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Michael Baker International - Insurance Certificate (2020)CERTIFICATE OF LIABILITY INSURANCE I DATE(MM08/30//20192019 YY) 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 Aon Risk Services Central Pittsburgh PA office EQT Plaza - Suite 2700 625 Liberty Avenue Pittsburgh PA 15222-3110 Inc. USA CONTACT NAME: PHONE (866) 283-7122 FAX (800) 363-0105 (A/C. No. Ext): I (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: XL Insurance America Inc 24554 Michael Baker International, Inc. INSURER B: Continental Casualty Company 20443 suit Prospect Park Drive INSURER C: American Casualty Co. of Reading PA 20427 Suite 220 � y g Rancho Cordova CA 95670 USA IINSURERD: Transportation insurance Co. 20494 IINSURERE: Beazley Insurance Company, Inc. 37540 INSURER F: COVERAGES CERTIFICATE NUMBER: 570078092972 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER 'rylryl/.�/yyyyM JM/ /DD/YYYYI LIMITS B X COMMERCIAL GENERAL LIABILITY 6078988730 ui;�'(f���l Q8 30 2020 EACH OCCURRENCE $2,000,000 CLAIMS -MADE Fx -1 OCCUR ( DAMAGE TO RENTED $100 , 000 PREMISES (Ea occurrence) MED EXP (Any one person) $10 , 000 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY M PRO LOC JECT OTHER: B AUTOMOBILE LIABILITY O ANYAUT OWNED OWNED SCHEDULED _ AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY A UMBRELLA LIAB OCCUR I I EXCESS LIAB CLAIMS -MADE DED I X IRETENTION $10, 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR / PARTNER, D OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E I E&O-PL-Primary BUA 6078988680 us00079952LI19A wc6078988713 ADS wC6078988727 wI PERSONAL &ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OPAGG $4,000,000 08/30/2019 08/30/2020 COMBINED SINGLE LIMIT $2,000,000 (Ea accident) BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) 08/30/2019 08/30/2020 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 $1,000,000 $1,000,000 0) rn N m co 0 0 I- rn O Z d 0 V w- d L) $1,000,000 —_ $5,1J60,000 — $5,000,000. J DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For Named Insured only: Attn: Pam warfield. RE: Project Name: As Needed Planning and Environmental Services. The City ofj Gilroy, its officers, officials and employees are included as Additional Insured in accordance with the policy provisions ofy the General Liability and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein -�- are Primary and Non -Contributory to other insurance available to Additional Insured, but only in accordance with the policy's provisions. Should General Liability, Automobile Liability, Professional Liability and workers' Compensation policies be cancelled before the expiration date thereof, the policy provisions will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy provisions. CERTIFICATE HOLDER CANCELLATION PSDEF1900460 Professional & Pollution 08/30/2019 08/30/2020 X (STER I ATUTE I (FORTH 08/30/2019 08/30/202n E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE -POLICY LIMIT 08/30/2019 08/30/2020 Per Claim Aggregate SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �y City of Gilroy AUTHORIZED REPRESENTATIVE F 7351 Rosanna Street Gilroy CA 95020 USA (� c�.Ka�a c��Gf.�XiacD p IG�Crn,L`tca4 ��za. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027699 LOC #: A ADDITIONAL REMARKS SCHEDULE AGENCY NAMEDINSURED Aon Risk Services central, Inc. Michael Baker International, Inc. POLICY NUMBER See Certificate Number: 570078092972 CARRIER NAIC CODE See Certificate Number: 570078092972 I EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER (INSURER (INSURER Page _ of ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL SUBR LTR TYPE OF INSURANCE INSD wVD POLICY NUMBER WORKERS COMPENSATION C N/A wc6078988694 CA POLICY POLICY EFFECTIVE EXPIRATION LIMITS DATE DATE (MM/DD/YYYY) (MM(DDfYYYY) _ 08/30/2019 08/30/2020 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/201YYYY) ACORO 08/30/2019 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 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 CONTACT NAME: Aon Risk Services Central, Inc. PHONE (866) 183-7122 FAX (800) 363-0105 Pittsburgh PA office (A/C. No. Ext): (A/C. No.): EQT Plaza - Suite 2700 I EMAIL 625 Liberty Avenue ADDRESS: Pittsburgh PA 15222-3110 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: XL Insurance America Inc 24554 Michael Baker international, Inc INSURERB: Continental Casualty Company 20443 Hutton Centre Drive suite500IINSURERC: American Casualty Co. of Reading PA 20427 Santa Ana CA 92707 USA (INSURER D: Transportation Insurance Co. 20494 INSURER E: Beazley Insurance Company, Inc. 37540 INSURER F: COVERAGES CERTIFICATE NUMBER: 570078094 61 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER I MM/DD/YYYY JMM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY 6078988730 U8/30/2U1� O813012020 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X❑ OCCUR General Liability (DAMAGE TO RENTED $100,000 PREMISES (Ea occurrence) MED EXP (Any one person) $10 , 000 PERSONAL & ADV INJURY $2,000,000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY PRO- M JECT LOC (PRODUCTS - COMP/OP AGG $4,000,000 EC —1 OTHER: B AUTOMOBILE LIABILITY BUA 6078988680 08/30/2019 08/30/2020 COMBINED SINGLE LIMIT Commercial Auto - ADS (Ea accident) _ X ANYAUTO BODILY INJURY ( Per person) — OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS _ HIREDAUTOS NON -OWNED I PROPERTY DAMAGE — ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR U500079952L119A 08/30/2019 08/30/2020 EACH OCCURRENCE Umbrella AGGREGATE EXCESS LIAB CLAIMS -MADE DED I X IRETENTION $10, 000 C WORKERS COMPENSATION AND wc6078988713 08/30/2019 08/30/2020 X I pER I IoTH- EMPLOYERS' LIABILITY Y / N ADS STATUTE ER ANY PROPRIETOR / PARTNER'EXECUTIVE D N/A WC6078988727 08/30/2019 I E.L. EACH ACCIDENT 08/30/2020 OFFICER/MEMBEREXCLUDED7 (Mandatory in NH) WI E.L. DISEASE -EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below F.L. DISEASE -POLICY LIMIT E E&O-PL-Primary PSDEF1900460 08/30/2019 08/30/2020 Per Claim Professional Liab. and cP Aggregate $2,000,000 $10,000,000 $10,000,000 (D LL w 0 U m a L D w a (D m d 'a 0 2 O Z a) ca 0 w E a) 0 $1,000,000 $1,000,000 $1;000,000 —_ $5,000,000 $5,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Project Name: All Operations. City of Gilroy, its officers, officials and employees are included as Additional Insured W in accordance with the policy provisions of the General Liability policy.■ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Gilroy AUTHORIZED REPRESENTATIVE 7351 Rosanna Street �-. Gilroy CA 95020 LW USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027699 LOC #: A ADDITIONAL REMARKS SCHEDULE AGENCY NAMEDINSURED Aon Risk services Central, Inc. Michael Baker International, Inc POLICY NUMBER See Certificate Number: 570078094161 I1II CARRIER NAIC CODE See Certificate Number: 570078094161 I EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSLTRER INSURER INSURER IINSURER ADDITIONAL POLICIES Page _of_ If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER WORKERS COMPENSATION C N/A wc6078988694 CA POLICY POLICY EFFECTIVE EXPIRATION LIMITS DATE DATE (MM/DD/YYYY) (MM/DD/YYYY) _ 08/30/2019 08/30/2020 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD