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COI - Thyssenkrupp Elevator Corporation - Expires 2021-10-01ACORN® Page 1 of 3 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/28/2020 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 endorsements . PRODUCER CONTACT NAME:Aon Risk Services Central Inc. Aon Risk Services Central, Inc. PHONE (A/C No.Ext): (866) 283-7122 FAX (A/C No.Ext): 800 363-0105 200 East Randolph E-MAIL ADDRESS:acs.chicago@aon.com CHICAGO, IL 60601 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: HDI Global Insurance Company 41343 INSURED INSURER B: ACE American Insurance Company 22667 THYSSENKRUPP ELEVATOR CORPORATION INSURER C: Indemnity Insurance Company of NA 43575 INSURER D: ACE Fire Underwriters Insurance Company 20702 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1886880 REVISION NUMRER- 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 INSD SUBR WND POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP (MM/DDNYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY J CLAIMS -MADE a] OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT a LOC OTHER: GLDS6688001 GLD5668900 07/31/2020 10/01/2021 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS ONLY AUTOS ONLY Ir HIRED AUTOS NON -OWNED ISAH25313665 10/01/2020 10/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY(Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS -MADE DED RETENTION $ EACH OCCURRENCE AGGREGATE C B COFFICER/MEMBER WORKERS COMPENSATION YIN AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE D EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WLRC67462671 (AOS) WLRC67462713 (CA,MA) WLRC67462750 (TX) WLRC67462798(WI) 10/01/2020 10/01/2020 10/0112020 10/01/2020 1010112021 10/01/2021 10/01/2021 10/01/2021 X PER STATUTE OTHER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000 000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 Limits shown as requested: DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Division Number: 108750 - Named Insured Includes: ThyssenKrupp Elevator Corporation - Address: 2140 Zanker Road San Jose, CA 95131 Project Number: US117839 - Project Name: OLD CITY HALL - Address: 7400 MONTEREY RD GILROY, CA 95020 - Project Type (s): Elevator Maintenance t►tIK I Ir14A I t MULUtK UANUtLLA 1 IUN 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 7351 ROSANNA ST GILROY, CA 95020 United States ©1988-2016 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ' LOC #: ACORO ADDITIONAL REMARKS SCHEDULE Page 2of3 AGENCY NAMED INSURED POLICY NUMBER THYSSENKRUPP ELEVATOR CORPORATION See First Page CARRIER NAIC CODE See First Page EFFECTIVE DATE: ADDITIONAL REMARKS CERTIFICATE NUMBER: 1886880 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of Gilroy, its officers, officials and employees The Additional Insured(s) listed above is/are added as Additional Insured(s) with respect to Automobile and General Liability policies, but only to the extent required by written contract and only to the extent that coverage is afforded under these policies. ACORD 101 (2008101) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C� i H O (D Q cn w} O E rzff W Wzt-Pi o Z Om> n°C. �Hm¢ = O _� � a 3:WU CnaW JF- C � '- N O ODw DOOWww w .- o w¢O W p�w�m m LL O¢ww<<o �OEL Z : w z Z� aOzwOHw -dZG w F( ¢0() z .o �... QU W wz szo O~Z2t=L _ o W�w�O Ot Z- � O z L= z La C, ¢_j =>Wof-�Qr LLI w Z WW O=�O UWO Ww�=¢C w I-Omb3 � W=;F. u-°o W¢W60OnoLz zNa Z~WF- z G > L ¢zOz aFa ¢o-�-za a z�r CO z CL o w- OOc > OOm OSw-j of-->-Wu.zw a _ cl c~nw UmW. Wcn gzO w v o U' Q- X ma moo=- oom -Zo Q x Xar �Z pwZ LLH~E=-' tr}020Qz V) w H� '' g zg §} aa,- -ouzo U) Co y m �¢ Z-Om �Q-[Oo°'(nU w }� Om�w �¢o�Mwcn H x of w , WO-o O� JO�z oC F, > OZ ¢O W �a U ww °-Wwo 00501 Ed' Z =j z¢WE UWoZwU_aC O �� ¢Ozcn =MOT XCL J N = �- z 4 >- w¢ E-- J C) U F O ¢ o o o Z� C J z z ¢ (DARstate. You're In food 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 17 -- Specifically Described Autos I X 18 - Hired Autos Only X 19 - Nonowned Autos Only Policy Effective Date : 11-16 - 2 0 2 0 1 Policy Expiration Date: 11-16 - 2 0 21 Umitsof $2, 000, 000 Combined Single Limit (each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description ion of O rations/Locations/Vehicles/Endorsements/S aal 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:09-02-20 Includes copyrighted material of Insurance Services Office, Inc., with its permission 13I11>4-3 CI CW A021011 Allstate Insurance Company Additional Insured Copy Page 1 of 1 (WAIstate. You're In good hands. POLICY NUMBER: 04 8 7 516 5 3 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 after 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 2 0 SCHEDULE Name Of Person(s) Or Organization(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. 61A.1-; CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Additional Insured Copy Page 1 of 1