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Complete Paperless Solutions - Insurance Certificate (2020)AC® ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) I 6/3/2019 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 OUN1ACI Van Dan NAME: g Robert Harris Insurance Agency, Inc. I talc Nr o. Extt: (714) 619-4493 I FAX No): 1714)619-4481 Lic. #0216736 IE-MAIL van@reharris.com ADDRESS: 3150 Bristol St., Suite 200 I INSURER(S) AFFORDING COVERAGE NAIC # Costa Mesa CA 92626 IINSURER A:Travelers Cas Ins Co of America 19046 INSURED j INSURER 13: Hartford Casualty Ins. Co. 29424 Complete Paperless Solutions LLC IINSURER C:Llovds of London 4025 E. La Palma Ave #204 I INSURERD: INSURER E : Anaheim CA 92807 IINSURERF: COVERAGES CERTIFICATE NUMBER:19/20 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICYNUMBER (MM/DDIYYYY) (MM/DDNYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 68OBB847614-19 6/23/2019 6/23/2020 I MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X PRO POLICY LOC IPRODUCTS JECT - COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY tSINGLE LIMIT (Ea accident) $ 1,000,000 ANYAUTO I BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED 68083847614-19 6/23/2019 AUTOS 6/23/2020 BODILY INJURY Per accident $ I ( ) X HIREDAUTOS X NON -OWNED AUTOS I PROPERTY DAMAGE (Per accident) $ Is UMBRELLALIAB HCLAIMS_I OCCUR I I EACH OCCURRENCE I $ EXCESS LIAB MADE AGGREGATE Is DED I I RETENTION $ I I I$ WORKERS COMPENSATION I X I PER I I OH AND EMPLOYERS' LIABILITY Y / N STATUTE R I ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A I E.L. EACH ACCIDENT I $ 1,000,000 OFFICER/MEMBER EXCLUDED? B (Mandatory in NH) 72WECZX9262 6/23/2019 6/23/2020 I E.L. If yes, describe under DISEASE - EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT I $ 1,000,000 C Professonial Liability ESHOS1163944 6/23/2019 6/23/2020 Each Claim: 1,000,000 Claims -Made Policy Each Claim DED: $10,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Gilroy, its officers and employees are named Additional Insured as their interest may appear as respects operations of the Named Insured as per attached CGD2470419. All Members/owners are excluded from Workers Compensation coverage. Policies are subiect to 10-days Notice of Cancellation in the event of non-payment of premium. 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 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE Steve Harris/VAND��_ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)