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COI - American Medical Response, Inc. - Expires 2024-03-31ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03,28/2023 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 Aon Risk Services Central, Inc. Philadelphia PA Office 100 North 18th Street 15th Floor Philadelphia PA 19103 USA CONTACT NAME: FAX (NC.NNo. Ext): E (866) 283-7122 (NC. No.): (800) 363-0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED American Medical Response, Inc. 6363 Fiddlers Green Circle Suite 1400 Greenwood Village CO 80111 USA INSURER A: Lloyd's Syndicate No. 1729 AA1120157 INSURER B: ACE American Insurance Company 22667 INSURER C: ACE Fire Underwriters Insurance Co. 20702 INSURERD: Indemnity Insurance Co of North America 43575 INSURERE: ACE Property & Casualty Insurance Co. 20699 INSURER F: CERTIFICATE NUMBER: 570098624153 REV 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY bFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY XSLG72962722 03/31/2023 03/31/2024 EACH OCCURRENCE $2,750,000 CLAIMS -MADE X OCCUR SIR applies per policy terns & condi-ions DAMAGE REN1ED PREMISES (Ea occurrence) 5100,000 MED EXP (Any one person) Excluded PERSONAL & ADV INJURY $2,750,000 GENILAGGREGATE LIMIT APPLIES PER: PRO- GENERALAGGREGATE $5,000,000 21 POLICY J JECT LOC PRODUCTS • COMP/OP AGG 52,750,000 OTHER: SIR $250, 000 B AUTOMOBILE LIABILITY ISA H25578193 03/31/2023 03/31/2024 COMBINED SINGLE LIMIT (Ea accident) S10,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED — SCHEDULED AUTOS BODILY INJURY (Per accident) AUTOS ONLY HIRED AUTOS ONLY _ NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) E UMBRELLA LIAB X OCCUR XCQG72514816003 03/31/2023 03/31/2024 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED RETENTION D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N WLRC70317370 AOS 03/31/2023 03/31/2024 x PER STATUTE OTH- ER B ANY PROPRIETOR! PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N/A WLRc70317333 03/31/2023 03/31/2024 E.L. EACH ACCIDENT 51 , 000 , 000 (Mandatory In NH) II yes. describe under CA, MA E.L. DISEASE -EA EMPLOYEE S1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S1,000,000 A E&O - Professional Liability - Excess CSHLC2301663 Claims Made- Lead Carrier SIR applies per policy terns 03/31/2023 & condi-ions 03/31/2024 Per Claim Aggregate SIR S15,000,000 515,000,000 S10,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED IN ACCORDANCE WITH THE POLICY PROVISIONS OF THE GENERAL LIABILITY POLICY. A WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS OF THE GENERAL LIABILITY POLICY. R ECFROV7I DD APR 1 0 2023 CERTIFICATE HOLDER CANCELLATION IGIRO ear CLERK 5 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. THE CITY OF GILROY AUTHORIZED REPRESENTATIVE ITS OFFICERS AND EMPLOYEES ATTN: CHIEF FOSTER 7351 ROSSANA STREET GILROY CA 95020 USA ,444 tadunaiee ata99ez4 IZ1S,4I, 9Kc, Holder Identifier 570098624153 Certificate No 000000 03 05 010622 034777 P ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000073826 LOC #: 4WRL ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Central, Inc. NAMED INSURED American Medical Response, Inc. POLICY NUMBER See Certificate Number: 570098624153 CARRIER See Certificate Number: 570098624153 NAIC CODE , EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER • INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD St1BR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS WORKERS COMPENSATION C N/A SCFC70317412 WI 03/31/2023 03/31/2024 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. Certificate No: 570098624154 THE CITY OF GILROY ITS OFFICERS AND EMPLOYEES ATTN: CHIEF FOSTER 7351 ROSSANA STREET GILROY CA 95020 USA Thursday, March 30, 2023 To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570098624154) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. MSC# 17755 I Aon P.O. Box 1447 Lincolnshire, IL 60069 ro 000000 04 05 010622 034778 P