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Hexagon Transportation - Insurance Certificate (2017)
ACOROa CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 3/1/2017 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 RC Fischer Cc 1301 Ygnacio Valley Rd #100 Walnut Creek CA 94596 NAMEACT Melissa Rivera PHONE 925- 627 -5467 FAx E-MAIL mrivera@rcfischer.com @ INSURERS AFFORDING COVERAGE NAIC # Y INSURER A:Travelers Indemnity of CT 25682 3/1/2017 INSURED HEXAG -1 INSURER B :Travelers Prop Cas Co of Amer 25674 Hexagon Transportation Consultants, Inc. INSURER C:Technology Insurance Company 4 North Second St., #400 San Jose CA 95113 INSURER D :Ar onaut Insurance Company INSURER E: DAMAGE TO RENTED PREMISES Ea occurrence INSURER F : MED EXP (Any one person) COVFRAGFS CFRTIFICATF NI IMRFR• 1457149695 RPVICIrVJ MI 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY Ell MM /DDNYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 68088411-482 3/1/2017 3/1/2018 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY 7X JECOT- 7 LOC PRODUCTS - COMP /OP AGG $4,000,000 1 $ OTHER: A AUTOMOBILE LIABILITY BA9H798647 3/1/2017 3/1/2018 Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ B X UMBRELLA LAB X OCCUR CUP5819P929 3/1/2017 3/1/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A TWC3611791 3/1/2017 3/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $1,000.000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below D Professional Liability Claims -Made Form IAE13455 -0 3/1/2017 3/1/2018 Each Claim $2,000,000 Aggregate $2,000,000 Deductible $5,000 RIPTION OF OPERATIONS CATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) On -Call Contract 10 day otice in the event of cancellation for non - payment of premium City of Gilroy, its employees, officers, officials, and lunteers are nam additional insured per policy form CGD3820907 attached %. rzm 1 Iri%,A 1 C r7VLUCK GANGtLLA I IUN City of Gilroy 7351 Rosanna Street Gilroy CA 95020 -6141 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 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COMMERP ILITY POLICY NUMBER: 680- 8841L482- TCT -16 ISSUE DATE: 01 -05 -16 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): CIVY OF GILROY, ITS IWLOYZES, OFFICEM, OFFICIALS AND VOLUNTEERS 7351 ROSAMUL STREET GILROY CA 95020 -6141 PROJECTILOCA71ON OF COVERED OPERATIONS: PROVISIONS A. The following Is added to WHO IS AN INSURED (Section In: The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respeci to liability for'bod- Ily injury", °property damage' or 'personal injury' caused, In whole or in part, by your ads or omis- sions or the ads 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 wor1P 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 hvsurance' to provide fir 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 Iln for this Coverage Part 8. The following is added to Paragraph a of 4. Other Insurance In COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, If you specxiicafly 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 08 07 0 2007 The Travelers Companles, Inc. Page 1 of 2 Includes fire copyrighted material or Insurance Services Office, Inc., with its perrrdwion 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 mail - able to such additional insured which osvers such additional Insured as a named Insured, and we will not share with the other insurance. provided that (1) The abodiy injury or °property damage for which coverage is sought ocx,urs; and (2) The - personal injury" for which coverage is sought arises out of an offense oomnMed; after you have entered Into that - oontmet or agreement requiring insurance° far suet, addt- tional insured. But this Durance still Is excess over valid mid collectible other insurance, whether primary. excess, contingent or on any other basis, that is avatable to the additional 'In- sured when the additional insured is also an addi- tional Insured under any other Insurance. C. The foyawing Is added to Paragraph t3. Transfer Of Rtghts Of Recovery Ag drwt Others To Us In COMMERCIAL GENERAL LIABiLfiY CON - DrWN8 (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°. Vmperty damage° or °personal Injury- arising out of °your woW on or for the pro- 194 or at the location, shown In the Schedule above, performed by you, or on your behalf, un- der a °oordrad or agreement requiring insurance' with that addlilanal it m red. We whhre these ruts only where you have agreed to do so as part of the "coMrad or agreement requiring km r- ance° with that additional insured entered Into by you before, and In etfeif Vahan, the -body Injury or - property damage° occurs. or the °personal In- jury' offense is committed. D. The following definition is added to DEFINITIONS (Sedlon V): °ConMad or agneemaM requiring insurance° means that part of any contract or, mireement un- der which you are required to Include the person or organiEation sho m in the She as an ad- ditional Insured on this Coverage Part; Provided tt,at the °bodily tnjurf and °property d~ oo- curs, and the - personal injury' Is caused by an Of- fame committed: a. After you have entered Into that contract or agn�ement; b. While that part of the oontract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2007 TFm TOM= Ca parfta, Ina. CG D3 82 09 07 Indudw the wWWftd metedal for ImWNM SW*N 011100, lno, ankh Its pembdon