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HomeMy WebLinkAboutNova Partners - Insurance CertificateACORO0 ` CO CERTIFICATE OF LIABILITY INSURANCE DATE (AMA/DDNYYY) 6/17/2016 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 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 Arthur J. Gallagher & Co. Insurance Brokers of California Inc. I LIC #0726293 1255 Battery Street, Suite 450 San Francisco CA 94111 NAM: Certificate Department PHONE 415- 391 -1500 FAX 415- 391 -1882 EL . CertRe uests @a com 9 1g INSURERS) AFFORDING COVERAGE NAIC # INSURER A:James River Insurance Company 12203 INSURED INSURER B: Republic Indemnit Company ofAmeri 122179 Nova Partners, Inc. 201 Moffet Blvd. INSURER c: Underwriters at Lloyd's London 115792 PERSONAL & ADV INJURY Mountain View, CA 94043 INSURER D: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 INSURER E: $ INSURER F: AUTOMOBILE LIABILITY ANY AUTO p AUTOS�ED AUTOSULED HIRED AUTOS X NON -OWNED AUTOS COVERAGES CERTIFICATE NUMBER: 573223040 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 INSD � WVD POLICY EFF POLICY NUMBER i MM/DDIYYYY POLICY EXP MM/DDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51 OCCUR Y Y 000242449 5/16/2016 5/1612017 EACH OCCURRENCE $1,000,000 DAMAGE TO PREMISES Ea oocccu ence $50,000 MED EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: POLICY JET F—] LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO p AUTOS�ED AUTOSULED HIRED AUTOS X NON -OWNED AUTOS Y Y 000242449 5/16/2016 511612017 Ea accident $1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ X Per accident $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 000716960 5/1612016 5/1612017 EACH OCCURRENCE 64,000,000 X d AGGREGATE &4,000,000 DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 16649911 8/1/2015 8/1/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional Liab. PGIARK0323702 9/24/2015 9/24/2016 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Construction Management services for multiple facilities around City of Gilroy. ADDITIONAL INSURED(S): City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers. L,tK I Ir ILA I t MULUtK GANGtLLA 1 ION City of Gilroy 7351 Rosanna Street Gilroy CA 95020 ACORD 25 (2014/01) 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 < V 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C -1253 2 of 12 AGENCY CUSTOMER ID: LOC #: A�oRD ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED POUCY NUMBER CARRIER NAIC CODE EFFECTNE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: `Additional Insured per attached Form CG201 D0704 CONGO] `Additional Insured per attached Form CG20370704 (COOP) `Coverage is Primary & Non - Contributory is required by written contract per attached Form AP5031 USO410 'Waiver of Subrogation is required by written contract per attached Form CG24040509 AUTOMOBILE LIABILITY: 'Additional Insured per attached Form AP2126US0108 'Additional Insured per attached Form AP2127US0812 'Waiver of Subrogation is required by written contact per attached Form AP5004US1106 ACORD 101 (2008101) C 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C -1253 3 of 12 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organ ization s : Locations Of Covered Operations City of Gilroy, its officers and employees All Operations of Named Insured 7351 Rosanm Street Gilroy, CA 95020 -6141 Information re uired 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: 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 insureds) 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 equip- ment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 C 180 Properties, Inc., 2004 Page 1 of 1 CI C -1253 4 of 12 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 Insured Person(s) Or Organization(s): Location And Description Of Completed Operations City of Gilroy, its officers and employees All Operations of Nained Insured 7351 Rosanna Street Gilroy, CA 95020 -6141 Information required to complete this Schedule if not shown above will be shown in the Declarations. 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" or "property dam- age" caused, in whole or in part, by 'your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 C -1253 5 of 12 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional insured Person(s) Or Organization( s Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy, Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US 04 -10 Page 1 of 1 C -1253 6 of 12 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, If not shown above, will be shown In the Declarations. The following Is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "Your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 C -1253 7 of 12 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limit of insurance I I Additional Premium Hired Auto Liability 1 000 000 1 ; 1 Included The Insurance provided under SECTION 1, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily Injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above Is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The limits of Insurance shown in the Schedule above are included within and are not In addition to the Limits of Insurance shown in the Declarations. Nothing In this endorsement shall increase the Limits of Insurance shown In the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the Insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily Injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 C -1253 8 of 12 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto" means any "auto" you lease, hire or borrow. This does not include any "auto" you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer" of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP212OUS 01 -08 Page 2 of 2 C -1253 9 of 12 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON -OWNED AUTO LIABILITY - EXCLUDING LOADING AND UNLOADING This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 Included The insurance provided under SECTION I — COVERAGES, COVERAGE. A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto ". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the Insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown In the Schedule above are included within and are not In addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily Injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the Insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION II —WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b, above. None of the following is an insured: AP2127US 08 -12 Page 1 of 2 C -1253 10 of 12 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person white employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or "employee' of any such owner, (5) Any person or organization for the conduct of any current or past partnership or joint venture that Is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you area partnership, a "non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 C -1253 11 of 12 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which Is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 C -1253 12 of 12 �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) F5/10/2016 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 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 Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. LIC #0726293 1255 Battery Street, Suite 450 CONTACT NAME: Certificate Department PHONE 415- 391 1500 FAX 415- 391 -1882 E -Ma RL CertRe uests @a ESS: G._ Jg• com INSURERS AFFORDING COVERAGE NAIC • San Francisco CA 94111 INSURERA:James River Insurance Company 12203 5116/2016 INSURED INSURER B: Republic Indemnity Company of Ameri 22179 Nova Partners, Inc. INSURER c: Underwriters at Llo d's London 15792 855 El Camino Real #307 Palo Alto, CA 94301 INSURER D: DAMAGE TO RENTED PREMISES Ea occurrence $50,000 MED EXP (Any one person) INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2065851135 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 INSD WVD POLICY NUMBER POLICY EFF MMfDDNYYY POLICY EXP MIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 000242449 5116/2016 5/16/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE IX OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $50,000 MED EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY [X] jE Q [::] LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 000242449 5/16/2016 511612017 Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AUTOS�ED AUTOSU�D BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X A Per accident $ E A UMBRELLA LIAB X OCCUR 000716960 5/16/2016 5/16/2017 EACH OCCURRENCE $4,000,000 X AGGREGATE $4,000,000 EXCESS LAB CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 16649911 8/1/2015 8/1/2016 X STATUTE ORH E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional Liab. PGIARK0323702 9/24/2015 9/24/2016 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: On Call Construction Management Services City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liability as required by written contract only as pertains to Insured's operations. Project or Job #: GtK I Ill- IGA I t HOLUER GANGELLA I ION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of GilroyCommunity Development Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 USA AUTHORIZED REPRESENTATIVE ® 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC #: ACC>Roi ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMEDINSURED POLICY NUMBER CARRIER NAIL CODE EFFECTIVE DATE: MVVI I IVlVAL KGIWAKR.3 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: 'Additional Insured Is required by written contract per attached Form AP2009US0410 'Coverage Is Primary 8 Non - Contributory is required by written contract per attached Form AP5031 US0410 'Waiver of Subrogation is required by written contract per attached Form CG24040509 AUTOMOBILE LIABILITY: "Additional Insured per attached Form AP2126US0108 `Additional insured per attached Form AP2127US0812 'Waiver of Subrogation is required by written contact per attached Form AP5004US1106 ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All riahts resarvad The ACORD name and logo are registered marks of ACORD POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This endorsement modifies Insurance provided under the following: ALL COVERAGE PARTS SECTION II - Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by written contract or written agreement In effect during this policy period and executed prior to the "occurrence" of the "bodily Injury" or "property damage." The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. The person or organization is only an additional insured with respect to liability arising solely out of "your work" or "your product" which is imputed to the Additional Insured. 2. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of insurance stated in the Declarations. 3. This Insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products - completed operations hazard" unless you are required to provide such coverage by written contract or written agreement but only for the period of time required by the written contract or written agreement and only for "bodily injury" or "property damage" that occurs during the policy period arising out of "your work" or "your product ". 4. Any coverage provided by this endorsement to an Additional Insured shall be excess over any other valid and collectible insurance available to the Additional Insured whether primary, excess, contingent or on any other basis. 5. Where no coverage under this policy shall apply for the Named Insured, no coverage or defense shall be afforded to the Additional Insured. 6. This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of the Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2009US 0410 Page 1 of 1 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or anization s : Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured tinder this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US 44 -10 Page 1 of 1 POLICY NO. 000242449 COMMERCIAL GENERAL LIABILITY CG 24 04 06 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, If not shown above, will be shown In the Declarations. The following Is added to Paragraph 8, Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and Included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limit of I I Additional Premium Hired Auto Liability 1 000 000 Included The Insurance provided under SECTION I, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily Injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not In addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I -- COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the Insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership orjoint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto" means any "auto" you lease, hire or borrow. This does not include any "auto" you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer' of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON -OWNED AUTO LIABILITY - EXCLUDING LOADING AND UNLOADING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury' or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the Insured becomes legally obligated to pay as damages because of "bodily Injury" or ' property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not In addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION II —WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b, above. None of the following is an insured: AP2127US 08 -12 Page 1 of (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person Injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or 'employee" of any such owner, (5) Any person or organization for the conduct of any current or past partnership or joint venture that Is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupatlon of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which Is used in connection with your business. However, if you area partnership, a "non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 POLICY NO. 000242449 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE 8/ DATE (M IDDIVVVY) 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 Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. LIC #0726293 1255 Battery Street, Suite 450 San Francisco CA 94111 NAMEACT Certificate Department PHONE 415-391-1500 FAX 415-391-1882 IA IN Ell. E -MAIL CertRe uests @a ADDRESS: Jg com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:James River Insurance Company 12203 5/16/2015 INSURED INSURER B: Underwriters at Lloyd's London (KY) 32727 Nova Partners, Inc. El Camino Real #307 .Pal Pal o Alto, CA 94301 INSURER c: National Union Fire Ins Co Pittsbur 19445 INSURER D:Republic Indemnity Company of Ameri 22179 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMRFP- 160952448 loicvlclnnl w lUVII70 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 INSD WVD POLICY NUMBER POLICY EFF MIDDNYYY POLICY EXP M/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 000242448 5/16/2015 5/1612016 EACH OCCURRENCE $1,000,000 PREMISES Ea occurrence $50,000 CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7X F7 GENERAL AGGREGATE 82,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY JE� LOC $ OTHER: A AUTOMOBILE LIABILITY Y Y 000242448 5/16/2015 5/16/2016 8INFL) SINGLE LIMIT (Ea accident ) $1,000,000 BODILY INJURY (Per person) S ANY AUTO AUTOS OWNED AUTOSULED BODILY INJURY (Per accident) S HIRED AUTOS X NON -OWNED AUTOS X Per =AMAGE S S C X UMBRELLA LIAB X OCCUR BE066695191 /16/2015 5/16/2016 EACH OCCURRENCE $4,000,000 X AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA 16649911 /1/2015 8/1/2016 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liab. PGIARK0323701 9/24/2014 9/24/2015 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: On Call Construction Management Services City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liability as required by Written contract only as pertains to Insured's operations. Project or Job #: City of GilroyCommunity Development Department 7351 Rosanna Street Gilroy CA 95020 USA ACORD 25 (2014/01) 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 27, 0 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: 'Additional Insured when required by written contract per Form(s): CG20100704 & CG20370704 "Coverage is Primary and Non - contributory per Form: AP5031US0410 `Waiver of Subrogation as required by written contract per Form: CG24040509 AUTOMOBILE LIABILITY: 'Additional Insured where required by written contract per Form: AP2126US0108 "Additional Insured where required by written contract per Form: AP2127US0812 *Waiver of Subrogation as required by written contract per Form: AP5004US1106 ACORD 101 (2008101 ) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 000242448 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TT - �. d rel This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Locations Of Covered Operations City of Gilroy, its officers and employees All Operations of Named Insured 7351 Rosanna Street Gilroy, CA 95020 -6141 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 B 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. 