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COI - Trinity Source Group, Inc. - Expires 2023-11-03A� CERTIFICATE OF LIABILITY INSURANCE D1/20DII3 2/1/2023 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. 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 REPRESENTATIVWR PRODUCER, AND THE CERTIFICATEHOLDER. IMPORTANT: If the certificateholder is an ADDITIONALINSURED,the policy(ies)must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms andconditionsof the policypertain policies nayrequirmn endorsement.A statementon thiscertificatedoes not conferrights to the certificateholder in lieu of such endorsement(s). PRODUCER ISU INS SERV - BC ENV BROKERAGE 1037 Suncast Ln Ste 103 El Dorado Hills, CA 95762 CONTACT DINA ATHEY NAME PHONE (916) 939-1080 I (AIC,NOFAX (916) 939-1085 ANo.Ext): ADDRESS: INSURER(S) AFFORDING COVERAGE NAICR INSURERA: ADMIRAL INSURANCE COMPANY 24856 INSURED TRINITY SOURCE GROUP, INC. 119 ENCINAL ST. SANTA CRUZ, CA 95060 INSURER _ OHIO SECURITY INS. COMPANY 24082 INSURERC: STATE COMPENSATION INS.FUND 35076 INSURERS OHIO SECURITY INSURANCE COMPAN 24082 INSURERE: AMERICAN FIRE AND CASUALTY CO. 24066 INSURERE: AMERICAN FIRE AND CASUALTY CO. 24066 COVERAGES CERTIFICATE NUMBER: • THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL INSD SUER WVD POLICY NUMBER POLICY EFF IMM/DDIYAY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIALGENERAL LIABILITY Y FEI-ECC-10975-10 11/03/22 11/03/23 EACH OCCURRENCE § 2,000,000 CLAIMS -MADE X OCCUR DAMAGE rO REN I LU PREMISES (Ea occurrence) § 50,000 X CONT . POLLUTION MED EXP (Any one person) $ 5,000 PERSONAL BASV INJURY § 2,000,000 GENII AGGREGATE POLICY OTHER. LIMIT X APPLIES PER: PR0. 1^, JECT 1 1 LOC GENERAL AGGREGATE § 2,000,000 PRODUCTS -COMP/OPAGG § 2,000,000 B AUTOMOBILE X X LIABILITY ANYAUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON-OWAUTOSRJED BAS (23) 56350264 11/06/22 11/06/23 COCOMBINES SINGLE LIMIT § 1,000,000 ,000,000 BODILY INJURY (Per person) § BODILY INJURY (Per accident) § PROPERTY DAMAGE (Per accident) § § E X l:::E UMBRELLA LIAB SS LIAB X OCCUR CLAIMS -MADE ESA(23) 56350264 ONLY) 11/06/22 11/06/23(AUTO EACH OCCURRENCE § 1,000,000 AGGREGATE § 1,000,000 RETENTION b § 1,000,000 C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatortin NH) If yes, describe under DESCRIPTION OFOPERATIONS below N/A 9152112-23 02/01/23 02/01/24 X I STATUTE I I ER E.L. EACH ACCIDENT § 1,000,000 E.L. DISEASE -EA EMPLOYEE § 1,000,000 E.L. DISEASE -POLICY LIMIT § 1,000,000 A D PROF.LIAB. CLAIMS MADE PROP/IM FEI-ECC-10975-10 RETRO: 11/21/08 BKS(23)56350264 11/03/22 11/06/22 11/03/23 11/06/23 $2,000,000 OCCURRENCE $2,000,000 AGGREGATE SPECIAL FORM INC. THEFT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached i/ more space is required) RE: SERVICES AGREEMENT: FIRE DEPARTMENT PERSONNEL TRAINING - JOB 585 CITY OF GILROY, ITS OFFICERS, OFFICIALS, AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED, PER ATTACHED ENDORSEMENT. (BLANKET ENDORSMENTS ATTACHED) R E©[aWIMD FEB 1 0 2n23 I CERTIFICATE HOLDER CITY OF GILROY, ITS OFFICERS) G ycpscLERK'S OFFIC QDLD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITHTHE POLICY PROVISIONS. AND EMPLOYEES 7351 ROSANNA STREET GILROY, CA 95020 AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION. All rights reserved.