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Harris & Associates - Insurance Certificate (2018)HARR &AS -01 nAFKHAMI ,4c'ORO CERTIFICATE OF LIABILITY INSURANCE DATE / Y) 06 /20 /2018 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 License # 0757776 Concord, CA - HUB International Insurance Services Inc. 2300 Clayton Rd. Concord, CA 94520 CONTACT NAME: PHONE o, Ext): (925) 609 -6500 FAX 925 609 -6550 (A/C, No):( 925) ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Citizens Insurance Company of America 31534 08/01/2017 INSURED INSURER B: Navigators Specialty Insurance Company 36056 INSURER C: Travelers Property Casualty Company of America 25674 Harris & Associates Inc. Attn: Susan Mandilag 1401 Willow Pass Road, Ste. 500 INSURER D: Continental Casualty Company 20443 INSURER E: Concord, CA 94520 INSURER F: COVERAGES CERTIFICATE NUMBER: RFVISInN NIIMRFR- 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 L R TYPE OF INSURANCE ADDL D SUBR WVD POLICY NUMBER POLICY EFF DD POLICY EXP M DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR ZBF 9201722 08 08/01/2017 08/01/2018 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ X MED FRCP (Any one person) $ 10 °000 Ded: 0 PERSONAL & ADV INJURY $ 2'000'000 AGGREGATE LIMIT APPLIES PER: POLICY ❑X JECOT- ❑ LOC GENERAL AGGREGATE $ 4,000,000 GENT PRODUCTS - COMP /OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY AMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10'000'000 AGGREGATE $ 10,000,000 X EXCESS LIAB CLAIMS -MADE LA17EXC7127011C 08/01/2017 08/0112018 DED X RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE F-N—] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A PJUB8166N36A17 08/01/2017 08/01/2018 X STATUTE ERH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ D PROFESSIONAL LIAB AEH591891588 08101/2017 08/01/2018 Per Claim 10,000,000 D Claims- Made;150k Ded AEH591891588 0810112017 08/01/2018 Aggregate 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation policy excludes monopolistics states ND, OH, WA, WY. Re: On -Call Agreement for Surveyor /Map Review Services (HA #150 -0412 (2023)) City of Gilroy, It's Officers, Officials and Employees as Additional Insured as respects General Liability per attached forms MAN -0426 0715 & MAN -0427 0715. General Liability Primary/Non- Contributory and Waiver of Subrogation forms 421- 04521214 and CG2404 0509 attached. Workers Compensation Waiver of Subrogation form WC990376 attached. (This certificate supersedes certificate previously issued.) City of Gilroy Attn: Jorge Duran, Development Engineer 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 ACORD 25 (2016/03) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ZBF 9201722 08 5701053 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION MAN -0426 07/15 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City of Gilroy, its Officers, Officials and Employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) 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; This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 in the performance of your ongoing operations for 2. That portion of "your work" out of which the the additional insured(s) at the location(s) injury or damage arises has been put to its designated above. intended use by any person or organization other than another contractor or subcontractor B. With respect to the insurance afforded to these engaged in performing operations for a additional insureds, the following additional principal as a part of the same project. exclusions apply: ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. MAN -0426 07/15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ZBF 9201722 08 5701053 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS MAN -0427 07115 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, Officials and Employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. MAN -0427 07/15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: ZBF9201722 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON - CONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance: Additional Insured — Primary and Non - Contributory If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION II — WHO IS AN INSURED, Is primary and non - contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: (1) Primary Insurance This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INURY AND PROPERTY DAMAGE LIABILITY. (b) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other Insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (c) When this insurance Is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) For the sole negligence of the Additional Insured; (1) The total amount that all such other insurance would pay for the loss in the (b) When the Additional Insured is an Additional absence of this insurance; and Insured under another primary liability policy; 11 The total of all deductible and self insured or amounts under all that other insurance. (c) When (2) below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in (3) below. (2) Excess Insurance (a) This Insurance Is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work "; (ii) That is Fire Insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (Ili) That is Insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. (3) Method Of Sharing (a) If all of the other Insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. (b) If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each Insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 421 -0452 1214 Includes copyrighted materials of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: ZBF9201722 08 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: BLANKET WITH WRITTEN CONTRACT Information required 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 05 09 © Insurance Services Office, Inc., 2008 nw wr Page 1 of 1 TRAVELERS` WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (PJUB- 8166N36 -A -17) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 02.000 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 07 -27 -17 ST ASSIGN: Page 1 of 1 A` oito® CERTIFICATE OF LIABILITY INSURANCE DATE IYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 2 /201 06/22/2018 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 1S 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 NAME CT Marsh Sponsored Programs Marsh Sponsored Programs AHCNNo Ext: 1.877. 320.9393 FAX No 515 - 365 -0895 a division of Marsh USA Inc. E -MAIL riskmana ement @marsh m.com Vendor ID: 31459 ADDRESS: PO Box 14404 Des Moines, IA 50306 -9686 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Old Republic Insurance Company 24147 INSURED INSURERS: HARRIS & ASSOCIATES, INC RENTED 1401 Willow Pass Road, Ste 500 INSURERC: CLAIMS -MADE 171 OCCUR Concord, CA 94520 INSURER D: INSURER E: $ INSURER F: $ 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM Y IDDIYYYY MMIDD /YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ RENTED CLAIMS -MADE 171 OCCUR PREMISES Ea occurrence) PREMISES $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN'L POLICY 1 PET LOC PRODUCTS - COMP /OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY X X L100554 -17 08/01/2017 08/01/2018 EeaccidentSINGLELIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- I STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBEREXCLUDED7 ❑ N /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 (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GPBR: 1 XL1 Policy provides protection for any & all operations /jobs performed by the named insured where required by written contract. Certificate holder is an Additional Insured where required by written contract. Waiver of Subrogation included where required by written contract. Insurance is primary and non - contributory. City of Gilroy, its officers & officials are additional insured where required by written contract. On-Call Agreement for Surveyor /Map review services (HA #1500412) CERTIFICATE HOLDER CANCELLATION 150.0412 (2023) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Jorge Duran ACCORDANCE WITH THE POLICY PROVISIONS.. Development Engineer 7351 Rosanna Street AUTHORIZED REPRESENT T Gilroy, CA 95020 @ 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 6558490 OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Schedule Person(s) or Organization(s): 150 -0412 (2023) City of Gilroy Jorge Duran Development Engineer 7351 Rosanna Street Gilroy, CA 95020 1. SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended to include the person(s) or organization(s) designated in the Schedule above but only for damages: a. Which are covered by this insurance; and b. Which you have agreed to provide in a written contract. 2. The limits of insurance afforded to such person(s) or organization(s) will be: a. The minimum limits of insurance which you agreed to provide, or b. The limits of insurance of this policy whichever is less. CA 560 002a 1213 L100554.17 Page 1 of 1 08/01/2017 - 08/01/2018 HARRIS & ASSOCIATES, INC