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COI - Davaco LP - Expires 2020-11-01A CGRD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �....•� 9/25/2020 PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 1900 West Loop South, Suite 1600 Houston TX 77027 INSURED Davaco LP 4050 Valley View Lane, Suite 150 Irving, TX 75038 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: It the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) 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). CdNTACT NAAME: DAVAINC-0 PIEN ):713-623-2330 E-MAIL ADDRESS: IvAX N:713.622-6722 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company 165 INSURER B : Aspen American Insurance Company INSURER C 43460 INSURER 0__, INSURER E : INSURER F COVERAGES CERTI ICATE NUMBER: 1838688946 REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH TYPE OF INSURANCE OF INSURANCE PERTAIN, POLICIES. AbieL INSD WWI WVD LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN REDUCED �_.__. _ _—___-._____,__ __..._ POLICY NUMBER ISSUED TO CONTRACT THE POLICIES BY - POLICY EFpp (MM/DD/YYYY) THE INSURED OR OTHER DESCRIBED PAID CLAIMS. POLICY Exx.. (NIM/C) /YYYY) NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS A X COMMERCIAL GENERAL LIABILITY GLO107180402 10/1/2019 11/1/2020 EACH OCCURRENCE $1,000,000 _._._..I CLAIMS -MADE IX..J OCCUR DAMAGCTORENTED (rIaEMISESII~.0-09QuiWlgncII1_.. MED EXP (Any one person) 1 0QO 000. _...,._..__.... 516,000 PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE ... POLICY LIMIT APPLIES xi ,1�C PER: -X� GENERAL AGGREGATE CTS _._ .___ ..._.._ PRODU UCTS COMP/OP'AGO $2 000,000 .._�,..._...,w...._._-....._._. $2000,000 OTHER: A AUTOMOMLE.LIABILITV ANY AUTO BAP107180602 10/1/2019 11/1/2020 C BINE I) SINGLE LIMIT BODILY INJURY (Per person) 1,000,000 $ AWNED AUTOS ONLY r..__ SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY PROPERTY DAMAGE (f?ei„t+t 910911l.. _...._. _....._._...-. _ _ _. _ B X UMBRELLA LIAB X OCCUR CX004QQ19 10/1/2019 11/1/2020 EACH OCCURRENCE $10,000,000 EXCESS DEC LIAB X RETENTON$ C CLAIMS -MADE ,tn,nno AGGREGATE $10,000,000 S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC1071805 10/1/2019 11/1/2020 X S7aTUrE 0R I. ANYPROPRIETOR/PARTNER/EXECLITIVE OFFICER/MEMBEREXCLUDED'7 (Mandatory In NH) Y / N N / A G.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 1,000,000 .._._.._......_ .....,.._......._.___ $ 1,000,000 II es, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE . POLICY LIMIT $1,000,000 See Below A Auto Physics! Damage ACV Subject to Deductible DAP107180602 10/1/2019 1'1/1/2020 Deductibles DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Hired Auto Physical Damage Deductibles: Based on Gross Vehicle Weight 0 lbs - 12,500 lbs - $2,500 12,501 lbs - 26,000 lbs - $3,500 26,001 lbs - 45,000 lbs - $5,000 45,001 lbs and above - $7,500 See Attached... CERTIFICATE HOLDER CITY OF GILROY 7351 ROSANNA STREET GILROY CA 121727 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 rPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 8 7938 AGENCY CUSTOMER ID: DAVAINC-01 LOC #: ACORD ADDITIONAL REMARKS SCHEDULE Page i of AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Davaco LP 4050 Valley View Lane, Suite 150 Irving, TX 75038 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE FORMS/ENDORSEMENTS IF APPLICABLE: General Liability -Form #UGL11 5FVVC (04/13) Additional Insured - Automatic - Owners, Lessees or Contractors Primary and Noncontributory Insurance -Form #U0L1060ECW (04/13) Contractors Liability Supplemental Coverages and Conditions Additional Insured — Lessor of Leased Equipment — Automatic Status when required in Lease Agreement With You Additional Insured — Managers Or Lessors Of Premises Additional Insured State Of Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations -Form #UGL1446ACVV (05/10) Notification to Others of Cancellation -Form #UGL925BCW (12/01) Waiver of Subrogation (Blanket) Endorsement -Form #CG2404 (05/09) Waiver of Transfer of Rights of Recovery Against Others to Us -Form #CG2503 (05/09) Designated Construction Project(s) General Aggregate Limit A general aggregate limit applies to each construction project where the Named Insured is performing operations Automobile Liability -Form #CA2001 (10/12) Lessor - Additional Insured and Loss Payee -Form #UCA812ACW (05/10) Notification to Others of Cancellation -Form #UCA424FCW (04/14) Coverage Extension Endorsement Amended Who Is An Insured -Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. -Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional Insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. Waiver Of Transfer Of Rights Of Recovery Against Others To Us MCS-90 Endorsement Workers Compensation -Form #VVC990643 (01/13) Blanket Notification to Others of Cancellation or Nonrenewal Endorsement -Form #VVC000313 (04/84) Waiver of Our Right to Recover From Others Endorsement -Form #VVC000303C (10/04) Employers Liability Coverage Endorsement - ND, OH, WA, WY -Form #WC990321 (06/09) Puerto Rico - Employers Liability Coverage Endorsement CITY OF GILROY is additional Insured as respects general liability policy, pursuant to and subject to the policy's terms, definitions, conditions and exclusions ACORD 101 (2008/01) * 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3* of 8 7938 Notification to Others of Cancellation ZURICH Policy No, Eft'. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add I. Prem Return Prem. OLD 1071804-02 10/01/2019 10/01/2020 'I 4432000 INCL. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part Liquor Liability Coverage Part Products/Completed Operations Liability Coverage Part A. If we cancel this Coverage Part(s) by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organization(s): Number of Days Notice: TO BE DETERMINED AS REQUIRED BY WRITTEN CONTRACT 60 All other terms and conditions of this policy remain unchanged. U-GL-I446-A SW (05/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 4* of 6 7938 Notification to Others of Cancellation ZURICH Policy No. Eff. Date of Pol, Exp. Date of Pol. Eft'. Date of End. Producer Add't Prem, j Return Prem, BAP 1071806-02 10/01/2019 10/01/2020 14.432000 $ INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial Automobile Coverage Part A. If we cancel this Coverage Part by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organization(s): TO BE DETERMINED AS REQUIRED BY WRITTEN CONTRACT All other terms and conditions of this policy remain unchanged. Number of Days Notice: 60 U-CA-812-A OW (05/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 5* of 6 7938 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1. If we cancel or non -renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non -renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non -renewal; b. Must contain the names and addresses of only the parsons or organizations requiring notification that such policy has been cancelled or non -renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described In Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non -renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Wthin seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or (2) Non -renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2, above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non -renewal date; b. Negate the cancellation or non -renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. 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 Cornpany WC 99 06 43 (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission. *20'12 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved. 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