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Hexagon Transportation - Insurance Certificate (2016)
ACORLY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) 12/5/2016 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 CONTACT Melissa Rivera RC Fischer Co 1301 Ygnacio Valley Rd #100 Walnut Creek CA 94596 PHONE 925- 627 -5467 F ° X E-MAIL . mdvera @rcfischer.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Travelers Indemnity of CT 25682 311/2017 INSURED HEXAG-1 INSURER B :Travelers Prop Cas Co of Amer 25674 Hexagon Transportation Consultants, Inc. INSURERC:Admiral Insurance Co. 24856 4 North Second St., #400 San Jose CA 95113 INSURER D:Technology Insurance Company PREMI E Ea occurrence) . RENTED $300,000 INSURER E: MED EXP (Anyone person) INSURER $ : CnVFRAGFS CFRTIFICATF Nt1MRFR. 403467904 RFVISInN Nt1MRFR- THIS 1S 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 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_. 1LTR TYPE OF INSURANCE INSD' WVD POLICY NUMBER MMI'DY EFF POLICY EXP LIMITS _ A x COMMERCIAL GENERAL LIABILITY Y 68088411-482 3/1/2016 311/2017 EACH OCCURRENCE $2,000,000 CLAIMS -MADE a OCCUR PREMI E Ea occurrence) . RENTED $300,000 MED EXP (Anyone person) $5,000 PERSONAL & ADV INJURY $2,000,000 GR AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY, JET LOC PROEML DUCTS - COMP /OP AGG $4,000,000 _ $ OTHER: A AUTOMOBILE LIABILITY 68088411_482 3YI/2016 3/1/2017 Ea accdent) $Induded in GL BODILY INJURY (Per person) $ ANY AUTO AAUTOS�� AUTOSU�D HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ %(' DAMAGE Peraccldent $ B X UMBRELLA LIAB OCCUR CUP5819P929 3/1/2016 3/1/2017 EACH OCCURRENCE $5,000,000 HCLAIMS-MADE AGGREGATE $5,000,000 EXCESS LIAB DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N / A TWC3536143 3 /1/2016 .3/1/2017 X qT ETH- E E.L. EACH ACCIDENT $1,000,000 E.L DISEASE - EA EMPLOYEE - $1,000,000 (Mandatory lnNH) 0 s, describe under DESCRIPTIONOFOPERATIONSbelow EL DISEASE - POLICY LIMIT $1,000,000 C Professional Liability E000000146619 3/1/2016 3/1/2017 Each Claim $2,000,000 Claims -Made Form Aggregate $2,000,000 Deductible $5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional. Remarks Schedule, may be attached N more space Is required) thirty (30) Day notice of cancellation; Ten (10) day notice in the event of cancellation for non- payment of premium 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. AUTHORRED ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680- 8841L482417T -16 COMMERCIAL GENERAL LIABILITY 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): CITY OF GILROY, ITS 111111111PLOYESS, OFFICIM, OFFICIALS Am VOLES 7351 ROSAtit1M STRZET 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 respect to liability for "bod- ily injury", "property damage" or "personal injury" caused, In whole or in part, by your acts 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 work' 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 addl- tionai insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional Insured, or the limits shown in the Dec are Lions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated In the LIMITS OF INSURANCE (Section 110 for this Coverage Part B. The following is added to Paragraph a. of 4. Other Insurance In COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring Insurance" that for the addi- tional insured shown in the Schedule, the insur- anoe provided to that additional insured under this CG 03 82 09 07 0 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance services OfRcs, Ina, with its permission COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and norrtorrtributory basis, this Insur- ance is primary to other Insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "baby injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which overage is sought arises out of an offense committed; after you have entered Into that "contract or agreement requiring insurance" for such addi- tional Insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional in- sured when the additional Insured is also an addi- tional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (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", "property damage or "personal injury" arising out of -your work" on or for the pro- ject, or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der a °centred or agreement requiring insurance' with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring Insur- ance" with that additional insured entered into by you before, and in effect when, the "bodily Injury - or "property damage" occurs, or the - personal in- jury" offense Is committed. D. The following definition is added to DEFINITIONS ( Sectlon V): "Contract or agreement requiring insurence- means that part of any contract or agreement un- der which you are required to include the person or organisation shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily injury" and "property damage" oo- curs, and the "personal injury" is caused by an of- fense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect and c. Before the end of the policy period. Page 2 of 2 ® 2007 The Travelers Cwnpanies, Inc. CG 03 82 09 07 Irr Judes the copyrighted material of Irmuranoe Services Office, Inc., with Its pemdssion