COI - Motivational Systems Inc - Expires 2024-01-01AHOLDREN
MOTISYS-02
1
CERTIFICATE OF LIABILITY INSURANCE
DATE
rE/6/2023)
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 endorsements .
PRODUCER License # 0525512
Teague Insurance Agency, Inc.
4700 Spring St., #400
La Mesa, CA 91942-0275
CONTACT
NA E
(NONE FAX
(ac, Na, Est) : (619) 464-6851 aC. Ne:(619) 668-4716
EMAIL . info@teagueins.com
ADDRESS
INSURERS AFFORDING COVERAGE
NAIC ft
INSURERA: Continental Insurance Company
35289
INSURED
Motivational Systems Inc
2200 Cleveland Ave.
National City, CA 91950
INSURERB:Zenith Insurance Company
13269
INSURER C:
INSURER D:
INSURER E
INSURER F
rnvoo Ar_ee CERTlelr ATE N111"ECR• RFVISIr1N NIIMRFR-
v 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 CONTRACTOR OTHER DOCUMENTWITH 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
ADDLSUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMBS
A
X
COMMERCIALGENERALLWBILITY
CLAIMS -MADE OCCUR
X
X
6023673615
1/1/2023
1/112024
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
S 500,000
MED EXP (AnyonePerson)
$ 15,000
PERSONAL& ADV INJURY
S 2,000,000
GEN'L AGGREGATE LIMIT - APPLIES PER:
POLICY �X JECT LOC
OTHER:
GENERAL AGGREGATE
S 2,000,000
PRODUCTS - COMPIOP AGG
S 2,000,000
WASH STOP LOSS
$
A
AUTOMOBILE LIABILITY
X ANYAUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
AUTOS ONLY AUTTOSWONLYY
6023673629
1/1/2023
1/1/2024
COMBINED SINGLE LIMIT
$ 1,000,000
BODILYINJURY Per erson
$
BODILY INJURY Per accident
$
PPeOiEarl t AMAGE
S
S
A
X
UMBRELLA LIAS
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
6023673601
1/1/2023
11112024
EACH OCCURRENCE
S 2,000,000
AGGREGATE
S 2,000,000
DED I X I RETENTION$ 10,000
S
B
WORKERS COMPENSATION
ANDEMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNEWEXECUTIVE N
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
w DESCRIPTION OF OPERATIONS beb
NIA
X
M1069513
1/1/2023
1/1/2024
OTH-
X PER TE ER
$ T
E.L. EACH ACCIDENT
1,000,000
E.L. DISEASE - EA EMPLOYE
1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached if mores ace is required)
All Operations Certificate Holder is included, when required by written contract, as additional insured for ongoing and completed operations, with waiver of
subrogation, and primary and non-contributory language with respects to the General Liability Waiver of Subrogation under the Worker's Compensation
Coverage per the attached forms.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
JT 20�� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
AN
CITY OF GILROY A N 1 / ACCORDANCE WITH THE POLICY PROVISIONS.
7351 ROSANNA ST
GILROY, CA 95020
GILROY CITY CLERK'S OFFICE AUTHORIZED REPRESENTATIVE
t y.
ACORD 25 (2016/03) U 19Sa-ZU15 ACUKU L,UKPVKAI IVN. All rlgnts reservea.
The ACORD name and logo are registered marks of ACORD
CNA CNA PARAMOUNT
Blanket Additional Insured -Owners, Lessees or
Contractors -with Products -Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by
written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily
injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or
the acts or omissions of those acting on your behalf:
A. in the performance of your ongoing operations subject to such written contract; or
B. in the performance of your work subject to such written contract, but only with respect to bodily injury or
property damage included in the products -completed operations hazard, and only if:
1. the written contract requires you to provide the additional insured such coverage; and
2. this coverage part provides such coverage.
II. But if the written contract requires:
A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10-
01 edition of CG2037; or
B. additional insured coverage with "arising out of language; or
C. additional insured coverage to the greatest extent permissible by law;
then paragraph I. above is deleted in its entirety and replaced by the following:
WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by
written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily
injury, property damage or personal and advertising injury arising out of your work that is subject to such written
contract.
In
co
III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide
co such additional insured with:
N A. coverage broader than required by the written contract; or
0
0
B. a higher limit of insurance than required by the written contract.
N
IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
damage, or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including:
1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; and
2. supervisory, inspection, architectural or engineering activities; or
B. any premises or work for which the additional insured is specifically listed as an additional insured on another
endorsement attached to this coverage part.
V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to
add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage
part:
CNA75079XX (10-16) Policy No: 6023673615
Page 1 of 2 Effective:1 /1 /2023
VALLEY FORGE INSURANCE COMPANY
Insured Name: MOTIVATIONAL SYSTEMS INC
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CNA CNA PARAMOUNT
Blanket Additional Insured -Owners, Lessees or
Contractors -with Products -Completed
Operations Coverage Endorsement
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named
insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written
contract requires the insurance provided by this policy to be:
I. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of
the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation,
defense, or settlement of the claim; and
3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or
self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However,
if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not
apply to insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives
written notice of a claim from the additional insured.
VI1. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to
add the following definition:
Written contract means a written contract or written agreement that requires you to make a person or organization an
additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and
B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury;
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA75079XX (10-16) Policy No: 6023673615
Page 2 of 2 Effective:1 / 1 /2023
VALLEY FORGE INSURANCE COMPANY
Insured Name: MOTIVATIONAL SYSTEMS INC
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CNA CNA PARAMOUNT
Waiver of Transfer of Rights of Recovery Against
Others to the Insurer Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
ANY PERSON OR ORGANIZATION WHOM THE
CONTRACT OR AGREEMENT TO WAIVE SUCH
CONTRACT OR AGREEMENT:
NAMED INSURED HAS AGREED IN WRITING IN A
RIGHTS OF RECOVERY, BUT ONLY IF SUCH
1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND
2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND
ADVERTISING INJURY GIVING RISE TO THE CLAIM.
(Information required to complete this Schedule, if not shown above, will be shown in the Declarations.)
Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled
Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following:
With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the
Insurer may have against such person or organization because of payments the Insurer makes for injury or damage
arising out of the Named Insured's ongoing operations or your work included in the products -completed operations
hazard.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,
and expires concurrently with said Policy.
CNA75008XX (10-16) Policy No: 6023673615
Page 1 of 1 Endorsement No: 23
VALLEY FORGE INSURANCE COMPANY Effective Date: 01 / 01 / 2 0 2 3
Insured Name: MOTIVATIONAL SYSTEMS INC
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY TheZedW
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT
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 any person or organization with whom you have a written contract that requires you
to obtain this agreement from us.
The additional premium for this endorsement shall be 2.00% of the California workers compensation
premium otherwise due.
Minimum Premium: $0
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 01/01/2023 ZENITH INSURANCE COMPANY - 13145
Insured MOTIVATIONAL SYSTEMS, INC.
Policy No. M1069513 CA
Policy Period 01/01/2023 To 01/01/2024
Issued On 12/23/2022
At San Diego, CA CHIEF EXECUTIVE OFFICER
WC-99-04-25B
(Ed. 10-07) Endorsement No. 17