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COI - TK Elevator Corporation - Expires 2023-10-01ACORD CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 DATE (MM/DD/YYYY) 09/12/2022 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 Aon Risk Services Central, Inc. 200 East Randolph CHICAGO, IL 60601 CONTACT NAME: Aon Risk Services Central, Inc. INSURED TK Elevator Corporation f/k/a ThyssenKrupp Elevator Corporation PHONE (A/C No.Ext): (866) 283-7122 I FAX (A/C No.Ext): (800) 363-0105 E-MAIL ADDRESS:acs.chicago@aon.com INSURER(S) AFFORDING COVERAGE INSURER A: HDI Global Insurance Company INSURER B: ACE American Insurance Company INSURER C: Indemnity Insurance Company of NA INSURER D: ACE Fire Underwriters Insurance Company INSURER E: NAIC # 41343 22667 43575 20702 INSURER F: COVERAGES CERTIFICATE NUMBER: 2216428 REVISION 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 SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY OCCUR GLD5668802 / GLD5668902 10/01/2022 10/01/2023 EACH OCCURRENCE $ 2,000,000 0 CLAIMS -MADE X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 AGGREGATE LIMIT POLICY I PROJECT APPLIES PER: MED EXP (Any one person) $ 5,000 GENII PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 X LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY ANY AUTO SCHEDULED AUTOS NON -OWNED AUTOS ONLY ISA H10757599 10/01/2022 10/01/2023 COMBINED SINGLE LIMIT (Ea accident) $ 4,000,000 X OWNED AUTOS BODILY INJURY(Per person) ONLY BODILY INJURY (Per accident) HIRED AUTOS ONLY PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB DED RETENTION OCCUR CLAIMS -MADE $ EACH OCCURRENCE AGGREGATE C B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A WLR C50730736 (AOS) WLR C50726836 (CA, MA) WLR C50726897 (TK Airport) 10/01/2022 10/01/2022 10/01/2022 10/01/2023 10/01/2023 10/01/2023 ( X PER I I OTHER STATUTE N E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 X Limits shown as requested: DESCRIPTION OF OPERATIONS / LOCATIONS Division Number: 108750 - Named Insured Project Number: US117839 - Project Name: / VEHICLES (ACORD 101, Includes: ThyssenKrupp Elevator OLD CITY HALL - Address: 7400 Additional Remarks Schedule, may be attached if more space is required) Corporation - Address: 2140 Zanker Road San Jose, CA 95131 MONTEREY RD GILROY, CA 95020 - Project Type (s): Elevator Maintenance RE©MOWED CERTIFICATE HOLDER OCT CANCELLATION CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 United States 12 2022 GILROY CITY CLERK'S OFFICE 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 RSZA �ti c G s V tie ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD © 1988-2016 ACORD CORPORATION. All rights reserved. Page 3 of 3 Named Insured Agent Name Agent No. T -Policy Number GLD5668902 ENDORSEMENT HDI Global Insurance Company ELEVATOR U S A HOLDING, INC. AON RISK SERV_CES CENTRAL INC PO20001 1 Effective Date: 10} —1)1 2 12:01 A.M.. Standard Time This EndorsemerTt Changes The Poky Please Read It Carefully. ADDITIONAL INSURED ENDORSEMENT BLANKET AUTOMATIC — WHERE REQUIRED BY CONTRACT SECTION II — WHO IS AN INSURED — IS AMENDED BY ADDING THE FOLLOWING PARAGRAPH: 4. ANY PERSON, FIRM, CORPORATION OR GOVERNMENT BODY FOR WHOM YOU ARE OBLIGATED BY VIRTUE OF A WRITTEN CONTRACT OR AGREEMENT ENTERED INTO WITH RESPECT TO YOUR OPERATIONS, TO AFFORD COVERAGE SUCH AS PROVIDED BY THIS POLICY. THE COVERAGE PROVIDED FOR ANY SUCH ADDITIONAL INSURED IS EXPRESSLY LIMITED TO APPLY ONLY TO LIABILITY ARISING OUT OF OPERATIONS CONDUCTED BY OR FOR YOU UNDER THE WRITTEN CONTRACT OR AGREEMENT AND THEN ONLY TO THE EXTENT REQUIRED BY SUCH WRITTEN AGREEMENT. NO COVERAGE IS PROVIDED FOR ANY ADDITIONAL INSURED FOR THE LIABILITY WHICH ARISES IN ANY MANNER, DIRECTLY OR INDIRECTLY. OTHER THAN FROM OPERATIONS CONDUCTED BY OR FOR YOU, ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. MAN-GL (01 i 02) ACORL' BRYON-1 CERTIFICATE OF LIABILITY INSURANCE OP ID: AT DATE (MM/DD/YYYY) 10/04/2022 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, If SUBROGATION IS WAIVED, subject to the terms and conditions this certificate does not confer rights to the certificate holder in lieu PRODUCER Homewell Insurance Serv, Inc 901 Via Piemonte Ste 205 Ontario, CA 91764 Aaron Brewart Byron Epp, pp, Inc. 26062 Merit Circle Suite 107 Laguna Hills, CA 92653 909-509-8103 the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. of the policy, certain policies may require an endorsement. A statement on of such endorsement(s). CONTACT NAME: PHONE 909-509-8103 (A/C, No, Ext): E-MAIL - -- - ADDRESS: FAX No):909-257-3027 INSURER1S) AFFORDING COVERAGE _ — NAIC_ _S INSURER A :Associated Industries Ins. 123140 INSURER B:AmGUARD Insurance Company 142390 INSURER C : Security National Insurance Co '19879 INSURER D:EMC Insurance Companies 21415 INSURERE: Indian Harbor Insurance Co 136940 INSURER F COVERAGES • --"-" '-""-"-•"-�"' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ADDL INSR TYPE OF INSURANCE INSDSUBR ! POLICY EFF ' POLICY EXP LTR'!WVD POLICY NUMBER IMM/DD/YYYYI INLV IJIVI•I IVVIYI1DCR. NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 1X AES120970201 110/01/2022 10/01/2023 -, - - -- GEN'L AGGREGATE LIMIT APPLIES PER POLICY X JECOT L.' L - OTHER I EACH OCCURRENCE DAMAGISE TOES (Ea RENTEDocalrrence) PREM $ $ 1,000,000 100,000 5,000 1,000,000 2,000,000 MED EXP {Anemone person] $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS_COMP/OP AGG $ 2,000,000 1,000,000 EBL _ - $ B AUTOMOBILE LIABILITY AUTO BYAU396313 10/01/2022 10/01/2023 ' OWNED SCHEDULED I AUTOS ONLYX AUTOS '' X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT LEa accWent)-_ANY BODILY INJURY (Per person) -- BODILY INJURYLPer accident) -- $ 1,000,000 - _ PROPERTY DAMAGE (Per accident) $ S A UMBRELLA LIAB X OCCUR X' EXCESS LIAB CLAIMS -MADE! EXA121387601 10/01/2022 10/01/2023 ' DED ' X • RETENTIONS 01 ' EACH OCCURRENCE $ 5,000,000 5,000,000 AGGREGATE $ S C WORKERS COMPENSATION - ANDY ROPRIETOR/P RTNEY SNP1361566 10/01/2022, Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE Y 'NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below I 10/01/2023 X ' PER f E , 0TH- E.L EACHA_CC_ ACCIDENT $_ E.L.ISEASE - EA EMPLOYE S - -- - - - E-- - E.L. DISEASE - POLICY LIMIT S 1,000,000 _ 1,000,000 - 1,000,000 D Contractors Equip 6X11606 10/01/2022 E Prof Liability I PL02262021 03/17/2022 10/01/2023 03/17/2023 Equipment Prof Liab 100,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is re. I -.a:. *Cancellation provision reverts to 10 days for non-payment of premium. R E©MO V ME) Re:City of Gilroy, PD City of Gilroy, its officers, officials and employees are included as additional insured with respects to the General Liability per form attached. OCT 1 2 2022 GILROY CITY CLERK'S OFFICE CERTIFICATE HOLDER CITYOGL City of Gilroy, its officers, officials and employees 7351 Rosanna Street 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 5 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD