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Citygate Associates - Insurance Certificate (2020)CITYG-1 OP ID: AN A�ORO CERTIFICATE OF LIABILITY INSURANCE I DATE 061261201 YY) 0612612019 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 Cummins Insurance Agency, Inc. ( PHONE Cummins Insurance Agency Fax License # OC42488 I AIC No. Edn: 916-961-6000 I (AIC. No): 916-961-3046 4401 Hazel Avenue, Suite 110 I MAIL Fair Oaks, CA 95628 ADDRESS: Cummins Insurance Agency, Inc I INSURER(S) AFFORDING COVERAGE NAIC M INSURER A: Sentinel Insurance Company Ltd 11000 INSURED Citygate Associates, LLC INSURER B:The Hartford 541611 David Deroos I INSURERC: Landmark American Ins. Co. 33138 600 Coolidge Drive, Suite 150 Folsom, CA 95630 I INSURERD: I INSURER E I INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AUUL SUBM POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 2 000 000 CLAIMS -MADE TOCCUR X 57SBAAZ1255 07115/2019 07115l2020 NTED PREMISES (Eaoccurrence)$ 1,000,000 X Primary/Non-Contr MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPL ES PER: ( GENERAL AGGREGATE $ 4,000,000 POLICY a JECT LOC PRODUCTS - COMP/OPAGG $ 4,000,000 OTHER: Empi DIS $ 50,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 _ A ANY AUTO X 57SBAAZ1255 07115/2019 07/15/2020 I BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ XX NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE (Per accident) $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE X 57SBAAZ1255 07/15/2019 07/15/2020 I AGGREGATE $ 4,000,000 DIED I X I RETENTION $ 10,000 $ WORKERS COMPENSATION X IPERH I I AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXE�UTIVE YIN 5TWECEU6620 10/0112018 STATUTE ER 10/01/2019 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N� (Mandatory in NH) N I A E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- PO -ICY LIMIT $ 1,000,000 C Errors 8, Omissions LHR774429 02/14/2019 02/14/2020 Aggregate 2,000,000 Ea. Occur 2,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Service Agreement for the Extended Scope Standards of Coverage Report Certificate holder is named as Additional Insured per attached. Primary/Non-contributory wording applies per attached. 30 day NOC applies per attached. CERTIFICATE HOLDER City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 ACORD 25 (2014/01) CITYG-2 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. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 57SBAAZ1-255 It 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: BUSINESS LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City of Gilroy, its officers California Officials and employees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section C. — 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; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. Form SS 41 70 06 11 Process Date: B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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 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 organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 1 of 1 Policy Expiration Date: © 2011, The Hartford (Includes copyrighted material of Insurance Services Office, Inc,, with its permission)