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COI - Byron Epp, Inc. - Expires 2023-10-01BRYON-1 CERTIFICATE OF LIABILITY INSURANCE I DATE ,M ,,DD^ YY) 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(les) 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 rlahts to the certificate holder in lien of snmh Pndnrsamantlel. isurance Sam, Inc nonte Ste 205 91764 art NAIL a 40 Inc. Circle Suite 107 :, CA 92653 INSURER D V `hhR u INSURER E : Indian r nVFRArAFR CFRTIFICATP NI IMDFR- DMIIQInIJ w IMDCD. 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. INSRLTR TYPE OF INSURANCE POLICY SUBR, POLICY NUMBER POLICYM.re yYyyt EFF POLICYEXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 8_ CLAIMS -MADE X OCCUR _ X 'AES120970201 10101I2022 10I01I2023 _ S 100,000 DAMAGE TO RENTED MISES rEa ocanepOel MEDEXPfAny One person) Is5,000 PERSONAL& ADV INJURY S 1,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER'. $ 2,000,000 POLICY I_xJ Ta- L_J 2,000,000 IOC $ - - -PRODUCTS_COMPIOP_AGG EEL OTHER: S 1,000,000 B AUTOMOBILE - LIABILITY COMBINED SINGLE LIMIT AEaaccdenl) 1,000,000 S _ _ ANY AUTO _ BYAU396313 10/01/2022 10/01/2023 BODILY INJURY (Per person S ji ED X AUUTOSSWU�LEEDp AUTOSONLY BODILY INJURY (Per amdenl $ X AUTOS ONLY x. AIITOB ONLY ,Pare.RO nIDAMAGE $ IS A 1 UMBRELLA LIAB X OCCUR EACH OCCURRENCE. S 5,000,000 X I EXCESS LIAB I_ � CLAIMS -MADE EXA121387601 1010112022I1 0/0112023 _._. AGGREGATE 5,000,600 § OEO X RETENTIONS O C WORKERS COMPENSATIONOTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE SNP1361566 10/01/2022 10/01/2023 - 1,000,000 $ E.L. EACH ACCIDENT IFFIppERIMEEMgg��pp EXCLUDED? FYI �andetorytn NH) MIA EL DISEASE_EAEMPLOYE If yes. describe under 5_-- _---1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below 1,000,000 D Contractors Equip 6X71606 10/0112022,10/01/2023 Equipment 100,000 E Prof Liability PL02262021 03/1712022103/17/2023 Prof Liab 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES ACORD 101. Additional RemerRs Schedule, maybe attached if more space is required) D I� � *30 days cancellation provision reverts to 10 days in the event of non- pa mentofpremium. 1 2 2�22 Ci ofGilroy, its officers, officials and employees are named as an OCT itional ad insured with respects to the General Liability per form attached. GILROY CITY CLERICS OFFICE CFRTIFICATF Hrll nPP I-Atdrel I ATIn AI CITYGIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy, its Officers, officials and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95020-6197 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BRYON-1 CERTIFICATE OF LIABILITY INSURANCE I DATE IMMIDDIYYYY) 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 909-509-8103 ICONTACT Homewell Insurance Sew, Inc NAME PRONE 909.509$103 - FA% 909-257-3027 901 Via Piemonte Ste 205 _JA/C,_NciEXtL-t_AiC, N1 Ontario, CA 91764_$Lnly__— _.— ___ Inc. Circle Suite 107 s, CA 92653 rnVPRAr9PC r-PRTIPICATF NI IMRPR- RPVIQrnlu 1u IMRPR- 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. INSRj rypE OF INSURANCE DOL UBR pOLICYNUMBER POLICY EFF POLICY EXP� L MITS A X COMMERCIALGENERALLIABWTY _- CLAIMS -MADE I X I OCCUR X AES120970201 10/0112022 10/01/2023 EACH OCCURRENCE $ 1,000,000 100,000 $__ _ _DAMAGE DAMAGE TO RENTED _MEDEXPLAnywe_ emn _ $5,000 PERSONAL A ADV INJURY -. $ 1,000,000 GENERAL AGGREGATE GEN'L 1 AGGREGATE---- LIMIT APPLIES PER . R POLICVI X] JRO- -J LOC OTHER EGA 2,000,000 $ _ _ $ 2,000,000 PRODUCTS - COMP/OP AGG IEBL $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO %t AUUTTO6WNLEDp A TU RA X AUTOS ONLY AUTO ONLY BYAU396313 10/01/2022 10/01/2023 CCOMBINED SINGLE LIMIT BODILY INJURY(Parr $ 1,000,000 e _ S $ - _ -- BODILY INJURY Per awde_,X PftaOaP�Et MAGE P -- A UMBRELI A LIAR X OCCUR X Excess une CLAIMS -MADE OLD X RETENTION$ 0 1j EXA121387601 f 10/01/2022 EACH,OCCURRENCE 10101I2023 AGGREGATE_ ___ _ 51000,000 $— ___ $ 5,000,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY f�alpp %I.MIEIMAW,, EXCLUDED? CUTIVE YIN (ManEaMryln NH)EXCLUDE09 II yas. scnbe uMer Ee DESCRIPTION OF OPERATIONSbeam NIA SNP1361566 10/01/2022 X PER OTH- . ST __ 10/01/2023�, EL EACHAC GENT _ EL DISEASE - EA EMPLOYE - EL DISEASE -POLICY LIMIT _.. ..... _ ... §__ 1,000,000 $ 1,000,000 1,000,000 D E Contractors Equip IProf Liability I �GX1 1606 PL02262021 i 10/0112022 103/1712022 10/01/2023 Equipment 0311712023, Prof Liab 100,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached if mare space is real i \VJD *Cancellation provision reverts to 10 days for non-payment of premium. Certificate holder to be included as additional insured with respects to the OCT 12 2022 General Liability perform attached. GILROY CRY CLERICS OFFICE rPRTIFIrATP Hni nPR rAMrPI I ATInM CITYGIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE DATE NOTICE WILL BE DELIVERED IN ACCORDANCEION PROVISIONS. WITH HE POLICY PRO Attn: Rick Brandini 7361 Rosanna Street Gilroy, CA 95020-6197 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD