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M-Group - Insurance Certificate (2019)METRPLA-01 MARLOWEM ,4�oRo CERTIFICATE OF LIABILITY INSURANCE DATE 10/26/2018Y) 10/26/2018 l 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 # 0252636 CONTACT Adrian Shaikh NAME: 1 United Agencies PHONE FAX 2075 De La Cruz Blvd., Ste. 200 (AIC, No, Ext): (A/C, No): 1 Santa Clara, CA 95050 E-MAILADDRESS: adnan@gsisol.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Ohio Security Insurance Companv 24082 INSURED INSURER B : United Financial Casualty Company 11770 Metropolitan Planning Group DBA M-Group INSURER C : Evanston Insurance Company 35378 1 307 Orchard City Drive, Suite 100 INSURER D: Mount Vernon Fire Insurance Companv 26522 1 Campbell, CA 95008 INSURER E : 1 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 'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DDIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY 2 nnn O00 = CLAIMS -MADE [,�] OCCUR BKS56609535 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- ❑ LOC JECT OTHER: B AU"OMOBILE LIABILITY X ANY AUTO 04105609-1 OWNED SCHEDULED AUTOS ONLY AUTOS X NON-OWNED OAUOS TONLY ONLY C X UMBRELLA LAB OCCUR EXCESS LIAB CLAIMS -MADE EZXS1018649 DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE XWS56609535 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below D Professional E&O PT2000323 EACH OCCURRENCE $ 04/09/2018 04/09/2019 DAMAGE TO RENTED 500,000 PREMISES (Ea occurrence) $ MED EXP (Anv one Derson) $ 15,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,0001 PRODUCTS - COMP/OP AGG $ 4,000,0001 $ 1 COMBINED SINGLE LIMIT (Ea accident) 1,000,0001 $ 08/31/2018 08/31/2019 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ EACH OCCURRENCE $ 1,000,0001 04/09/2018 04/09/2019 1,000,0001 AGGREGATE $ $ X IPER STATUTE EERH 04/09/2018 04/09/2019 1,000,0001 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 1,000,0001 E.L. DISEASE - POLICY LIMIT $ 1,000,0001 04/09/2018 04/09/2019 Per Claim 3,000,0001 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 30 Day Notice of Cancellation Provided. Insurance is Primary and Non -Contributory. The City of Gilroy, its officers, officials, and employees are listed as Additional Insureds as required by contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y y ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosana Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE I "Or ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKW56609535 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WITH WHOME THE INSURED HAS AGREED BY WRITTEN CONTRACT TO PERFORM SERVICES WITHIN THE TERMS AND CONDITIONS OS THIS POLICY TO WHICH THIS FORM IS ATTACHED Location(s) Of Covered Operations ALL LOCATIONS Information 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily in- jury", "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 operatons for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: This insurance does not apply to "bodily in- jury" or" property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed 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 arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 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 is 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 ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: BKW56609535 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) ANY PERSON OR ORGANIZATION WITH WHOME THE INSURED HAS AGREED BY WRITTEN CONTRACT TO PERFORM SERVICES WITHIN THE TERMS AND CONDITIONS OS THIS POLICY TO WHICH THIS FORM IS ATTACHED Location And Description Of Completed Operations CITY PLANNING SERVICES ALL LOCATIONS Information 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily in- jury" or "property damage" caused, in whole or in part, by "your work" at the location des- ignated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -com- pleted operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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 is 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 ap- plicable Limits of Insurance shown in the Dec- larations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 88 83 04 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION - DESIGNATED PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WITH WHOME THE INSURED HAS AGREED BY WRITTEN CONTRACT TO PERFORM SERVICES WITHIN THE TERMS AND CONDITIONS OS THIS POLICY TO WHICH THIS FORM IS ATTACHED (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. The following is added to Paragraph a. Primary Insurance of Condition 4. Other Insurance under Section IV -Commercial General Liability Conditions: However, when the person or organization shown in the Schedule of this endorsement has been added as an additional insured to this Coverage Part by attachment of an endorsement, we will not seek contribution from the "person's or organization's own insurance" provided that: (1) You have agreed in a written contract that this insurance is primary and non-contri butory; and (2) The "bodily injury", "property damage" or "personal and advertising injury" is: a. Committed subsequent to the execution of such contract; and b. This policy covers the "bodily injury", "property damage" or "personal and advertising in- jury". B. For the purposes of this endorsement the following is added to Section V - Definitions : "Person(s or organization's own insurance" means general liability coverage for damages for which the person or organization shown in the Schedule of this endorsement is designated as a Named Insured. © 2012 Liberty Mutual Insurance CG 88 83 04 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 79 (Ed. 01-13) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while en- gaged in the work described in the Schedule. The additional premium for this endorsement is $ 250 Schedule Person or Organization ANY INDIVIDUAL OR ORGANIZATION THAT REQUIRES THE WAIVER AS PER WRITTEN CONTRACT. Job Description ALL OPERATIONS 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 Effective 04/09/2018 State Policy No. XWS (19) 56 60 95 35 Insured METROPOLITAN PLANNING GROUP Endorsement No. 0004 Premium Insurance Company Ohio Security Insurance Company 19291 Countersigned by 4� 1514�? WC 99 06 79 (Ed. 01-13) © 2013 Liberty Mutual Insurance Includes copyrighted material of WCIRB,with its permission.