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COI - Temp Power Systems - Expires 2023-10-01,4CC)RL TEMPPOW-01 JLOPEZ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD(YYYY) 1 /3/2023 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 Commercial The Brokerage The Brokerage, an Alera Group Company 20261 SW Acacia St, Suite 200 Newport Beach, CA 92660 INSURED Temp Power Systems 8929 Irvine Center Drive, Ste 200 Irvine, CA 92618 CONTACT Jessica Lopez NAME: PHONE (A/C, No, Ext): (949) 287-5677 ADD"r ss:jlopez@ thebrokerageins.com INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A :Tokio Marine Specialty Insurance Company 23850 INSURER B: NATIONWIDE MUTUAL INSURANCE COMPANY 23787 INSURER C : TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 25674 INSURER D : ICW - INSURANCE COMPANY OF THE WEST 27847 INSURER E: INSURER F : FAX (A/C, No): COVERAGES CER 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM!DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 CLAIMS -MADE X OCCUR PPK2486666 11/11/2022 10/1/2023 DAMAGET Eaoccurrence) 5 1,000,000 MED EXP (Any one person) 5 10,000 PERSONAL & ADV INJURY 5 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY x PE O I LOC PRODUCTS - COMP/OP AGG 5 2,000,000 OTHER' 5 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) 5 X ANY AUTO ACP 3110291755 1/8/2023 1/8/2024 BODILY INJURY (Per person) 5 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S HIRED NON -OWNED PROPERTY DAMAGE AUT S ONLY AUTOS ONLY (Per accident) 5 5 C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 5,000,000 EXCESS LIAB CLAIMS -MADE CUP-1W792130-22-NF 11/11/2022 10/1/2023 AGGREGATE 5 5,000,000 DED RETENTION 5 5 D WORKERS AND EMPLOYECOMPENSATION S' LIABI LIABILITY X STATUTE ; EERPER 1 H ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N x WSD 5062304 01 10/1/2022 10/1/2023 1,000,000 OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT S (Mandatory in NH) E L DISEASE - EA EMPLOYEE S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Track #IN-2898 - City of Gilroy, CA. wcwv Waiver of Subrogation for Workers' Compensation: See Attached Endorsement. I(----)1-.—1 r=ni.-, CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna St. Gilroy, CA 95020 JAN 2 5 2023 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: TEMPPOW-01 JLOPEZ LOC #: 1 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Commercial The Brokerage POLICY NUMBER SEE PAGE 1 CARRIER SEE PAGE 1 NAMED INSURED !Temp Power Systems :8929 Irvine Center Drive, Ste 200 !Irvine, CA 92618 NAIC CODE SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Cancellation: *Should this policy be cancelled before the expiration date, The Brokerage, an Alera Group Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement.* *Except 10 Days Notice of Cancellation for Non -Payment of Premium. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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). The additional premium for this endorsement shall be 2 % of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization ANY PERSON / ORG WHEN REQUIRED BY WRITTEN CONTRACT Job Description ALL CA OPERATIONS 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 10/01/2022 Policy No. WSD 5062304 01 Insured TEMP POWER SYSTEMS Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC990634 (Ed. 8-00) Endorsement No. Premium $ INCL . INSURED