, Inc.-, 2012 Page 1 of 2 CO 20 10 04 13 Policy Number: 9080246 Transaction Effective Date: 1002 -2017. Additional Insured Copy C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured iis required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the- applicable Limits of Insurance shown' in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 Policy Number-: 9080246 Transaction Effective Date: 10 -12 -2017 Additional Insured Copy EXTENSION ENDORSEMENT Extension - CG 20 10 - CITY OF GILROY ANY COVERAGE PROVIDED BY THIS ENDORSEMENT APPLIES ONLY TO ELECTRICAL SERVICE WORK AT 7851 CARMEL ST, GILROY CA 95020 OF THE CERTHOLDER. ADDITIONAL INSUREDS ALSO INCLUDE: CITY OF GILROY, ITS' OFFICERS, OFFICIALS, -AND EMPLOYEES-ARE-NAMED AS ADDITIONALLY INSURED. IL -F -40 -0039 (05 -10) Policy Number: 9080246 Transaction Effective Date: 10 =42 -2017 '`� °® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/04/2017 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(les) 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE. P.O. BOX 328 CONTACT NAME' CLIENT CONTACT CENTER A CNNO Ext : 888 - 33313949 a/c No 507 - 446 -4664 E-MAIL CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC INSURER C. PO BOX 668 MORGAN HILL, CA 95038 -0668 INSURER D: $100,000 INSURER E• MED EXP (Any one person) EXCLUDED INSURER F: COVERAGES CERTIFICATE NUMBER: 207 REVISION NUMBER. 1 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 DL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD /YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR TED DAMAGE M ET Ea occurrenm $100,000 MED EXP (Any one person) EXCLUDED A Y N 9080246 08/14/2017 08/14/2018 PERSONAL a ADV INJURY $1,000,000 -GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY ❑ PRO- ❑ LOC JECT PRODUCTS - COMPIOP AGG $2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acciden $1,000,000 BODILY INJURY (Per person) X ANY AUTO A OWNED AUTOS ONLY SCHEDULED Auros N N 9080246 08/14/2017 08/14/2018 BODILY INJURY (Per accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE Per acciden X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS -MADE N N 9080247 08/14/2017 08/14/2018 AGGREGATE $5_,000,000 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE OTH- ER E L EACH ACCIDENT ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED ❑ (Mandatory in NH) N I A E L DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7851 CARMEL ST, GILROY CA 95020 CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 207 1 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 Q 19RR -2015 ACORD CORPORATION_ All riahts reserved ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD CL COMMERCIAL GENERAL UABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsernent modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising Injury' caused, in whole or in pail, by: 1. Your acts or omissions; or 2. Tne acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1, Only applies to the extent permitted by law, and 2. Will not be broader than that v0iich you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an ,additional insured under this cndcTsemenl ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1, "Bodily injury ". "property damage" or 'personal and advertising injury' arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or fading to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage ". or the offense which raused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. O Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 33 04 13 Policy Number. 9080246 Transaction Effective Date. 08- 31-2017 GL 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials. parts or equipment furnished in connection with such work, on the project (other thart 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 b. That portion of *your work" ou, of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Umits Of insurance, The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured: or 2. Available under the applicable Ltmtts of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown to the Declarations: Page 2 of 2 © Insurance Services Office. Inc., 2012 CG 20 33 04 13 Policy Number. 9080245 Transaction Effective Date: 08-31-2017 CERTIFICATE OF LIABILITY INSURANCE DATE8 /31/217 08/31/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE. P.O BOX 328 CONTACT NAME: CLIENT CONTACT CENTER A /C, NNo Ext : 888 - 333 -4949 a/c No): 507 - 446 -4664 ADDRESS: CLIENTCONTACTCENTER FEDINS COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC INSURER C• PO BOX 668 INSURER D: MORGAN HILL, CA 95038 -0668 INSURER E $100,000 INSURER F EXCLUDED COVERAGES CERTIFICATE NUMBER: 207 REVISION NUMBER: 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 LTR TYPE OF INSURANCE DL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM /DD /YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR AMAGE To PRE ES Ea occurrence $100,000 MED EXP (Any one person) EXCLUDED A Y N 9080246 08/14/2017 08/14/2018 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 �OTHER POLICY [:1 SECT ❑ LOC PRODUCTS - COMP /OP AGG $2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc den $1,000,000 X ANY AUTO BODILY INJURY (Per person) A OWNED AUTOS ONLY SCHEDULED autos N N 9080246 08/14/2017 08/14/2018 BODILY INJURY (Per accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS -MADE N N 9080247 08/14/2017 08/14/2018 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE _ OTH- ER E L EACH ACCIDENT ANY PROPRIETORIPARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ N I A E L DISEASE - EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required) RE: 7851 CARMEL ST, GILROY CA 95020 CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 2070 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 O 1988 -2015 ACORD CORPORATION. All riahts reserved ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORDL. CERTIFICATE OF LIABILITY INSURANCE _ _ _ _ DATE(MMMDNWY) 7/25/2017 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PROFESSIONAL INSURANCE ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE _ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 430 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICY EFFECTIVE POLICY EXPIRATION PITTSBURG, CA 94565 925 - 432 -1810 INSURERS AFFORDING COVERAGE NAIC# INSURED KM ELECTRIC, INC. INSURER A OAK RIVER INSURANCE COMPANY DATE MM /DD INSURER B P.O. BOX 668 INSURER C MORGAN HILL, CA 95038 INSURER D EACH OCCURRENCE $ INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR kD131 POLICY EFFECTIVE POLICY EXPIRATION LM NERD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM /DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ D G COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ CLAIMSMADE CI OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ POLICY JE° F71 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ BODILY INJURY ALL O WNED AUTOS SCHEDULED AUTOS (Per person) $ BODILY INJURY HIRED AUTOS NON - OWNEDAUTOS (Peramdent) $ PROPERTY DAMAGE $ (Peramdent) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ AUTOONLY AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CI CLAIMSMADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WC ST OTH- WORKERS COMPENSATIONAND X TORV LIMIT MITS ER EMPLOYERS' LIABILITY E L EACH ACCIDENT $ 1,000,000 A ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? MJWC814901 08/19/17 08/19/18 EL DISEASE - EA EMPLOYEE $ 1,000,000 Ifyes descnbeunder SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ALL CALIFORNIA OPERATIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF GILROY DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 7 351 ROSANNA STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GILROY CA 95020 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD25(2001 /08) (/ ©ACORD CORPORATION 1988 A� °r CERTIFICATE OF LIABILITY INSURANCE DATO6r26/ D,YYYY, 0 6/2 62 0 1 7 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 terns 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 NAME CONTACT CLIENT CONTACT CENTER A CNNo Ext . 888 - 333 -4949 a/c No): 507- 446 -4664 ADDRIESS. CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC PO BOX 668 INSURER C: INSURER D: MORGAN HILL, CA 95038 -0668 INSURER E DAMAGE TO RENTED PREMISES a occurrence $100,000 MED EXP (Any one person) INSURER F: COVERAGES CERTIFICATE NUMBER: 136 REVISION NUMBER: 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 LTR TYPE OF INSURANCE DL INSR SUER WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM /DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES a occurrence $100,000 MED EXP (Any one person) EXCLUDED A Y N 9080246 08/14/2017 06/14/2018 PERSONAL a ADV INJURY $1,000,000 GEN'L NOTHER AGGREGATE LIMIT APPLIES PER POLICY ❑ T ❑ LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGO $2,000,000 AUTOMOBILE X LIABILITY ANY AUTO COMBINED SINGLE LIMIT cden a $1,000,000 BODILY INJURY (Per person) A OWNED AUTOS ONLY AUT SUED N N 9080246 08/14/2017 08/1412018 BODILY INJURY (Per acadenQ HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE Per ccideno X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS -MADE N N 9080247 08/14/2017 08/14/2018 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE ❑ I PER STATUTE -OTH- I ER _ E L EACH ACCIDENT OFFICERIMEMBER EXCLUDED NIA A EL DISEASE - EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED PAGE GtK I IFIGA I t 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 ACORD 25 (2016103) 1360 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE lc�] The ACORD name and logo are registered marks of ACORD All riehts rP_servPd ACS AGENCY CUSTOMER ID 315 -542 -1 LOC #. ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY MJR ELECTRIC INC PO BOX 668 MORGAN HILL, CA 95038 -0668 POLICY NUMBER SEE CERTIFICATE # 136.0 CARRIER NAIC CODE SEE CERTIFICATE # 136.0 EFFECTIVE DATE SEE CERTIFICATE # 136.