COI - Two Brothers Cathodic Service - Expires 2022-11-16(QlAstate.
You're in good hands.
CERTIFICATE OF INSURANCE
Cl CW A02 10 11
This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued
to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided
by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage
is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other
contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at
the policy inception. Subsequent paid claims may reduce these limits.
Certificate Holder Named Insured:
CITY OF GILROY TWO BROTHERS CATHODIC SERVICE
ITS OFFICERS, OFFICIALS AND 5361 HILLTOP RD
EMPLOYEES AS ADDITIONAL INSURED GARDEN VALLEY CA 95633-9501
7351 ROSANNA ST
GILROY, CA USA 950206141
Automobile Uability
Insurer Name: Allstate Insurance Company
PolicyNumber 048751653
1 --Any Auto
2 - Owned Autos Only
3 — Owned Priv. Pass. Autos Only
4 -- Owned Autos Other Than Priv.
Pass. Autos Only
5 - Owned Autos Subject to
No Fault
6 — Owned Autos Subject to a Compulsory UM Law
X
7 --Specifically Described Autos
X
18 - Hired Autos Only
fX
19 — Nonowned Autos Only
Policy Effective Date: 11-16 - 2 0 21
1 Policy Expiration Date: 11-16 - 2 0 2 2
Limits of
$2, 000, 000
Combined Single Limit (each accident)
Insurance:
BI Per Person
BI Per Accident
PD Per Accident
Description of O rations/Locations/Vehicles/Endorsements/S cial Provisions
Interested Party Type: Additional Insured - Municipality
THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER.
IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST
EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL
INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH
POLICY LANGUAGE OR ENDORSEMENT.
Producer.
CENTURY PARTNERS INSURANCE AGENCY
Authorized Representative:
Date:09-02-21
Includes copyrighted material of Insurance Services Office, Inc., with its permission
BI "''}- 3 CI CW A021011
Allstate Insurance Company
Additional Insured Copy
Page 1 of 1
®Allstate.
You're in good hands.
i"
POLICY NUMBER: 048751653
COMMERCIAL AUTO
CA20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage
provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: TWO BROTHERS CATHODIC SERVICE
Endorsement Effective Date: 11-16 - 2 0 21
SCHEDULE
Name Of Person(s) Or Organizaton(s):
CITY OF GILROY
ITS OFFICERS,OFFICIALS AND EMPLOYEES AS
ADDITIONAL INSURED
7351 ROSANNA ST
GILROY, CA USA 950206141
I Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section II —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
6WI�1 i CA20481013
O Insurance Services Office, Inc., 2011
Additional Insured Copy
Page 1 of 1
September 08, 2021
RLI INSURANCE COMPANY
1 st Addntl Ins Copy
REINSTATEMENT
Policy Number: BOP1047197
Named Insured and Mailing Address Ageni's Name and Mailing Address
JENNY RAY-CAMARA C/O Lindbergh Insurance Agency
JENNY RAY CAMARA
194 Paseo Gularte 9025 N Lindbergh Drive
SAN JUAN BAUTISTA, CA 95045 Peoria, IL 61615
(844) 249-2684
Coverage has been reinstated effective: 09/20/21
Please disregard the Notice of Cancellation previously sent to you: Your policy has been reinstated on the
date and time shown above.
LOSS PA YEE AND ADDRESS:
N/A
LOSS PAYEE AND ADDRESS:
N/A
Attached to and forming a part of the policy of the RLI Insurance Company.
All other terms and conditions remain unchanged.
IBP 503 (11 /00)
CITTOZGELROY
735 I'ROSANNA STREET'
GILROY .CA- 95020
I.J