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COI - Verizon Wireless, LLC - Expires 2024-06-30AC Ro O® t� CERTIFICATE OF LIABILITY INSURANCE OgTEOIMwDDD2" 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 Aon Risk services Northeast, Inc. New York NY Office CONTACT NAME: PHONE INC. No. ExO; (866) 283-7122 (800) 363-0105 E-MNL ADDRESS: One Liberty Plaza 165 Broadway, suite 3201 New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC M INSURED INSURER A: Liberty Mutual Fire Ins Co 23035 verizon wireless, LLC 1095 Avenue of the Americas New York NY 10036 USA INSURER B: LM Insurance Corporation 33600 INSURER C: Liberty Insurance Corporation 42404 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570100672857 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. Limps shown are as requested INSH LTR TYPE OF INSURANCE AUDI INSD BUSH MO POLICY NUMBER POLICY LEE MWDDMYYI POLICY EXI, (MIWDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY Ta EACH OCCURRENCE $1, 000, 000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence$2,000,000) X MED EXP (Any one person) 510, 000 XCU Coversge N mciuded PERSONAL &ADV INJURY S1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S2,000,000 X POLICY ❑JEST1-1 LOC PRODUCTS - COMPIOP AGO $2,000,000 OTHER: A AUTOMOBILE LIABILITY AS2-691-550588-123 ADS 06/30/2023 06/30/2024 COMBINED SINGLE LIMIT (Ea accident $2,000,000 BODILY INJURY(Perpersonl A ANYAUTO AS2-691-550588-133 06/30/2023 06/30/2024 BODILY INJURY (Par =Want) A OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON-OWNED ONLY AUTOS ONLY I NH - Primary TL2-691-550588-183 NH - E%Cess 06/30/2023 06/30/2024 PROPERTY DAMAGE Par aecrtlen UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DED1 IRETENTION B a WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/ PARTNERI EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NM If yes,descMeunde, 0 SCRIPTK)N OF OPERATIONSbelow NIA Wq 69D550$ ADS wc56915$0588083 WI, MN 30 202 06/30/2023 06 2 4 06/30/2024 X PERSTATUTE OTH- ER E.L. EACH ACCIDENT s1, 000, 000 E.L DISEASE EAEMPLOYEE Y1,000,000 E.L DISEASE POLICY LIMIT S110001000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Named insured includes: GTE Mobilnet of California Limited Partnership dba verizon wireless. The city of Gilroy and its elected and appointed council members, board members, commissioners, officers and officials are included as Additional Insured with respect to the General Liability and Automobile Liability policies. The General Liability policy shall apply as Primary Insurance to each Additional insured listed herein. G-91EPT7 V 0 2 py CERTIFICATE HOLDER II 11 n u mnnn I CANCELLATION y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE GILROY MY CLERICS OFFICE POLICY PROVISIONS. City of Gilroy AUTHORIZED REPRESENTATIVE Attn: City Administrator 7351 Rosanna Street Gilroy CA 95020 USA (4 &P_ Q 5f% ,roa O Qi 01988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027366 LOC #: ACORU® ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk Services Northeast, Inc. verizon Wireless, LLC POLICY NUMBER See Certificate Number: 570100672857 CARRIER NAIC CODE See certificate Number: 570100672857 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. 1NSR t;FR TYPE; OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE IMM/Dll/YYYYf POLICY EXPIRATION DATE (M!✓UDU/YYl'1') LIMITS WORKERS COMPENSATION C N/A WA769D550588073 MA 06/30/2023 06/30/2024 ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number TB2-691-550588-143 COMMERCIAL GENERAL LIABILITY CG20261219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. { Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: AS2-691-550588-123 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 the 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. SCHEDULE Name Of Person(s) Or Organ ization(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. 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 11 - 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. CA 20 48 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 Certificate No: 570100673125 AON City of Gilroy Attn: City Administrator 7351 Rosanna Street Gilroy CA 95020 USA Wednesday, July 12, 2023 To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570100673125) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. MSC# 17755 1 Aon P.O. Box 1447 Lincolnshire, IL 60069 rrm . 1 3*4.`= 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/07/2023 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 endorsement(s). PRODUCER Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME' PHONE (A/C. No. Ext): (866) 283-7122 aC No.): (800) 363-0105 E-MAIL ADDRESS: One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Liberty Mutual Fire Ins CO 23035 Verizon wireless, LLC 1095 Avenue of the Americas New York NY 10036 USA INSURER B: LM Insurance Corporation 33600 INSURERC: Liberty Insurance Corporation 42404 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570100673125 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDD/YYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR XCU Coverage is Included TB EACH OCCURRENCE S1,000,000 PREMISES Ea occurrence)$2 , 000, 000 X MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $110001000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECT PRO- LOC OTHER: GENERAL AGGREGATE $2 , 000 , 000 PRODUCTS COMPlOP AGG $2 , 000 , 000 A A A AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY AS2-691-550588-123 ADS AS2-691-550588-133 NH - Primary TL2-691-550588-183 NH - Excess 06/30/2023 06/30/2023 06/30/2023 06/30/2024 06/30/2024 06/30/2024 COMBINED SINGLE LIMIT (Ea accident $2,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAB EXCESS LIAB H OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? a (Mandatory in NH) It yos, doscribe under DESCRIPTION OF OPERATIONS below NIA WA569D55 588093 AOS WC5691550588083 WI, MN 06 30 2023 06/30/2023 06/30/2024 06/30/2024 X PER STATUTE I OTH. ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1, 000, 000 E.L. DISEASE -POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Named Insured includes: GTE Mobilnet of California Limited Partnership dba verizon wireless. The City of Gilroy and its elected and appointed council members, board members, commissioners, officers and officials are included as Additional Insured with respect to the General Liability and Automobile Liability policies. The General Liability policy shall apply as Primary Insurance to each Additional Insured listed herein. CERTIFICATE HOLDER L ry 0 ti- e� r.— ad SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Gilroy AUTHORIZED REPRESENTATIVE Attn: City Administrator 7351 Rosanna Street Gilroy CA 95020 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CANCELLATION a A 0 m v O A 0 o= �a -� z v C �v_ z vo r° m D m "~ D 0 n O� M n -i Cl) cr m = 3 c m a• m c O o m O .-► O CD f7 n to = a M v --x C Co O O S O b 0 O 0 �c c n z 0 n �7 O m v+ n o , � m � o � D H � O Z •r ^ Z D 7p p� O� D v o� 0 � t!1 T 00D0 -ne O w x O 01 m w _.�. T �p�C W vpi � r•. � y�0 C r N � z m m x Cl)V• v 0 v_ Z O m _a n �# n v v z a r m v N m � m n = z c J. J. -J.m 7r J. J. (p r�am+ < M m z z aa o - fD (D 'S i 7 e't V7 V1 14 O V r'F ,J O .. O O p H C1 O 3 V 14 n w w F-' N NJ D O O m m � n n .�. O 1 N m O cZii o � � D :E m m �, o ro J f0 r r n m Cl)I V rn v C r m a fi vi V 0 p 0 0 0 N V W rn rn Policy Number T132-691-550588-143 COMMERCIAL GENERAL LIABILITY CG 20 26 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are • required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: AS2-691-550588-123 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 the 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. SCHEDULE Name Of Person(s) Or Organization(s): kny person or organization whom you have agreed in writing to add as an additional insured, but only to :overage and minimum limits of insurance required by the written agreement, and in no event to exceed either he scope of coverage or the limits of insurance provided in this policy. 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 11 - 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. CA 20 48 1013 0 Insurance Services Office, Inc., 2011 Page 1 of 1