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COI - Temp Power Systems - Expires 2021-11-11ACOR®� CERTIFICATE OF LIABILITY INSURANCE � DATE(MM/DD/YYYY) 11/9/2020 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 Venbrook Insurance Services CA Lic 0D80832 6320 Canoga Avenue, 12th Floor Woodland Hills, CA 91367 www.venbrook.com CA Lic No. 0D80832 CONTACT NAME: PHONE FAX (9LC. No Ext): 818-598-8900 (A/c, No): 818-598-8910 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Company 39993 INSURED Temp Power Systems 8929 Irvine Center Drive, Suite 200 Irvine, CA 92618 INSURER B : StarStone National Insurance Company 25496 INSURER C: Travelers Property Casualty Co of Amer 25674 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A / COMMERCIAL GENERAL LIABILITY i / 600 GL 0188541-00 11/11/2020 11/11/2021 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ✓ OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 / BFPD/XCU MED EXP (Any one person) $ 5,000 V Contractual PERSONAL & ADV INJURY $1,000,000 GEN'L / AGGREGATE / $2,500 LIMIT APPLIES PROOT- Deductible PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY(Per accident ) $ PROPERTY DAMAGE (Per accident) $ C / UMBRELLA LIAB EXCESS LIAB / OCCUR CLAIMS -MADE ✓ / ZUP-16N0251A-20-NF 11/11/2020 11/11/2021 EACH OCCURRENCE $5,000,000 AGGREGATE $S,000,QQQ DED / RETENTION $10,000, Products/Comp) Agg: $ 5,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A / T20201127 10/1/2020 10/1/2021 ,/ STATUTE 0TH E.L. EACH ACCIDENT $ 1,000,000 $ 1,000 000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Equipment Leased/Rented QT-660-9A146793-TIL-20 11/11/2020 11/11/2021 $500,000 Limit $1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Track #IN-2898 - City of Gilroy, CA *** See Addendum *** CANCELLATION City of Gilroy 7351 Rosanna St. Gilroy CA 95020 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 April Johnson ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 1 of 8 ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Venbrook Insurance Services CA Lic 0D80832 POLICY NUMBER CARRIER NAIC CODE NAMED INSURED Temp Power Systems 8929 Irvine Center Drive, Suite 200 Irvine, CA 92618 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Gilroy ADDRESS: 7351 Rosanna St. Gilroy CA 95020 RE: Track #IN-2898 - City of Gilroy, CA City of Gilroy, its Officers, Officials, Representatives, Agents, Employees, and Volunteer are Additional Insured's under the General Liability policy if required by written contract with the Named Insured but only for coverage and limits provided by the policy and the additional insured endorsement. Primary and Non -Contributory coverage applies to General Liability. Waiver of Subrogation applies to General Liability and Workers Compensation. *10 Days Notice of Cancellation for Non -Payment of Premium, 30 Days All Others. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) Page 2 of 8 Temp Power Systems 600 GL 0188541-00 COMMERCIAL GENERAL LIABILITY CG20370704 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations as required by written contract with the Named Insured As designated in written contract with the Named Insured for commercial projects only including apartments Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG20370704 © ISO Properties, Inc., 2004 Page 1 of 1 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 3 of 8 Temp Power Systems 600 GL 0188541-00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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): All persons or organizations as required by written contract with the Named Insured Location(s) Of Covered Operations As designated in written contract with the Named Insured Information required to complete this Schedule, if not shown above, will 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 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 4 of 8 POLICY NUMBER: 600 GL 0188541-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY CG20120413 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: As required by written contract and/or issued and valid permit(s). The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, 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. a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 applicable Limits of Insurance shown in the Declarations. 2. This insurance does not apply to: CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 56495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 5 of 8 Temp Power Systems 600 GL 0188541-00 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG20010413 © Insurance Services Office, Inc., 2012 Page 1 of 1 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 6 of 8 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY 600 GL 0188541-00 CG 24 04 05 09 Temp Power Systems THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Whereas Required by Written Contract Information required to complete the Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59)41 PM (PST) I Page 7 of 8 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA WC 04 03 06 (Ed. 4-84) 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 engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Blanket Waiver of Subrogation Schedule Job Description As respects to all CA jobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. 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 No.: Endorsement Effective: 10/01/2020 Insured: Temp Power Systems, Inc. (A Corp) Policy No.: T20201127 Insurance Company: StarStone National Insurance Company Countersigned By ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. 58495573 120-21 GL, EX & CPP & WC I April Johnson 111/9/2020 1:59:41 PM (PST) I Page 8 of 8