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER. 25 FORM TITLE CERTIFICATE OF LIABILITY INSURANCE RE: LIBRARY LIGHTS CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,4C"R ® CERTIFICATE OF LIABILITY INSIJ_ RANCE MAT 06Q017 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 ri Ms to the certificate holder in lieu of such endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME. CLIENT CONTACT CENTER A CN No. Ext : 888 - 333 -4949 a,c No): 507 - 446 -4664 =ESs• CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: $1,000,000 MJR ELECTRIC INC PO BOX 668 INSURER C: $100,000 INSURER D: EXCLUDED MORGAN HILL, CA 95038 -0668 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 138 REVISION NUMBER: 0 THIS IS TO CERTTFY 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 DL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DDIYYYY POLICY EXP MM /DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED REMISES a occurrence $100,000 MED EXP (Any one person) EXCLUDED A Y N 9080246 08/14/2017 08/14/2018 PERSONAL & ADV INJURY $1,000,000 GEN'L NOTHEPOLICY AGGREGATE LIMIT APPLIES PER PRO LOC JECT GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGO $2,000,000 R AUTOMOBILE X LIABILITY ANY AUTO COMBINED SINGLE LIMIT IE. $1,000,000 BODILY INJURY (Per person) A OWNED AUTOS ONLY SCHEDULED AUTOS N N 9080246 08/14/2017 08/14/2018 BODILY INJURY (Per accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE e Per .cldeno X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS -MADE N N 9080247 08/14/2017 08/14/2018 AGGREGATE $5,000,00.0 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE PER STATUTE OTH- ER E L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? NIA E L DISEASE - EA EMPLOYEE _ (Mandatory in NH) If yes, describe under E L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: ALL CERTHOLDER LOCATIONS CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REWIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 1380 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELI_ VERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD '4oCIISPR °r CERTIFICATE OF LIABILITY INSURANCE DAT06 /24/D/YYYY) 0624/2016 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 POUCIES 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER (AC NNo Ext : 888 - 333 -4949 FAX No): 5074464664 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # 08/14/2017 INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC INSURER C: GEN'L X PO BOX 668 INSURER D: $1,000,000 MORGAN HILL, CA 95038 INSURER E: $2,000,000 PRODUCTS - COMP /OP AGO INSURER F: COVERAGES CERTIFICATE NUMBER: 136 REVISION NUMBER: 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 LTR TYPE OF INSURANCE DL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD /YYYY ) POLICY EXP (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Y N 9080246 08/14/2016 08/14/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) EXCLUDED GEN'L X PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: JECT PRO - POLICY El PRO ❑ LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGO $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS NED A AUTOS q N N 9080246 08/14/2016 08/14/2017 COMBINED SINGLE LIMIT Ea acciden $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE - Per cideno A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE N N 9080247 08/14/2016 08/14/2017 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y N ANY PROPRIETOR /PARTNERIEXECUTIVE ❑ OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 -6141 1360 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACOR AGENCY CUSTOMER ID: 315 -542 -1 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY MJR ELECTRIC INC PO BOX 668 MORGAN HILL, CA 95038 POLICY NUMBER SEE CERTIFICATE # 136.0 CARRIER NAIC CODE SEE CERTIFICATE # 136.0 EFFECTIVE DATE: SEE CERTIFICATE # 136.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE RE: LIBRARY LIGHTS CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AoCOROr CERTIFICATE OF LIABILITY INSURANCE DA�06/24/2016 ) 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER A IC, Ext : 888 - 333 -4949 a/c No): 507- 446 -4664 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 315 -542 -1 INSURER B: MJR ELECTRIC INC INSURER C: PO BOX 668 INSURER D: MORGAN HILL, CA 95038 INSURER E: $100,000 INSURER F: EXCLUDED COVERAGES CERTIFICATE NUMBER: 138 REVISION NUMBER: 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 LTR TYPE OF INSURANCE DDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM /DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE a OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $100,000 MED EXP (Any one person) EXCLUDED A Y N 9080246 08/14/2016 08/14/2017 PERSONAL & ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC JECT GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acciden $1,000,000 X ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS N N 9080246 08/14/2016 08/14/2017 BODILY INJURY (Per accident♦ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A 4DE CESS LIAB CLAIMS -MADE N N 9080247 08/14/2016 08/14/2017 AGGREGATE $5,000,000 D RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N PER STATUTE OTH- ER E.L. EACH ACCIDENT ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N I A E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: ALL CERTHOLDER LOCATIONS CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONALLY INSURED THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 315 -542 -1 CITY OF GILROY 7351 ROSANNA ST G I LROY, CA 95020 -6141 1380 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 O 1968 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD