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COI - Drewberry Engineers Inc. - Expires 2023-07-01AcoRD® CERTIFICATE OF LIABILITY INSURANCE DATE5M0/DD/YYYY) 07/L..- 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 MARSH USA, INC. 1050 CONNECTICUT AVENUE, SUITE 700 WASHINGTON, DC 20036-5386 CN102736896-7/1-1.1 a-22-23 GAWU CONTACT Justin Mineo NAME: X A/c, N No, Est): (804) 344-8614 (A/C, No): E-MAIL ADDRESS: justin.mineo@marsh.corn INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Charter Oak Fire Insurance Company 25615 INSURED DEWBERRY ENGINEERS INC. 1760 CREEKSIDE OAKS, SUITE 280 SACRAMENTO, CA 95833 INSURER B : Travelers Indemnity Co 25658 INSURER C : Travelers Property Casualty Co. Of America 25674 INSURER D : Beazley Insurance Company, Inc. 37540 INSURER E : Travelers Casualty And Surety Company 19038 INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006482907-12 REVISION NUMBER: 5 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 D INW D SUBR VD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY P-630-7792B312-COF-22 07/01/2022 07/01/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE RETED PREMISESO(Ea occurrence) $ 1,000,000 X CONTRACTUAL INS. COV. MED EXP (Any one person) $ 10,000 (INSURED CONTRACTS) PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED 810-1N788974-22-43-G 07/01/2022 07/01/2023 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ COMP / COLL DED: $ 1,000 C X UMBRELLA LIAB EXCESS LIAB X O OCCUR CLAIMS -MADE CUP-4J583077-22-43 07/01/2022 07/01/2023 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXOF ICERMEMBEREXC UDED?ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N/A UB-6P972264-22-43-G 07/01/2022 07/01/2023 x PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D PROFESSIONAL LIABILITY V11B5E221301 RETRO. DATE: FULL PRIOR ACTS 07/01/2022 07/01/2023 PER CLAIM/AGGREGATE SIR 5,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: CITY OF GILROY RENOVATION.DEWBERRY PROJECT/JOB/PLN # 50118429, BU 8890. CITY OF GILROY PROJECT NO. 19-RFP-PW-429. CITY OF GILROY, ITS OFFICERS, AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT WITH RESPECT TO THE GENERAL LIABILITY, AUTO LIABILITY, AND UMBRELLA POLICIES. THE GENERAL LIABILITY POLICY COMPLIES WITH THE PROVISIONS OF THE STANDARD ISO ENDORSEMENT FORMS FOR ONGOING AND COMPLETED OPERATIONS. 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 City of lllroy roytes 7351 Rosnna Street Gilroy, CA 95020 R E Vlv MD 0 JUL 18 2022 GILROY CITY CLERK'S OFFICE AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0000438 SP 0252-001-P00438-I City of Gilroy Attn:Julie Oates 7351 Rosnna Street Gilroy, CA 95020 0252-01-00-0000438-0001-0001672 AGENCY CUSTOMER ID: CN102736896 LOC #: Washington ACORD® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA, INC. NAMED INSURED DEWBERRY ENGINEERS INC. 1760 CREEKSIDE OAKS, SUITE 280 SACRAMENTO, CA 95833 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 AS RESPECTS THE GENERAL LIABILITY, AUTOMOBILE LIABILITY, UMBRELLA LIABILITY, AND WORKERS' COMPENSATION COVERAGES EVIDENCED ABOVE, NOTICE OF CANCELLATION WILL BE PROVIDED BY THE INSURER(S) TO THE CERTIFICATE HOLDER PER THE ATTACHED AS REQUIRED BY WRITTEN CONTRACT. CSC OWFED JUL 18 2022 GILROY CITY CLERK'S OFFICE RE ACORD 101 (2008/01) 0252-01-00-0000438-0002-0001673 © 2008 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO POLICY NUMBER: 810-1N788974-22-43-o ISSUE DATE: 06-28-22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, VIRGINIA BLANKET CANCELLATION AND NONRENEWAL NOTICE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM In the event of cancellation or nonrenewal or material change that reduces or restricts the insurance afforded by this Coverage Part, we agree to mail prior written notice of cancellation or nonrenewal or material change to: SCHEDULE Any person or organization to whom you have agreed to under any contract or agreement that notice of cancellation or material limitation of this policy will be given, but only if: 1. You send us a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured receives notice from us of the cancellation or nonrenewal or material change of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this endorsement. 3. Number of days advance notice: Cancellation for nonpayment of premium: Days Cancellation other than nonpayment of premium: 30 Days Nonrenewal: Days Material change: Days Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CAF2360321 ® 2021 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: P-630-7792B312-COie-22 ISSUE DATE: 06-17-22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: PERSON OR ORGANIZATION: ANY PERSON OR. ORGANIZATION (CONTINUED ON IL T8 06) ADDRESS: SEE IL T8 06 FAIRFAX VA 22031 30 PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. ILT4050519 0252-01-00-0000438-0003-0001674 0 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of ' POLICY NUMBER: P-630-77928312-COF-22 GENERAL PURPOSE ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US IL T4 05 05 19 THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CONTINUATION OF FORM IL T4 05, PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED SHOWN IN THE DECLARATIONS RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. IL T8 06 Page 1 NOTICE: THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. HOWEVER, THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. Effective date of this Endorsement: 01-Jul-2022 This Endorsement is attached to and forms a part of Policy Number: V11B5E221301 Beazley Insurance Company, Inc. referred to in this endorsement as either the "Insurer" or the "Underwriters" DEWBERRY NOTICE OF CANCELLATION TO CERTIFICATE HOLDER This endorsement modifies insurance provided under the following: ARCHITECTS AND ENGINEERS PROFESSIONAL LIABILITY INSURANCE POLICY In consideration of the premium charged for the Policy, it is hereby understood and agreed that in addition to the provisions of the Cancellation section of the Conditions, if this policy is cancelled by us, other than for non-payment of premium, we will provide 30 days written notice to the following party(ies): As per list to be provided by the Named Insured or its Broker of Record. All other terms and conditions of this Policy remain unchanged. A EDB005NYFTZ 032011 ed. Class Code: 2-14180 Page 1 of 1 0252-01-00-0000438-0004-0001675 POLICY NUMBER: CUP-4,7583077-22-43 ISSUE DATE: 06/17/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: SCHEDULE Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF; 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATIONâ–  AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 1. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: TIE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. IL T4 05 05 19 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 TRAVELERS J ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R4 (00) - 001 POLICY NUMBER: UB-6P972264-22-43-G NOTICE OF CANCELLATION OR NONRENEWAL TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX — CONDITIONS : Notice Of Cancellation Or Nonrenewal To Designated Persons Or Organizations If we cancel or non -renew this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation or non -renewal to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation or nonrenewal is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation or nonrenewal to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation or nonrenewal. SCHEDULE Name and Address of Designated Persons or Organizations: Number of Days Notice: ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OR NON RENEWAL OF THIS POLIC Y WILL BE GIVEN, BUT ONLY IF: 1. YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQU EST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NA MED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OR NON RENEWAL OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGA NIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. All other terms and conditions of this policy remain unchanged. 30 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 Company DATE OF ISSUE: 06-17-22 STASSIGN: ® 2013 The Travelers Indemnity Company. All rights reserved. 0252-01-00-0000438-0005-0001676 Countersigned by Page 1