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Rincon Consultants - Insurance CertificatesRINr_rnki-n'1 P14ILLIPSC CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/1412017 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 License # OE67768 Legends Environmental Ins. Services 13 0 Vantis Suite 250 Aliso Viejo, CA 92656 rC2ArCT Elizabeth Leach HO,N o, Ext): (949) 297 -5537 52011 FAX, No :(949) 297 -5960 RORESS: Elizabeth.Leach@ioausa.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Crum & Forster Specialty Insurance Company 44520 INSURED Rincon Consultants, Inc. 180 N Ashwood Ave Venture, CA 93003 INSURER B : Trumbull Insurance Company 27120 INSURER C: StarStone National Insurance Company 25496 INSURER D: INSURER E : EACH OCCURRENCE INSURER F: rnVFl7er:FC rFRnFIrATF NI MRF:R- 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 LTR TYPE OF INSURANCE ADDDL SUBDR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3'000'000 CLAIMS -MADE OCCUR X X EPK714155 09/2212016 09122/2018 PREMISES TO RENTED $ 50,000 X MED EXP (Any one person) $ 10'000 Transportation Poll. PERSONAL & ADV INJURY $ 3'000'600 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: ❑JC JE'T , LOC GENERAL AGGREGATE $ 4'000'000 PRODUCTS - COMP /OP AGG $ 4,000,000 Deductible $ 2,500 X OTHER: Contractors Pollution Liability B AUTOMOBILE LIABILITY (CEO, aBcidED SINGLE LIMIT $ 1,000,000 BODILY INJURY Per person) $ X ANY AUTO X X 72UUNPT4318 1211712017 12/17/2018 AURTEO�S ONLY AUTOOSVUyLEEDD BODILY INJURY Per accident $ X AUTOS ONLY X AUOTOS ONLY X jfgColl Ded Perr../Cent AMAGE $ A UMBRELLA LIAB �Xj OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE 5,000,000 X EXCESS LIAB I I CLAIMS =MADE EFX108624 09/22/2017 09/22/2018 DED I X I RETENTION $ 1 0,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN FFICER/MEMBEER EXCLUDED? ❑N Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X T10170329 02/01/2017 02/01/2018 X PTAT TE OTH- FR E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 • Professional Liab * EPK114155 09122/2016 09122/2018 Per Claim 3,000,000 • Professional Liab * EPK114155 09122/2016 0912212018 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) *Professional Liability and Transportation Pollution Liability are written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. Professional Liabilty Deductible $10,000 Each Claim. Re: 15 -01971 City of Gilroy On -Call Services City of Gilroy, its officers, officials, and employees are Additional Insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement EN0147 -1111, EN0320 -0211, EN0321 -0211 & HA99160312. SEE ATTACHED ACORD 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE City of Gilroy, its officers, officials and employees 7351 Rosanna Street ACORD 25 (2016/03) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: RINCCON -01 LOC #: 1 '4C40R V' ADDITIONAL REMARKS SCHEDULE PHILLIPSC Page 1 of 1 AGENCY License # OE67768 NAMED INSURED Legends Environmental Ins. Services 180 N Ashw Consultants, Ave Inc. Ventura, CA 93003 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EFFECTIVE DATE: SEE PAGE 1 EE PAGE 1 SEE P 1 MCIVIAMINQ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations /LocationsNehicles: Liability Coverage is Primary and Non - Contributory as required by written contract, per endorsement EN0147 -1111 & HA99160312. Blanket Waiver of Subrogation applies to General Liability, Auto Liability and Workers Compensation as required by written contract, per Endorsement EN0147 -1111, HA99160312 & WC000313. Excess policy follows General Liability, Auto Liability and Employers Liability form. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RINCCON -01 PHILLIPSC CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 9/11/2017 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 License # OE67768 Legends Environmental Ins. Services 13 Suite 250 Suite 250 NAMEACT Elizabeth Leach A /CN o, Ext) (949) 297 -5537 52011 FAX No) (949) 297 -5960 E-MAIL Elizabeth. Leach@ioausa.com ADDRESS INSURER (S) AFFORDING COVERAGE NAIC # Aliso Viejo, CA 92656 INSURER A Crum & Forster Specialty Insurance Company 44520 INSURED INSURER B Trumbull Insurance Company 27120 INSURER StarStone National Insurance Company 25496 Rincon Consultants, Inc. INSURER D EPK114155 180 N Ashwood Ave Ventura, CA 93003 INSURER E INSURER F 50,000 $ COVERAGES CERTIFICATE NUMBER- 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 IN SR LTR TYPE OF INSURANCE ADDL D SUBR D POLICY NUMBER POLICY EFF M DD POLICY EXP M DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3'000'000 CLAIMS -MADE X OCCUR X X EPK114155 09/2212016 09/22/2018 DAMAGE TO RENTED PREMISES Ea occurrence 50,000 $ MEO EXP (Any one person) $ 10,000 X Transporation Poll. PERSONAL & ADV INJURY $ 3'000'000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY Fx1 ,E LOC GENERAL AGGREGATE $ 4'000'000 PRODUCTS - COMP /OP AGG $ 4'000,000 X OTHER Contractors Pollution Liability Deductible $ 2,500 B AUTOMOBILE LIABILITY EOe ao dent SINGLE LIMIT $ 1,000,000 BODILY INJURY Per person) $ X ANY AUTO X X 72UUNPT4318 12/17/2016 1211712017 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ Pa,. ,de^t AMAGE $ X X W E AUTOS ONLY X AUTOS ONLDY P9 Coll Ded A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5'000'000 X EXCESS LIAB CLAIMS -MADE EFX108624 09/2212017 09/22/2018 AGGREGATE $ 5'000,000 DIED I X I RETENTION$ 10,000 $ C NPLENT ION AND EMPLOYERS' IA ANY PROPRIETOR/PARTNER/EXECUTIVE Y® PtNandat /MEMBE NH) EXCLUDED If yes, describe under DESCRIPTION OF OPERATIONS below NIA X 710170329 02/01/2017 02/01/2018 X PTAT T ERH E L EACH ACCIDENT $ 1'000'000 E L DISEASE - EA EMPLOYE 1,000,000 $ E L DISEASE -POLICY LIMIT $ 1,000,000 • Professional Liab' EPK114155 09/22/2016 09122/2018 Per Claim 3,000,000 • Professional Liab' EPK114155 09/22/2016 09/22/2018 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re. 15 -01971 City of Gilroy On -Call Services *Professional Liability and Transportation Pollution are written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. City of Gilroy, its officers, officials, and employees are Additional Insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement EN0147 -1111, EN0320 -0211, EN0321 -0211 & HA99160312. Liability Coverage is Primary and Non - Contributory as required by written contract, per endorsement EN0147 -1111 & HA99160312 Blanket Waiver of SEE ATTACHED ACORD 101 ►ea.tar City of Gilroy, its officers, officials and employees 7351 Rosanna Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ACORD 25 (2016/03) 0)1988 -2015 ACORD CORPORATION All rinhfc roccrvnri The ACORD name and logo are registered marks of ACORD ACGORO' AGENCY CUSTOMER ID: RINCCON -01 LOC #: ADDITIONAL REMARKS SCHEDULE PHILLIPSC Page 1 of 1 AGENCY License # OE67768 NAMED INSURED Legends Environmental Ins. Services 180 N Ashwood Consultants, Inc. Ventura, CA 93003 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations /LocationsNehicles: Subrogation applies to General Liability, Auto Liability and Workers Compensation as required by written contract, per Endorsement EN0147 -1111, HA99160312 & WC000313. Excess policy follows General Liability, Auto Liability and Employers Liability form. AWKD 1U1 (ZUUB /U7) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RINCCAN_M P14ILLIPSC '4��® CERTIFICATE OF LIABILITY INSURANCE (MWDD) DA1/27/2017 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 suchendorsement(s). PRODUCER License #OE67768 NAppMEACT Elizabeth Leach Legends Environmental Ins. Services 130 Vands Suite 250 (v°c ,No Ext : (949) 297 -5537 52011 FAX No): ADA&ss: Elizabeth.Leach@ioausa.com Aliso Viejo, CA 92656 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Crum, & ForsterSpecialty Insurance Company 44520 .09/2212018 INSURED INSURERS: Trumbull Insurance Company 27120 INSURER C: StarStone National Insurance Company 25496 Rincon Consultants, Inc. INSURER D : $ 10,000 180 N Ashwood Ave Ventura, CA 93003 INSURER E: PERSONAL & ADV INJURY INSURER F: COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER fMPOUCY EFF .POLICY EXP LIMITS A X. COMMERCIAL. GENERAL LIABILITY CLAIMS -MADE FX—] OCCUR X X EPK114155 09/2212016 .09/2212018 EACH OCCURRENCE $ 3,000,000 DAMAGET TO T D PREMISS $ 50,000 MED EXP (Any one person) $ 10,000 X Transporation Poll. PERSONAL & ADV INJURY 3,000'000, GEN'L AGGREGATE LIMIT APPLIES PER: HPOLICY ❑X PEST F7 LOC GENERAL AGGREGATE 41000'000 PRODUCTS - COMP /OP AGG $ 4,000,000 x OTHER: Contractors Pollution Liability Deductible $ 2,500 B AUTOMOBILE LIABILITY Ea accid.D.SINGLE LIMIT $ 1,000,000 BODILY INJURY Per. person) $ X ANYAUTO X X 72UUNPT4318 12/17/2016 12/17/2017 OWNED SCHEDULED AURTEO�S ONLY AUTOS -BODILY BODILY.INJURY (Per accident) - $ X. X D AUTOS ONLY X AUTO ONLY Coa/Coll' Ded 3$ Parr amide t AMAGE $, $_ A UMBRELLA LUU3 X OCCUR EACH OCCURRENCE $ 51000,000 X EXCESS LIAB CLAIMS -MADE EFX106084 09/2212016 0912212017 AGGREGATE $ 5'000'000 DED X RETENTION $ 101000 C AND E PLOVERS' N LIABILITY TION ANYPROPRIETORIPARTNER /EXECUTIVE YIN QF�FICER/MEMggEER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X 710170329 02/01/2017 02/01/2018 X PER OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE' -'EA EMPLOYE $ 1,000,000 . E.L. DISEASE- 'POLICY LIMIT 1,000,000 ' • Professional Liab.' EPK114155 09/22/2016 09122/2018 Per Claim 3,000,000 • Professional Liab' EPK114155 09/2212016 0912212018 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 15 -01971 City of Gilroy On -Call Services 'Professional Liability and Transportation Pollution are written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. City of Gilroy, its officers, officials, and employees are Additional Insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement CG20100704, CG20370704 & HA99160312. Liability Coverage is Primary and Non - Contributory as required by written contract, per endorsement CFENV 01 036 10 13 & HA99160312. Blanket Waiver of Subrogation applies SEE ATTACHED ACORD 101 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 REPRESENTATIVE City of Gilroy, its officers, officials and employees 7351 Rosanna Street 25 (2016/03) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: RINCCON -01 LOC #: 1 ACCOREV ADDITIONAL REMARKS SCHEDULE PHILLIPSC Page 1 of 1 AGENCY License # OE67768 NAMED INSURED Legends Environmental Ins. Services 9 180 N Consultants, Inc. 780 N Ashwood Ave Ventura, CA 93003 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: to General. Liability, Auto Liability and Workers Compensation as required by written contract, per Endorsement CG 24 0410 93, HA99160312 & WC000313. Excess policy follows General Liability, Auto Liability and Employers Liability form. ACORD 101 © 2008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD POLICY # EPK114155 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART SCHEDULE IName Of Additional Insured Person(s) or Organization(s) Required By Written Contract. A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability arising out of "your work" for that person or organization performed by you, or by those acting on your behalf. B. As respects additional insureds as defined above, this insurance also applies to "bodily injury" or "property damage" arising out of your negligence when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to these additional insureds shall apply as excess and not contribute as primary to the insurance afforded by this endorsement. 2. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for injury or damage arising out of "your work" performed under a written contract with that person(s) or organization(s). 3. The term "additional insured" is used separately and not collectively, but the inclusion of more than one "additional insured" shall not increase the limits or coverage provided by this insurance. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0147 -1111 Page 1 of 1 POLICY #: EPK114155 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Person(s) or Organization(s): Location And Description Of Completed Operations Where Required by Written Contract. Where Required by Written Contract. Information required to complete this Schedule, if not shown above, will be shown in the Dec_larations.. A. Section III — Who Is An Insured within the Common Provisions is amended to include as an insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused; in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the products- completed operations hazard ". EN0320 -0211 Page 1 of 1 POLICY #: EPK114155 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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): Locations of Covered Operations Where Required by Written Contract. Where Required by Written. Contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section III — Who Is An Insured within the Common Provisions 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" cause, in whole or in part, by: 1. Your acts or omissions; or 2. The acts, or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 3. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 4. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. EN0321 -0211 Page 1 of 1. COMMERCIAL AUTOMOBILE HA 99 16 03 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A.1. - WHO IS AN INSURED - of SECTION II - LIABILITY COVERAGE is amended to add: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. D. Additional Insured if Required 'by Contract (1) Paragraph A.1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add: f. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured ", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto." © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 1 of 5 The insurance afforded to any such E. Primary and Non- Contributory if additional insured applies only if the Required by Contract "bodily injury" or "property damage" Only with respect to insurance provided to occurs: an additional insured in 1.D. - Additional (1) During the policy period, and Insured If Required by Contract, the (2) Subsequent to the execution of such following provisions apply: written contract, and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written to the additional insured. agreement that this insurance be (2) How Limits Apply primary. If other insurance is also primary, we will share with all that other If you have agreed