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COI - Davaco LP - Expires 2022-11-01DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 11/1/2021 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 NAAME Stephanie Castle Arthur J. Gallagher Risk Management Services, Inc. PHONE 713-358-5828 ac No): 713-358-5829 1900 West Loop South, Suite 1600 E-MAIL Houston TX 77027 ADDRESS: Stephanie Casfle@ajg.com INSURED Davaco LP 4050 Valley View Lane, Suite 150 Irving, TX 75038 INSURERS AFFORDING COVERAGE NAIC # INSURER A : Aspen American Insurance Company 43460 DAVAINC-01 INSURER B : Hartford Casualty Insurance Company 29424 INSURER C : National Union Fire Insurance Company of Pittsburg19445 INSURER D : Hartford Underwriters Insurance Company_ _ _ ` 30104 INSURER E: AIU Insurance Company 19399 INSURER F: Commerce and Industry Insurance Companv 19410 rnV=aer-=c r9:CITIFIrATG NIIBARFR•,)nrranA1a1 RRVIRInN NIIMRER' 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 'POLICY EFF _ POLICY EXP LTR ! TYPE OF INSURANCE IN D ! WVD) POLICY NUMBER I MMIDDIYYYY I MWDDIYYYY l LIMITS B X ; COMMERCIAL GENERAL LIABILITY I 61 UEADF8281 11/1/2021 I 11/1/2022 I EACH OCCURRENCE i $1.000.000 pj X 61 UEA DF9064 11/1/2021 I 11/1/2022 _ CLAIMS -MADE OCCUR 61 UEA DF9804 11/1/2021 11/1/2022 PREMISES fEa occurrence) -.$ 300,000 1 i ; MED EXP (Any one person) } i $10.000 $1.000,000 , PERSONAL & ADV INJURY I $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ! � I GENERAL AGGREGATE r_ i -- PRO- POLICY! X 1 JECT 1 LOC I PRODUCTS COMP;OP AGG I $ 2.000,000 is OTHER: f I C AUTOMOBILE LIABILITY 11/1/2022 EOMBftVEDLINGLE LIMIT $ j,000,OQ0 CA134149Q 1 V1/2021 a- accdent _ ANY AUTO ; BODILY INJURY (Per person) $ OWNED r SCHEDULED i BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS I X HIRED NON -OWNED I j PROPERTY DAMAGE $ X AUTOS ONLY AUTOS ONLY 1 (Per accident___-.__ i f i$ A X UMBRELLA LIAB ! X i !OCCUR CX0040021 11/1/2021 11/1/2022 EACH OCCURRENCE $10,000,000 $10,000,000 _--.-_ C EXCESS UAB ! CLAIMS -MADE I I AGGREGATE k I ;------�_ oEo RETENTION $ I i $ E WORKERS COMPENSATION WC13751691 -All Other States 1 11/1/2021 11/1/2022 !X i STATUTE 1 I ERH E AND EMPLOYERS' LIABILITY Y / N E i ANYPROPRIETORr'PARTNERJEXECUTIVE F WC 13751692 - CA 11 /1/2021 i I WC13751693 - NY 11/1/2021 11/1 /2022 I 11/1/2022 E.L. EACH ACCIDENT $1,000,000 �. $1,OOQ000 OFFICERIMENIBEFIEXCLUDED? �'N!A` i (Mandatory In NH) j ii WC137516Gap 94 -WI &Stop G; 11/112021 i } 11/1/2022 E.L. DISEASE - EA EMPLOYEE T $1,000,000 11 yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT C Auto Phyyssi�cal Damage ACV 5ublect to Deductible ! CA1341490 11/1/2021 11/1/2022 Deductibles ! See Below j DESCRIPTION OF OPERATIONS / LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Hired Auto Physical Damage Deductibles: Hired or Borrowed Autos: -Comprehensive: $2.500 -Collision: $2,500 FORMS/ENDORSEMENTS IF APPLICABLE: See Attached... CERTIFICATE HOLDER CANC:tLLA I IUN CITY OF GILROY 7351 ROSANNA STREET GILROY CA 121727 USA 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 PRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 3 7561 AGENCY CUSTOMER ID: DAVAINC-01 LOC #: AC40RV ADDITIONAL REMARKS SCHEDULE L__�__ Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Davaco LP 4050 Valley View Lane, Suite 150 Irving, TX 75038 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AL THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE General Liability •Form #HS2424 (12/20) — Contractors Broad Form Endorsement — Texas -Per Project and Per Location General Aggregate Limits of Insurance — A separate Per Project General Aggregate Limit or a separate Per Location General Aggregate Limit applies to each "project" or "location", whichever is applicable. The Per Project General Aggregate Limit and Per Location Aggregate Limit is equal to the amount of the General Aggregate Limit shown in the declarations -Form #HG0001 (09/16) — Commercial General Liability Coverage Form -Other Insurance — Excess Insurance — When You Add Others As An Additional Insured to This Insurance — Primary and Non -Contributory to Other Insurance When Required by Contract -Transfer of Rights of Recovery Against Others To Us — Waiver of Rights of Recovery (Waiver of Subrogation) -Form #IH0307 (06/11) — Notice of Cancellation to Certificate Holder(s) •Form #HS2483 (07113) — Additional Insured — Owners, Lessees, or Contractors — Option IV -Form #CG2404 (05/09) — Waiver of Transfer of Rights of Recovery Against Others to Us •Policy #61UEADG2980 - Puerto Rico Stop Gap - Hartford Fire Insurance Company - Eff 11/1/2021-11/1/2022 Auto Liability •Form #87950 (09/14) — Additional Insured — Where Required Under Contract or Agreement -Form #107232 (03/11) — Limited Advice of Cancellation To Entities Other Than The First Named Insured •Form #62897 (06/95) — Waiver of Transfer of Rights of Recovery Against Others to Us -Form #74445 (10/99) — Insurance Primary As To Certain Additional Insureds •Form #MCS90 (04/21) — Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 Workers' Compensation •Form #WC990045 (07/03 — Notice of Cancellation and Nonrenewal to Certificate Holder -Form #WC000313 (04/84� — Waiver of Our Right to Recover From Others Endorsement -Form #WC340301C (03/10) — Ohio Employers Liability Coverage Endorsement -Form #WC000303C (10/04) — Employers Liability Coverage Endorsement (All Other States) (CITY OF GILROY is additional Insured as respects general liability policy, pursuant to and subject to the policy's terms, definitions, conditions and exclusions ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3" of 3 7561