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Sub-Contractor for Articulate Solutions - EDT Tec
EDTTECI -01 NICKB '44c®?'ex CERTIFICATE OF LIABILITY INSURANCE � P ATE (M 3/28//2017 2017W) 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 License # 0504035 Pacific Diversified Insurance, Inc. 925 - 686 -2860 200 Gregory Lane Bldg A Pleasant Hill, CA 94523 CNTACT NAME: PHONE 686 -2860 FAX A/c No. a,,: ( 925 ) A/C No): E MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 03/28/2017 INSURER A: Landmark American Insurance Co EACH OCCURRENCE $ 1,000,000 INSURED INSURER B: WeSCO Insurance Company 25011 EDT Tec, Inc. INSURER C: RSUI Indemnity Company $ 10,000 INSURER D: Cypress Insurance Group 10855 3737 First Street Livermore, CA 94551 INSURER E: Mt Hawley Ins. Co. GENERAL AGGREGATE INSURER F: PRODUCTS - COMP /OP AGG' $ 2,000,000 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDNYYY MMIDD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE T OCCUR X LHA139367 03/28/2017 03/28/2018 EACH OCCURRENCE $ 1,000,000 PREMISES Ea oboiu"ence $ 50,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1;000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG' $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS WPP146704000 06/17/2016 06/17/2017 COE,MB MBINED dent S INGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NHA242183 03/28/2017 03/28/2018 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,060,000 BED _ X .. RETENTION :$ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y! N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA EDWC806474 03128/2017 03128/2018 X PER OTH- STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 E POLLUTION COVERAGE EGL004789 03/2812017 03/2812018 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: City of Gilroy Wayfinding, Gilroy, CA The City of Gilroy, its officers, Officials, representatives, agents, employees and volunteers are additional Insured on the general liability as required by written contract perendorsementRSGIS017 06 -15 attached. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE' WILL BE DELIVERED IN 7351 Rosanna St ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. ADDITIONAL INSURED BLANKET - YOUR WORK This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Any person or organization to whom or to which you are obligated by virtue of a written contract or by the issuance or existence of a written permit, to provide insurance such as is afforded by this policy. 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; and /or "your work" defined for the additional insured(s) designated above included in the "products- completed operations hazard ". This endorsement effective 3/28/2017 forms part of Policy Number LHA139367 issued to E D T Tec Inc by Landmark American Insurance Company RSG 15017 0615 Includes copyrighted material of Insurance Services Office, Inc. 1984 with its permission