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COI - Oldcastle Infrastructure, Inc. - Expires 2023-09-01
Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions, Inc. All rights reserved. //\® \\ mm -22 a. Koln mmo CMr- 79, 331110 SA313 A113 AOS119 1,0 NJ NJ a This document was issued by the Liberty Mutual Insurance Group. woo.ientnAA4Jegn nnnnm :pip Z :seed 30 -oM / CA.0 R rt / co 6ullao uu3 :aapuas 9739370 I LM 44 109.22-09.23 Standard 10 oink/ WETS s s03 (£0/91.0Z) 5Z a2100V © 1988-2015 ACORD CORPORATION. All rights reserved. aoaaa aualeA AUTHORIZED REPRESENTATIVE D -1 CO 0 m 0 O c O X O D-0D m D • 0 71 0 z 2 = -i 0 m D D m 1co m0 O m =O �^m xi0 <- w 00- z-+0 co m� m rtWiD 0 m rr m m xico m m 00 0 zm 0 m 7J T_ m m x 0 m NOI1V133ONVO DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Gilroy, its officers, officials and employees are listed as additional insured with regards to the general liability and automobile liability policies, where required by written contract. Waiver of subrogation is included in favor of the additional insured, where required by written contract, and where applicable by law. 30-day Notice of Cancellation. W CO D D D r y A 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. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTN ER/EXECUTI V E OFFICER/MEMBEREXCLUDED? N (Mandatory in NH) If yes, describe under , DESCRIPTION OF OPERATIONS below TYPE OF INSURANCE DED RETENTION $ UMBRELLA LIAB EXCESS LIAB ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Separation of Insured OCCUR CLAIMS -MADE Z D t t No Or- t t t co co WA7-C8D-004095-022 All except OH, ND, WA, WY WC7-C81-004095-012 WI, MN AS2-C81-004095-122 AS2-C81-054502-522 Physical Damage only: Comprehensive Ded $10,000 Collision Ded $10,000 TB2-C81-004095-112 XCU Coverage Included POLICY NUMBER 9/1/2022 9/1/2022 co co N N ON N N N co N N N POLICY EFF (M M/DD/YYYYj 9/1/2023 9/1/2023 co Po N N O O OD w co N 0 w POLICY EXP I M M/DD/YYYY) E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT No D� H m 00 D 0 0 A D m EACH OCCURRENCE PROPERTY DAMAGE (Per accident) BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT (Ea accident) PRODUCTS - COMP/OP AGG GENERAL AGGREGATE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL BADV INJURY EACH OCCURRENCE LIMITS O O O O O 0 O O 0 0 0 O c O 0 0 0 0 $ 2,000,000 $2,000,000 $ 2,000,000 N O O 0 O 0 O $300, 000 $ 50,000 $2,000,000 0 m m n rn m z c Co m rn 0 w CO 0 O rn rn O z z c W m