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COI - Bay Area Community Health - Expires 2024-06-01A� o® CERTIFICATE OF LIABILITY INSURANCE DATE E/12023Yrv) 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(a). PRODUCER Arthur J. Gallagher Risk Management Services, LLC 500 N Brand Boulevard, Suite 100 Glendale CA 91203 CONTACT NAME: Brenda Alda e PHONE t 818.539-8802 FAX No:818-539-8702 fmc. No E-MAIL ADDRESS: Brenda Alda a a' .Coro INSURERS AFFORDING COVERAGE NAICA INSURER A: Pr0AssuranceSpecialty Insurance CO Inc 10179 Llomrsa# OD69293 INSURED TRLHEA41 INSURER B Bay Area Community Health 40910 Fremont Blvd. INSURERC: INSURER D: Fremont, CA 94538 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 645784105 REVISION NUMBER: 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 LTfl OF INSURANCE ADDLSTYPE SR JIMU POLICYNUMBER MNDDfYYYY Y EFF POLICY LIMITS COMMERCIAL GENERALUASIUTY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISES Ea occumencei S MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE If POLICY jECT LOC PRODUCTS - COMP/OP AGG $ S OTHER: AWOMOBILEUABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTO$ BODILY INJURY (Per aodden0 $ _ PROPERTYDAMAGE Per acciffer,t HIRED NON -OWNED AUTOS ONLY AUTOSONLV $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION$ If WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY Y/N I PER STATUTE ERH ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDEDT N/A E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE -- — $ (MandaloryinNH) If as, descnbe umier DESCRIPTIONOFOPERATIONSbatm E.L. DISEASE -POLICY LIMIT "--- $ A Professional Liability/E&O 736420 6/1/2023 6/1/2024 Per Claim $1,00D,000 Reba Date: 11/15/1984 Claims -Made form AV9re$ate $3,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarl s SChadule, may be attached if more space is required) Evidence of insurance. MFFICE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF GILROY ACCORDANCE WITH THE POLICY PROVISIONS. Housing and Community Development Program AAUT'H�OARIZE.OREP SENTATIVE 7351 Rosanna Street Gilroy CA 95020 I�IIVJLL► ., C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher Risk Management Services, LLC 500 N Brand Boulevard, Suite 100 Glendale CA 91203 MDG2023 00010989 01 1111�l�l�l����ll�l�������l�l����l����is1111111111NJ181 511, CITY OF GILROY Housing and Community Development Program 7351 Rosanna Street Gilroy, CA 95020 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: TRI-HEA-01 4. This Certificate Number: 645784105 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www.ajg.com/us/privacy-policy/.