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HomeMy WebLinkAboutPhysio-Control - Insurance CertificatesCERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 01/24/2018 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 Central, Inc. Grand Rapids MI Office CONTACT NAME: (AIC.NNo. Ext): (616) 456 -5366 JC No ): (616) 456 -7451 E -MAIL ADDRESS: 50 Louis Street NW Suite 200 INSURERS) AFFORDING COVERAGE NAIC # Grand Rapids MI 49503 USA INSURED INSURER A: Old Republic Insurance Company 2414.7 Stryker Corporation & Subsidiaries INSURER B: 2825 Airview Boulevard INSURER C: Kalamazoo MI 49002 USA INSURER D: INSURER E: $500,000 INSURER F: Excluded COVERAGES CERTIFICATE NUMBER: 570070044896 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 REQUIREMEN'r, TERM OR CONDITION OF ANY CON'I RACT OR O fHER DOGUMEN I VVI H RESPECT T O VVFiiCH 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 re- uested INSR LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER MM /DDIYYYY MM /DD/ YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y MWZY EACH OCCURRENCE $5,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE T RENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) Excluded PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP /OP AGG $5,000,000 OTHER: A AUTOMOBILE LIABILITY MWTB 312744 02/01/2018 02/01/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY I PROPERTY dent) AGE Per accident X Phys -Dmge -Self Insc UMBRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DED RETENTION A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY' PROPRIEIOR / PARTNER / EXECUTIVE YIN OFF ICER /MEMBEREXCLUDED7 (Mandatory in NH) NIA MWC 312743 00 AOS MWXS 312745 EXcess we - MI 02/01 2018 02/01/2018 —02—/0-1-72-019 02/01/2019 X I PERT ,UTE OTH- E.L. EACH ACCIDENT $1,()00,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Physio- Control, Inc. and -its affiliated companies are named under the referenced policy(s). Governmental Entity (Form G- 56015 -B) city of Gilroy, its officers, officials and employees are included as additional insured (form CG 2026 0413), where required by written contract, in accordance with the policy provisions of the commercial general liability policy. CERTIFICATE HOLDER CANCELLATION 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: Jennifer Baker 7351 Rosanna St._ p p 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 `m w w c m d O 2 ED rn m v 0 0 0 r uo O Z w M V d U CERTIFICATE OF LIABILITY INSURANCE DATE(b"DDNYYY) I . 04126=16 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 poilcy(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 central, Inc. Grand Rapids MI office 50 Louis street Nw suite 200 CONTACT NAME: PHUNIZ (616) 456 -5366 FAX (616) 456 -7451 No.Ext: A1C.No.: EMAIL ADDRESS` INSURER(S) AFFORDING COVERAGE NAICN Grand Rapids MI 49503 USA INSURED INSURER A: old Republic Insurance company 24147 INSURER B: Stryker Corporation & subsidiaries 2825 Airview Boulevard Kalamazoo MI 49002 USA INSURER C: INSURER D: INSURER E: INSURER F; " - - m m a m v 0 z COVERAGES GEKiimC;AtIz NumtJtK: 0 /VVVIvvow/ I ncvrarv,� .. 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 A TYPE OF INSURANCE X COMMERCIAL GENERALUA131UTY CLAIMS -MADE XJ OCCUR S POLICY NUMBER Y UMITs EACH OCCURRENCE $5,000,000 PREMISES Eaoccurrence) 5500'000 MED EXP (Any one person) Excluded m PERSONAL & ADV INJURY $1,000,00 GEML AGGREGATE LIMIT APPLIES PER: �'OTHER: POLICY PRO- LOC GENERAL AGGREGATE $5,000,000 PRODUCTS • COMPIOP AGG 55, 000, 000 A AUTOMOBILEUABIUTY MWTB 305805 02/01/2016 02/01/2017 COMBINED SINGLE UMIT ace • $1,000,000 BODILY INJURY ( Per person) OWNED SCHEDULED AUTOS ONLY AUTOS IxANY AUTO - HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PhpaAm@ Qlf I C Z yf BODILY INJURY (Per accident) PROPERTY DAMAGE Peracdde UMBRELLA I.YtB OCCUR EACH OCCURRENCE G7 AGGREGATE FEXCESS LIAR CLAUS -MADE om RETENTION A A WORKERS COMPENSATION AND EMPLOYERS' LIARILITY YIN ANY FiGERCAAF BEOR R xAOwDmvEXECUTIVE a (Mandatory In NH) It yyeea, deacrlbe under nE9CRIFVON Or OPERATIONS bolow N/A WC 306855 00 AOS MWxs 306856 Excess we - MI 02 O1 0 02/01/201602/01 /2017 PE X R UTE O -- E.L. EACH ACCIDENT $1,000,000 EA- DISEASE-EA EMPLOYEE $1,000.000 E.L DISEASE-POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Addmonal Remarks Schedule, may be akached 9 more space Is required) Physio- Control, Inc. and its affiliated companies are named under the referenced policies effective May 1, 2016. I . Governmental Entity (Form G- 56015 -B) city of Gilroy, its officers, officials and employees are included as additional insured (form CG 2026 0413), where required by written contract, in accordance with the policy provisions of the commercial general liability policy. -aei J0 �e CERTIFICATE HOLDER CANCELLATION 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 Attn: Jennifer Baker 7351 Rosanna St. Gilroy CA 95020 USA a if+�G+fC c%bevix� ECG ✓s'sa 01988 -2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2D 26 04 13 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): All Persons or Organizations with whom the Insured has agreed In a Written Contract or Agreement that is executed prior to loss. 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 shown in the Declarations; whichever is less. This endorsement shall not Increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 MINZY 306858 Stryker Corporation 02/01/2096 - 02/01/2017 ,4c�oR ®® CERTIFICATE OF LIABILITY INSURANCE DATE 2 /2015 /YYYY) 05/02/2015 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 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 Marsh USA, Inc. 1301 5th Avenue, Suite 1900 Seattle, WA 98109 Attn: Seatfle.CertRequest @marsh.com / F: 212- 948.4326 CONTACT NAME: PHONE F� No): EADpRIESS. GENERAL LIABILITY INSURER(S) AFFORDING COVERAGE NAIC A INSURER A: Continental Casualty Company 20443 184424 - STND -GAWUp -15-16 INSURED Physio-Control International, Inc. Physio-Control, Inc. INSURER B.: National Fire Insurance of Hartford 20478 INSURER C : N/A NIA 11811 Willows Road NE Redmond, WA 98052 INSURER D: DAMAGE TO RENTEO PREMISES Ea occurt n $ 1,000,000 MED EXP (Any one person) $ 5,000 INSURER E $ 1,000,000 INSURER F : COVERAGES CERTIFICATE NUMBER: SEA -002373887 -13 RFVISInN NIIMRFR -d3 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. ILT R LTR TYPE OF INSURANCE ADD SUBR POLICY NUMBER POLICY EFF MM DDIYYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY 4030507381 05101/2015 05!01/2016 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR DAMAGE TO RENTEO PREMISES Ea occurt n $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ EXCLUDED X POLICY PRO- LOC $ B AUTOMOBILE LIABILITY 4029265138 05/0112015 05/01/2016 COM.daml SINGLE Ea a ides 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) ,.$ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE Par. n $ COMP / COLL DED. $ 1,000 B X UMBRELLA LIAR X OCCUR 4030507395 05101/2015 05/0112016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE Products - Completed Ops Excluded DED RETENTION $ $ A j WORKERS COMPENSATION 4030507378 (ADS) 05/01/2015 0571/2016 X I WCSTATU- OTH- A AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory,in NH) H yes, describe under DESCRIPTION OF OPERATIONS below NIA 4030507364 (CA) 05I01I2015 05/01/2016 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 (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Additional Insured status applies only it is reflected in your written contract. Governmental Entity (Form G- 56015 -8) City of Gilroy, its officers, officials and employees are included as additional insured under general liability as required by written contract. City of Gilroy Attn: Jennifer Baker 7351 Rosanna St. Gilroy, CA 95020 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 of Marsh USA Inc. Cheryl Bermudez ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER INSURED NAME AND', ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL,. INC. "SEE ENDT" P.O. .BOX 97006 REDMOND, WA 98073 -9706 DOLICr.CAANGES FORM G300415A This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your'Policy and takes effect on the .effective date of your Policy, unleas another effective date is shown. G300415A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION This.endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF GILROY, IT -S OFFICERS, OFFICIALS AND EMPLOYEES (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. 'Section II Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured.. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or - .property damage" occurring after: E� Page 1 of 2 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. s� M 0W. aft Bmd G- 56015 -B (ED. 11191) POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. SOX 97.006 REDMOND, WA 98073 -9706 POLICY.CBANGES FOPS G3' This -Change Endorssmmt changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect bn the effective date of your Policy, unless another effective date is shown. G300415A (1),411 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 insureds) at the site of the covered operations has been completed; or (2) 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. Page 2 of 2 V k;CaZ Ch*MM of the Board G- 56015 -8 (ED. 11191) POLICY NUMBER INSURED NAM AND .ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. sox 97006 REDMOND, WA 9 @073 -9706 ADDITIONAL INSURED SCHMWLA 'LOCATION: Additional Insured Name and Addrease CITY OF GILROY, IT -S OFFICERS, OFFICIALS AND EMPLOYEES ATTN: PHIL KING 735.1 ROSANNA ST GILROY, CA 95020 TYP93 Additional Insured i ® ACC ° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 04/1312015 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 Marsh USA, Inc. 13015th Avenue, Suite 1900 C NT ACT NAME: PHONE FAX E-MAIL ADDRESS: Seattle, WA 98101 Attn: Seattle.CertRequest @marsh.com / F:212- 948 -4326 INSURERS AFFORDING COVERAGE NAIC #- INSURER A : Continenta4Casualty Company 20443 184424- STND -GAWUp -15-16 INSURED Physio-Control International, Inc. Physio-Control, Inc. National Fire Insurance of Hartford INSURER 8: . 20478 INSURER C: N/A N/A INSURER D: 11811 Willows Road NE Redmond, WA 98052 $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 71 PRO LOC PRODUCTS - COMP /OP AGG INSURER E.: ' INSURER F: B AUTOMOBILE COVERAGES CERTIFICATE NUMBER: SEA- 002373887 -13 REVISION NUMBER: 41 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 SUBR POLICY NUMBER MPOL POLICY EFF MPOOLICp EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR 4030507361 05/01015 05/0112016 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 71 PRO LOC PRODUCTS - COMP /OP AGG $ EXCLUDED $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 4029265138 05/01/2015 05/'01/2016 COMBINEDSINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ 1 BODILY INJURY. (Per accident) $ PROPERTY DAMAGE Per accident $ COMP / COLL DED. $ 1,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4030507395 Products - Completed Ops Excluded 05/01/2015 05/0112016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DIED I I RETENTION $ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE (Mandatory In ER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4030507378 (AOS) 4030507364 (CA)05I01I2015 05/01/2015 05/01/2016 05101/2016 X WCSTATU- I 0TH- TORY LIMITS E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured status applies only If it is reflected in your written contract. Govemmentat' Entity (Form G-56015 -B) City of Gilroy, its officers, officials and employees are included as additional insured under general liability as required by written contract City of Gilroy Attn: Jennifer Baker 7351 Rosanna St. Gilroy, CA 95020 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 of Marsh USA Inc. Cheryl Bermudez @ 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD A� °® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) .04/29/2014 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 be endorsed. If SUBROGATION IS-WAIVED, subject to the terns 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 Marsh USA, Inc. 13015th Avenue, Suite 1900 NAME: PHONE No): EMAIL ADDRESS: Seattle, WA 98101 Attn: Seattle.CertRequest @marsh.com I F: 212 - 948 -4326 05/01/2014 05/01/2015 EACH OCCURRENCE INSURERS) AFFORDING COVERAGE NAIC 0 INSURER A: Continental Casualty Company 20443 184424- STND -GAWUp -14-15 INSURED Physio-Control International, Inc. Physio-Control, 'Inc. INSURERS: National Fife Insurance of Hartford INSURER C : NIA N/A INSURER D: GEWL AGGREGATE LIMIT APPLIES PER: X POLICY 7 PRO LOC 11811 Willows Road NE Redmond, WA 98052 $ EXCLUDED $ INSURER E: AUTOMOBILE INSURER F: COVERAGES CERTIFICATE NUMBER: SEA - 002373887 -08 REVISION NUMBER:41 . 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 CONTRACTOR 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 SUBR POLICY NUMBER MM /DDY� MM/DDY� LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR 4030507381 05/01/2014 05/01/2015 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: X POLICY 7 PRO LOC PRODUCTS - COMP /OP AGG $ EXCLUDED $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED HIRED AUTOS AUTOS 4029265138 05/01/2014 05/01/2015 COMBINED SINGLE LIMIT Ea acciden 1,000,000 X BODILY INJURY (Per person) ! $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE r n $ COMP / COLL DED. $ 1,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4030507395 Products Completed Ops Excluded 05/01/2014 05/01/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? (Mandatory In NH) IF es, describe under DESCRIPTION OF OPERATIONS below NIA 4030507378 (ADS) 4030507364 (CA) 05/01/2014 05/0112014 05/01/2015 05101/2015 X TNC STATU- OTH- 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 (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured status applies only I it is reflected in your written contract Governmental Entity (Form G- 56015 -B) City of Gilroy, its officers, officials and employees are included as additional insured under general liability as required by written contract la City of Gilroy Attn:Jennifer Baker 7351 Rosanna St. Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. of Marsh USA Inc. Cheryl Bermudez © 1988 -2010 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD reserved. A� °® CERTIFICATE OF LIABILITY INSURANCE DATE(MMID °"""' 0412612013 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 be endorsed. If SUBROGATIQN 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 Marsh USA, Inc. 1301 5th Avenue, Suite 1900 CONTACT NAME: PHONE AIC No EMAIL ADDRESS: Seattle, WA 98101 Attn: SeaRle.CeORequesl@marsh.com I F: 212 - 948 -4326 INSURERS AFFORDING COVERAGE NAIC q INSURER A : Valley Forge Insurance Cc 20508 184424 -IS5- CAS -13 -14 INSURED Physio-Control International, Inc. Physio - Control, Inc. INSURER B : National Fire Insurance Co Of Hartford 20478 INSURER C: NIA NIA INSURER D 11811 Willows Road NE Redmond, WA 98052 $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PE� LOG 7 PRODUCTS - COMP /OP AGG INSURER E NSURER F: B B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COVFRArl CERTIFICATE NUMBER' SEA - 002373887 -04 REVISION NUMBER'29 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 D POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR of Marsh USA Inc. 4030507381 05101/2013 05101/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED _ PREMISES Ea occurrence $ 1,000,000 MED EXP Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PE� LOG 7 PRODUCTS - COMP /OP AGG $ EXCLUDED $ B B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 4029265138(AOS) 4029265172 (MA) 0510112013 0510112013 05101/2014 0510112014 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peracciden $ COMP I COLL DED. $ 1,000 B X UMBRELLA LIAB EXCESS LIAR, X OCCUR CLAIMS -MADE 4030507395 Products - Completed Ops Excluded 05/0112013 0510112014 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 DIED RETENTION$ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERdIXECUTIVE YIN OFFICEMMEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4030507378 (AOS) 4030507364 (CA) 0510112013 0510112013 I 0510112014 0510112014 - X WC STATU- OTH CRY LrM TS E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured status applies only if it is reflected in your written contract Governmental Entity (Form G- 56015 -B) City of Gilroy, its officers, officials and employees are included as additional insured undergeneral liability as required bywritten contract, CERTIFICATE HOLDER CANCELLATION City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Jennifer Baker THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna St. ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. rIi _ � Cheryl Bermudez C O —� Tpv- ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 POLICY CHANGES ENDORSNENTT EFFECTIVE 03/01/2013 This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown. G300415A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF GILROY, IT'S OFFICERS,. OFFICIALS AND EMPLOYEES (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after: Page 1 of 2 4' thaionen of the Surd 0- 56015 -B (ED. 11191) �etvry POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO-CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 POLICY CBANGES ENDORSEMENT EFFECTIVE 03/01/2013 This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown. G300415A (1) 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 site of the covered operations has been completed; or (2) 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. Page 2 of 2 Chairman of the Bowd G- 56015 -B (ED, 11/91) POLICY NUMBER INSURED NAME AND ADDRESS A 40305073B1 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 ADDITIONAL INSURED SCHEDULE LOCATION: 1 The following has been deleted, effective 03/01/2013. Additional insured Name and Address: CITY OF GILROY ATTN: PHIL KING 7351 ROSANNA ST GILROY, CA 95020 TYPE: Additional Insured The following has been added, effective 03/01/2013. Additional Insured Name and Address: CITY OF GILROY, IT'S OFFICERS, OFFICIALS AND EMPLOYEES ATTN: PHIL KING 7351 ROSANNA ST GILROY, CA 95020 TYPE: Additional Insured INSURED Page 3 of 4 POLICY NUMBER INSURED NAM AND ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 FORKS AND ENDORSEMENTS SCHEDULE These following forms have been added to your policy Form Number Form Title 056015E .11/1991 ENDORSMENT EFFECTIVE 03/01/2013 I Countersignature U swet w Cheirmart o} the Board P- 55170 -A (Ed. 01/86) INSURED Page 4 of 4 POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 POLICY CHANGES FORM G300415A This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown. G300415A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF GILROY, IT'S OFFICERS, OFFICIALS AND EMPLOYEES (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after: Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Chairman of the Board Secretary G- 56015 -B (ED. 11/91) POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO - CONTROL INTERNATIONAL, INC. "SEEENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 POLICY CHANGES FORM G300415A This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown. G300415A (1) 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 site of the covered operations has been completed; or (2) 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. Page 2 of 2 Chairman of the Board G- 56015 -B (ED. 11/91) V Wry POLICY NUMBER INSURED NAME AND ADDRESS A 4030507381 PHYSIO- CONTROL INTERNATIONAL, INC. "SEE ENDT" P.O. BOX 97006 REDMOND, WA 98073 -9706 ADDITIONAL INSURED SCHEDULE LOCATION: 1 Additional Insured Name and Address: CITY OF GILROY, IT'S OFFICERS, OFFICIALS AND EMPLOYEES ATTN: PHIL KING 7351 ROSANNA ST GILROY, CA 95020 TYPE: Additional Insured