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HomeMy WebLinkAboutEMC Planning Group - Insurance CertificateA� °® CERTIFICATE OF LIABILITY INSURANCE 5%1%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 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 Carmel Insurance Agency San Carlos 2 NW of 8th P.O. BOX 6117 Carmel- CA 93921 -6117 CONTACT Monique ThanOS, CIC PHONE (831) 624 -1234 FAX (831)624 -4605 AIC ,DAIS :moniquet @carmelinsurance.com INSURERS AFFORDING COVERAGE NAIC # [NtURERA4Colony Insurance Company LIMBS INSURED EMC Planning Group, Inc. 301 Lighthouse Avenue Suite C Monterey CA 93940 INSURERS Nationwide Mutual INSURER C : INSURER D: INSURER E : $ 1,000,000 INSURER F: $_ 50,000 COVERAGES CERTIFICATE NUMBER -GL s Prof 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 TR TYPE OF INSURANCE L SUB POLICY NUMBER POLICY EFF D POLICY EXP D LIMBS GENERAL LIABILITY EACH OCC URRENCE $ 1,000,000 $_ 50,000 • COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE a OCCUR EPK302184 /1/2014 /1/2015 MED EXP (Any one person) $ PERSONAL BADVINJURY $ 1,000,000 • Aggregate Limits Include Professional Liability GENERAL AGGREGATE $ 3,000,000 GE N L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 3,000,000 X POLICY PRO- LOC DEDUCTIBLE PER OCCURR $ 10,000 AUTOMOBILE LIABILITY COMBINE , D S dent) INGLE LIMIT 11000,000 B x. ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CP7834920791 /15/2014 /15/2015 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident) $ $ UMBRELLA Li OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I . I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? NIA LIMITS FIR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $. (Mandatory In NH) If yyes, describe under DESCRIPTIONOF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Errors 6 OmmissionS EPK302184 /1/2014 /1/2015 EACH CLAIM LIMIT 1,000,000 DEDUCTIBLE EACH CLAIM 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Hexwell Annexation and Prezoning Initial Study - Subject to a Signed, Written Agreement: The City of Gilroy, its officers and employees are named as Additional Insured under the General Liability per attached endorsement EV242 -0312 and under the Auto Liability per attached endorsement CA2048 02/99. 10 Days Notice of Cancellation for Non - Payment of Premium. The City of Gilroy Planning Divison Melissa Durkin 7351 Rosanna Street Gilroy, CA 95020 0 /05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Little, CIC /MRT If �iO 1988 -2010 ACORD CORPORATION. All rights reserved INS025 rgmnnsi m Tho ARr1Rr1 name and Innn am ranietararl marlte of Or npn EMC Planning Group, Inc. Policy #: ACP7834920791 Policy Term: 3/15/14 to 3/15/15 CA 20 48 (02 -99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modes insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS 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" 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): The City of Gilroy, its officers and employees. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, Insurance Services Office, Inc., 1998 CA 20 48 (02 -99) EMC PLANNING GROUP, INC. Policy #EPK302184 5/1/14 to 5/1/15 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION 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 Contrail 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 Policy 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" caused, 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) desig- nated above. B.. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 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 addi- tional insured(s) at the location 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 ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EV242 -0312 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. ACORO® 4� CERTIFICATE OF LIABILITY INSURANCE 4%30/2311' 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 _ Carmel. Insurance Agency San Carlos 2 NW of 8th P.O. BOX 6117 Carmel CA 93921 -6117 NAME: Monique Thanos, CIC PHONE (831) 624 -1234 FAX Nok (831) 626 -4605 No, IAIC ADMREssmmoniquet@carmelinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Colony Insurance Company LIMITS INSURED EMC Planning Group, Inc. 301 Lighthouse Avenue Suite C Monterey CA 93940 INSURER B :Nationwide Mutual INSURE RC: INSURER D : INSURER E : $ 1,000,000 INSURER F: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR COVERAGES CERTIFICATE NUMBER:GL - Prof- Auto 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 AODL SU R POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR P)C302184 /1/2015 /1/2016 DAMAGE TO RENTED PREMISES Ea occurrence $ .50, 000 MED EXP Ari one arson $ 5,000 PERSONAL BADVINJURY $ 1,000,000 X Aggregate Limits Include Errors — Omissions GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 3,000,000 X POLICY PRO LOC DEDUCTIBLE PER OCCURR $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 -X_ BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS P3047177663 /1/2015 /1/2016 BODILY INJURY (Per accident) $ PROPE� aT YDAMAGE P a $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED. RETENTION $ WORKERS COMPENSATION WC STATU- OTH= AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXEGUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory, 1n NH) N l A TORY LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under – _ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Errors a Omissions EPK302,184 /1/2015 /1/2016 EACH CLAIM LIMIT 1,000,000 Retroactive Date 8/22/02 DEDUCTIBLE EACH CLAIM 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: Hexwell Annexation and Prezoning Initial Study - Subject to a Signed, Written Agreement: The City of Gilroy, its officers and employees are named as Additional Insured under the General Liability Per attached endorsement EV242 -0312 and under the Auto Liability per attached endorsement CA2048 02/99. 10 Days Notice of Cancellation for Non - Payment of Premium. CERTIFICATE The City of Gilroy Planning Divison Melissa Durkin 7351 Rosanna Street Gilroy, CA 95020 25 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 Little, CIC /MRT ©1988 -2010 ACORD CORPORATION. All rights reserve IAIQn,)x ­,mc, n, "M— A/-AOr% . ..... ........1 1........-.. ­1­ —9 A, -f%E2 % EMC PLANNING GROUP, INC. Policy #EPK302184 5/1/15 - 5/1/16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - ONGOING OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s), Locations Of Covemd_O rations: Where Required By Written Contract Where Required By Written Contrail Information required to complete this Schedule, if not shown above, YA be shown in the Declarations. A. Section. Ill — Who Is An Insured within the Common Policy 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" caused, 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) desig- nated above. ' B. With respect to the insurance afforded to these additional insureds, the following add_ itional exclu- sions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after. 1. All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional Insured(s) at the location 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. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EV242 -0312 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. `°D CERTIFICATE OF LIABILITY INSURANCE 3i�9i2o15Y) 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 CONTACT Monique Thanos, CIC NAME: Carmel Insurance Agency PHONE (831)624-1234 FAX (A/C,No.an: (A/C.Nol: (831)624-4605 San Carlos 2 NW of 8th E-MAIL ADDRESS:moniq-uet@carmelinsurance.com P.O. Box 6117 INSURER(S)AFFORDING COVERAGE NAIC# Carmel CA 93921-6117 INSURERA:Colony Insurance Company INSURED INSURER B Nationwide Mutual EMC Planning Group, Inc. INSURER C: 301 Lighthouse Avenue INSURER D: Suite C INSURER E: Monterey CA 93940 INSURER F: COVERAGES CERTIFICATE NUMBER:GL/Prof & Auto 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $ r A CLAIMS-MADE X OCCUR EPK302184 5/1/2014 5/1/2015 MEDEXP(Anyoneperson) $ 5,000 X Aggregate Limits Include PERSONAL&ADV INJURY $ 1,000,000, Professional Liability GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 — 1 POLICY PRO-JECT LOC DEDUCTIBLE PER OCCURR $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 B x ANY AUTO ACP7844920791 3/15/2015 3/15/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident AUTOS AUTOS ( accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) Fi.L.DISEASE-EA EMPLOYEE $ If yes, O under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ N A Errors & Ommissions EPK302184 5/1/2014 5/1/2015 EACH CLAIM LIMIT 1,000,000 Retroactive Date 8/22/02 DEDUCTIBLE EACH CLAIM 10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101.Additional Remarks Schedule,if more space is required) RE: Hexwell Annexation and Prezoning Initial Study - Subject to a Signed, Written Agreement: The City of Gilroy, its officers and employees are named as Additional Insured under the General Liability per attached endorsement EV242-0312 and under the Auto Liability per attached endorsement CA2048 02/99. 10 Days Notice of Cancellation for Non-Payment of Premium. UPDATE FOR AUTO RENEWAL ONLY 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. The City of Gilroy Planning Divison Melissa Durkin AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy, CA 95020 M Little, CIC/ART ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. I0.1Cn9F Inn,nncs EMC Planning Group, Inc. Policy#: ACP7844920791 Policy Term: 3/15/15 to 3/15/16 CA 20 48 (02-99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS 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" 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): The City of Gilroy, its officers and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured"for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, Insurance Services Office, Inc., 1998 CA 20 48 (02-99) EMC Planning Group, Inc. Policy #: ACP3047177663 Policy Term: 5/01115 to 5/01/16 CA 20 48 (02 -99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS 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" 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): The City of Gilroy, its officers and employees. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, Insurance Services Office, Inc., 1998 CA 20 48 (02 -99) A °® CERTIFICATE OF LIABILITY INSURANCE 3/1 /2014rr) 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 Carmel Insurance Agency, Inc. San Carlos 2 NW of 8th P.O. BOX 6117 Carmel CA 939216117 NAME Monique R. Thanos, CIC PHONE (831)624 -1234 FAX No: (931) 624 -4605 No. ply: moniquet@carmelinsurance.com PRODUCER INSURERS AFFORDING COVERAGE NAIC A INSURED E M C Planning Group, Inc. 301 Lighthouse Avenue, Suite C Monterey CA - 93940 INSURER A -AMCO Insurance Company RCP7834920791 INSURER B .Nationw1de Mutual 3/15/2015 INSURER C: $ 2, 000, 000 INSURER D • $ 1,000,000 INSURER E : $ 5,000 INSURER F: $ 2,000,000 COVERAGES CERTIFICATE NUMBER:GL A Auto 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 REQUIREMENTrTERM 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:- LIMIT&SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF QAM1DD1YYYY1 POLICY EXP 0AMIDDNYYYl LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR RCP7834920791 3/15/2014 3/15/2015 EACH OCCURRENCE $ 2, 000, 000 DAMAGE T RENT _ .PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENL AGGREGATE LIMIT APPLIES PER: X - POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 4,666,060 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NO"WNED AUTOS P7834920791 3/15/2014 3/15/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 }� BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA A LJAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH -; E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ Li DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Nexwell Annexation and Prezoning Initial Study - Subject to a Signed, Written Agreement: The City of Gilroy, its officers and employees are named as Additional Insured under the General Liability 6 Auto Liability. 10 Day Notice of Cancellation Applies for Non - Payment of Premium. Attached Endorsements PB6003 04/11 6 CA2048 02/99. HOLDER The City of Gilroy Planning Divison Melissa Durkin 7351 Rosanna Street Gilroy, CA 95020 ACORD 25 (2009/09) INSUS (2oo96s) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR12ED REPRESENTATIVE Little, CIC /MRT ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EMC Planning Group, Inc. — Policy Number: ACP7834920791 — 3/15/2014 - 3/15/2015 BUSINESSOWNERS PB 60 03 0411 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MUNICIPALITIES OR PUBLIC AGENCY INSURED PROVIDING PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM The following is added to Section II. WHO IS AN INSURED: The municipality and /or public agency designated in the Schedule of this endorsement is also an insured, 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 in connection with your operations, other than the rendering of or the failure to render professional services, advice of instruction, subject to the following additional exclusion: This insurance, including any duty we have to defend "suits ", does not apply to "bodily injury", "properly damage" or "personal and advertising injury" that arises out of, in whole or in part, or is a result of, in whole or in part, the active or primary negligence of the municipality and /or public agency designated in the Schedule of this endorsement, whether or not such negligence has been assumed by you in a contract or agreement. All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Municipality and /or Public Agency: The City of Gilroy, its Officers and Employees 7351 Rosanna Street Gilroy, CA 95020 -6141 PB 60 03 0411 Page 1 of 1 EMC Planning Group, Inc. Policy #: ACP7834920791 Policy Term: 3/15/14 to 3/15/15 CA 20 48 (02 -99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS 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" 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): The City of Gilroy (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, insurance Services Office, Inc., 1998 CA 20 48 (02 -99)