in a written contract insurance by the method described in or written agreement that another Other Insurance 5.d. person or organization be added as an additional insured on your policy, the (4) Primary And Non - Contributory To Other most we will pay on behalf of such Insurance When Required By Contract additional insured is the lesser of: If you have agreed in a written contract (a) The limits of insurance specified in or written agreement that this insurance the written contract or written is primary and non - contributory with the agreement; or additional insured's own insurance, this (b) The Limits of Insurance shown in insurance is primary and we will not seek contribution from that other the Declarations. insurance. Such amount shall be a part of and not Paragraphs (3) and (4) do not apply to other in addition to Limits of Insurance shown insurance to which the additional insured in the Declarations and described in this has been added as an additional insured. Section. When this insurance is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the insured against any "suit" if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit ". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all insured must submit such claim or "suit" those other insurers. to the other insurer for defense and When this insurance is excess over other indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss, if any, that exceeds the sum to the extent that you have agreed in a of: written contract or written agreement (1) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance; and own insurance. (2) The total of all deductible and self- insured (4) Duties in The Event Of Accident, Claim, amounts under all that other insurance. Suitor Loss We will share the remaining loss, if any, by the If you have agreed in a written contract method described in Other Insurance 5.d. or written agreement that another person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto" you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT, CLAIM , SUIT by adding the following: OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 2 of 5 If an "employee's" personal insurance also 5. applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees ". Coverage is excess over any other collectible insurance. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss "; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident ", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident ". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees ", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000.. 6. LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto ", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan /lease. "Outstanding balance" means the amount you owe on the loan /lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 7. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 8. ELECTRONIC EQUIPMENT BROADENED COVERAGE a. The exceptions to Paragraphs B.4 - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss ", is: (1) Permanently installed in or upon the covered "auto'; (2) Removable from a housing unit which is permanently 'installed in or upon the covered "auto (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or © 2011, The Hartford (Includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc., with its permission.) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section III — Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C.2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss ", is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto ", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident ", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 14. HIRED AUTO - COVERAGE TERRITORY Paragraph e. of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos ", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. No deductible applies to glass damage if the 15. WAIVER OF SUBROGATION glass is repaired rather than replaced. TRANSFER OF RIGHTS OF RECOVERY 11. TWO OR MORE DEDUCTIBLES AGAINST OTHERS TO US - of SECTION IV - Under Paragraph D. - DEDUCTIBLE - of SECTION BUSINESS AUTO CONDITIONS is amended by III - PHYSICAL DAMAGE COVERAGE, the adding the following: following is added: ©2011, The Hartford (Includes copyrighted material Form HA 9916 03 12 of ISO Properties, Inc., with its permission.) Page 4 of 5 We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 16. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 17. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. 18. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non - hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a.lf the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10 %, to a maximum of $2,500, of the "non- hybrid" auto's actual cash value or replacement cost, whichever is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. For the purposes of the coverage provision, a.A "non - hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. b.A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 19. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto ", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. ©2011, The Hartford (Includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc., with its permission.) Page 5 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule WHERE REQUIRED BY WRITTEN CONTRACT, PROVIDED THE CONTRACT" IS SIGNED AND DATED PRIOR TO THE DATE OF LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE SHALL THE PROVISIONS AFFORDED BY THIS ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. Per Policy Minimum Waiver Premium by State: $500:. AL, AR, CA, CO, CT, DC, ID, IL, IN, IA, KS, ME, MD, MI, MS, MT, NV, NM, OH, OK, OR, PA, RI, SD, UT, VT, VA, WA, WV $250: AK, DE, LA, NY '$100: NC $50: WI N /A: AZ; FL, GA, HI, MA, MN, MO, NE, SC, TN, TX This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/01/17 Policy No. T10170329 Endorsement No. 5 Insured Rincon Consultants, Inc Policy Effective Date 02/01/17 Insurance Company StarStone National Insurance Company Countersigned Bye WC 00 03 13 (Ed. 4 -84) Copyright 1983 National Council on Compensation Insurance. RINCCON -01 PHILLIPSC - r CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 12/29/2016 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 License # OE67768 CRWCT Elizabeth Leach PHONE FAX (A/C, No, Et): (949) 297 -5537 52011 A/C, No): Le ends Environmental Ins. Services 130 Yantis Suite 250 E-MAIL SS: Elizabeth.Leach @ioausa.com Aliso Viejo, CA 92656 INSURERS AFFORDING COVERAGE NAIL # INSURER A: Crum & Forster Specialty Insurance Company 44520 09/22/2018 INSURED INSURER B: Trumbull Insurance Company 27120 INSURERC: 50,000 Rincon Consultants, Inc. INSURER D $ 10,000 180 N Ashwood Ave Ventura, CA 93003 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INTE TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X EPK114155 0912212016 09/22/2018 EACH OCCURRENCE $ 3'000'000 DAMAGE TO RENTED PREMI occurrence) 50,000 MED EXP (Any one person) $ 10,000 X Transporation Poll. PERSONAL & ADV INJURY $ 3'000'000 AGGREGATE LIMIT APPLIES PER: POLICY ❑X PEar LOC GENERAL AGGREGATE $ 4,000,000 GEN'L PRODUCTS- COMP /OP AGG $ 4,000,000 X OTHER: Contractors Pollution Liability Deductible 2,500 B AUTOMOBILE LIABILITY EOM�BIINdEeD SINGLE LIMIT $ 1,000,000 BODILY INJURY Per $ ANY AUTO OWNED .SCHEDULED AUTOS ONLY AUTOS X X 72UUNPT4318 12/17/2016 12117/2017 BODILY BODILYINJURY (Per accident $ AUTOS ONLY X pU 0 ONED C,�ino/Coll Ded 5$ PerracEcident AMAGE $ XI A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5'000'000 AGGREGATE $ 5,000,000 X EXCESS LIAB CLAIMS -MADE EFX106084 09/22/2016 0912212017 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE FICER/MEMBER EXCLUDED? WIand story In NH) If yes, describe under DESCRIPTION N/A PER OTH- TAT T ER E.L. EACH ACCIDENT $ E.L. DISEASE - .EA.EMPLOYE $ E.L. DISEASE - POLICY LIMIT OF OPERATIONS below • Professional Liab.' EPK114155 09/22/2016 09122/2018 Per Claim 3,000,000 • Professional Liab' EPK114155 09/22/2016 09/22/2018 Aggregate 4,000,000 DESCRIPT10N OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101,. Additional Remarks Schedule, may be attached If more space is required) Re: 15 -01971 City of Gilroy On -Call Services *Professional Liability and Transportation Pollution are written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. City of Gilroy, its officers, officials, and employees are Additional Insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement CG20100704, CG20370704 & HA99160312. Liability Coverage is .Primary and Non- Contributory as required by written contract, per endorsement CFENV 01 036 10 13 & HA99160312. Blanket Waiver of Subrogation applies SEE ATTACHED ACORD 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE City of Gilroy, its officers, officials and employees 7351 Rosanna Street AGUKU 25 (2016103) @ 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: RINCCON -01 LOC #: ADDITIONAL REMARKS SCHEDULE PHILLIPSC Page 1 of 1 AGENCY License # OE67768 NAMED INSURED Legends Environmental Ins. Services 9 180 N Consultants, Inc. 180 N Ashwood Ave Ventura, CA 93003 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations /LocationsNehicles: to General Liability and Auto Liability as required by written contract, per Endorsement CG 24 0410 93 & HA99160312. Excess policy follows General Liability, Auto Liability and Employers Liability form. ACORD 101 (2008/01) C 2008 ACORD CORPORATION. All rights reserved_ The ACORD name and logo are registered marks of ACORD