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 equip- ment fumished 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 13 POLICY NUMBER: 000242448 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • . • • - =I IXOGUA . • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Location And Description Of Completed Operations All Operations ofNained Insured City of Gilroy, its officers and employees 7351 Rosanna Street Gilroy, CA 95020 -6141 Information required to complete this Schedule, if not shown above will be shown in the Declarations. 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" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 O POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Or anization s : Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy, Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4 -10 Page 1 of 1 POLICY NUMBER: 000242448 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limit of Insurance I Additional Premium Hired Auto Liability $ $1,000,000 1 $ Included The insurance provided under SECTION I, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- . employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- °employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business", other than an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto" means any "auto" you lease, hire or borrow. This does not include any "auto" you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer" of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON-OWNED AUTO LIABILITY ® EXCLUDING LOADING AND UNLOADING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto ". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION 11— WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: AP2127US 0 &12 Page 1 of 2 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury, or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or "employee" of any such owner; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you are a partnership, a "non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. SUBROGATION WAIVER OF w !! BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 Rte® CERTIFICATE OF LIABILITY INSURANCE DnrrY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 7/23/2015 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 CONTACT Certificate cafe D Arthur J. Gallagher & Co. Insurance Brokers PHONE . 415-391-1500 FAX 415- 391 -1882 of California, Inc. LIC #0726293 E-MAIL CertRe uests @a com S q Jg 1255 Battery Street, Suite 450 INSURER(S) AFFORDING COVERAGE NAIC p San Francisco CA 94111 INSURERA:James River Insurance Company 12203 CLAIMS -MADE 7 OCCUR INSURED INSURER B: Underwriters at Lloyd's London (KY) 32727 Nova Partners, Inc. INSURER c: National Union Fire Ins Co Pittsbur 19445 855 El Camino Real #307 Palo Alto, CA 94301 INSURER D:Republic Indemnity Company of Ameri 22179 MED EXP (Any one person) $Excluded INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 724115072 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 I TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF M1DDNYYY POLICY EXP MMfDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 000242448 5/16/2015 5/16/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE 7 OCCUR DAMAGE TO RENTEU- PREMISES Ea occurrence $50,000 MED EXP (Any one person) $Excluded PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY � PE� LOC PRODUCTS - COMPlOP AGG 82,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 000242448 5/16/2015 5/16/2016 Ea accideD $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AUTOS OWNED SCHEDULED BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X Per accident $ 8 C X UMBRELLA LIAB X OCCUR BE066695191 5/16/2015 5116/2016 EACH OCCURRENCE $4,000,000 X AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA 16649911 11/2015 8/1/2016 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professlonal Liab. PGIARK0323701 9/24/2014 9/24/2015 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: On Call Construction Management Services City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liabilityy as required by written contract only as pertains to Insured's operations. Project or Job #: I.CK I Ir'tt..A 1 t r7ULUtK L:ANUILLLA I IUN City of GilroyCommunity Development Department 7351 Rosanna Street Gilroy CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. D REPRESENTATIVE I c j , , ® 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: .a►c pro ®® ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: r.1..mnF%na THIS ADDITIONAL. REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: *Additional Insured when required by written contract per Form: AP20D9US0410 'Coverage is Primary and Non - contributory per Form: AP5031 USO410 'Waiver of Subrogation as required by written contract per Form: CG24D40509 AUTOMOBILE LIABILITY: *Additional Insured where required by written contract per Form: AP2126US0108 "Additional Insured where required by written contract per Form: AP2127US0812 'Waiver of Subrogatlon as required by written contract per Form: AP5004US1106 ACORD 101 (2008101) n 'Inna Ad r^Dn J-nennoArnu _ _. __ _ _... �..r........ ..,.. W.— ..Owl vau. The ACORD name and logo are registered marks of ACORD POLICY NO, 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This endorsement modes insurance provided under the following: ALL COVERAGE PARTS SECTION II — Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage." The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. The person or organization is only an additional insured with respect to liability arising solely out of "your work" or "your product" which is imputed to the Additional Insured. 2. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance stated in the Declarations. 3. This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products — completed operations hazard" unless you are required to provide such coverage by written contract or written agreement but only for the period of time required by the written contract or written agreement and only for "bodily injury" or "property damage" that occurs during the policy period arising out of "your work" or "your product'. 4. Any coverage provided by this endorsement to an Additional Insured shall be excess over any other valid and collectible insurance available to the Additional Insured whether primary, excess, contingent or on any other basis. 5. Where no coverage under this policy shall apply for the Named Insured, no coverage or defense shall be afforded to the Additional Insured. 6. This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of the Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2009US 04 -10 Page 1 of 1 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Or anizatlon s : Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this poll . Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, AP5031 US O4 -10 Page 1 of 1 POLICY NUMBER: 000242448 in . This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY CO 24 04 05 09 COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage I Limit of Insurance I I Additional Premium Hired Auto Liability $ 1 $1,000,000 1 $ 1 Included The insurance provided under SECTION I, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", otherthan an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto' means any "auto" you lease, hire or borrow. This does not include any "auto" you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer" of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON -OWNED AUTO LIABILITY ® EXCLUDING LOADING AND UNLOADING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto' by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto'. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION II —WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: AP2127US 08 -12 Page 1 of 2 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business', other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or "employee" of any such owner, (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you area partnership, a "non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 POLICY NO. 0002424413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 ® CERTIFICATE OF LIABILITY INSURANCE F7/23/2015 DnYVy) 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. 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(iss) 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 NAME: Certificate Department Arthur J. Gallagher & Co. Insurance Brokers PHONE 415 391 -1500 FAX 4I5- 391 -1882 of California, Inc. LIC #0726293 E-MAIL - CertRequests@ajg.com 1255 Battery Street, Suite 450 INSURER(S) AFFORDING COVERAGE NAIC# San Francisco CA 94111 INSURERA:James River Insurance Company 12203 CLAIMS -MADE ❑ OCCUR INSURED INSURER B: Underwriters at Lloyd's London (KY) 32727 Nova Partners, Inc. INSURER C: National Union Fire Ins Co Pittsbur 19445 855 El Camino Real #307 INSURER D: Republic Indemnity Company of Ameri 22179 Palo Alto, CA 94301 $ Excluded INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER_ 1263776127 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 �� INSD WVD POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 000242448 5/16/2015 5/16/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑ OCCUR PREMISEGES ( a occurrence ) $50,000 MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECOT- [�] LOC PRODUCTS - COMP /OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 000242448 5/16/2015 5/16/2016 Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO pp AUTOSED AUTOSULED BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X O Per accident $ $ C X UMBRELLA LIAB X OCCUR B 06669519 5/16/2015 5/16/2016 EACH OCCURRENCE $4,000,000 X AGGREGATE 64,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA 16649911 /1/2015 8/1/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $1,000,000 B Professional Liab. PGIARK0323701 9/24/2014 9/24/2015 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liability as required by written contract only as pertains to Insured's operations. % r-mIir ILHIG rIVLUMK t ANGtLLAI IUN City of GilroyCommunity Development Department 7351 Rosanna Street Gilroy CA 95020 USA 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 REPRES ENTATIV E 47- G ® 1999 -2014 ACORD CORPORATION_ All rinhtc rPSPrvPd ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC 0: A4 V ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMEDINSURED POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE; yr r wr— 1\L19IPUII%1I THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: "Additional Insured when required by written contract per Form: AP200BUS0410 'Coverage is Primary and Non - contributory per Form: AP5031 US0410 `Waiver of Subrogation as required by written contract per Form: CG24D40509 AUTOMOBILE LIABILITY: 'Additional Insured where required by written contract per Form: AP2126US0108 'Additional Insured where required by written contract per Form: AP2127US0812 'Waiver of Subrogation as required by written contract per Form: AP5004US1106 ACORD 101 (2008101) n Ijnna APrt[fn nrtfl nrtllw ra- The ACORD name and logo are registered marks of ACORD POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS SECTION II — Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage." The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. The person or organization is only an additional insured with respect to liability arising solely out of "your work" or "your product" which is imputed to the Additional Insured. 2. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance stated in the Declarations. 3. This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products — completed operations hazard" unless you are required to provide such coverage by written contract or written agreement but only for the period of time required by the written contract or written agreement and only for "bodily injury" or "property damage" that occurs during the policy period arising out of "your work" or "your product". 4. Any coverage provided by this endorsement to an Additional Insured shall be excess over any other valid and collectible insurance available to the Additional Insured whether primary, excess, contingent or on any other basis. 5. Where no coverage under this policy shall apply for the Named Insured, no coverage or defense shall be afforded to the Additional Insured. 6. This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of the Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2009US 04 -10 Page 1 of 1 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Organization(s); Where required by written contract or written agreement If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4 -10 Page 1 of 1 POLICY NUMBER: 000242448 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limit of Insurance Additional Premium Hired Auto Liability $ $1 000 000 $ Included The insurance provided under SECTION I, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an 'auto business „, other than an "auto business” you operate; AP2126US 01 -08 Page 1 of 2 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto" means any "auto" you lease, hire or borrow. This does not include any "auto" you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer' of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Kohl 01110 reml 1 !, This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 1,000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto ". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION II —WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non - owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: AP2127US 08-12 Page 1 of 2 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury ", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or "employee" of any such owner, (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto" means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you are a partnership, a "non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 08 -12 Page 2 of 2 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by °your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 ACOR" CERTIFICATE OF LIABILITY INSURANCE d,�• DATE (MM/DD/YYYI) 1 5/18/2015 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 Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. LIC #0726293 1255 Battery Street, Suite 450 CONTACT Certificate Department D PNONE . 415 -cate 00 FAX 415- 391 -1882 E-pgLE . CertRequests @ajg.com INSURER(S) AFFORDING COVERAGE NAIC # San Francisco CA 94111 INSURERA:James River Insurance Company 12203 16/2015 INSURED INSURER B:Republic Indemnity Company ofAmeri 22179 Nova Partners, Inc. INSURER C: Underwriters at Lloyd's London KY 32727 855 El Camino Real #307 Palo Alto, CA 94301 INSURER D: National Union Fire Ins Co Pittsbur 19445 DAMAG TO RE PREMISES Ea occurrence -INSURER E: INSURER F $Excluded COVERAGES CERTIFICATE NUMBER_ 1412632959 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 000242448 16/2015 /16/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAG TO RE PREMISES Ea occurrence $50,000 MED EXP (Any one person) $Excluded PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY a] PELT F LOC PRODUCTS - COMP /OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 000242448 16/2015 /16/2016 _C6MMREffS=E LIMIT Fa accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AUT OWNED AUTOSU�D BODILY INJURY (Per accident) $ HIRED AUTOS X NON-OWNED AUTOS X PROPER DAMAGI_�_ Per accident D X UMBRELLA LIAB X OCCUR BE066695191 16/2015 /16/2016 EACH OCCURRENCE $4,000,000 X AGGREGATE $4,000,000 EXCESS IJAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 16649910 /1/2014 /1/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory In NH) IF yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - .POLICY LIMIT 1 $1,000,000 C Professional Liab. PGIARK0323701 /2412014 /24/2015 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: On Call Construction Management Services City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liability as required by written contract only as pertains to Insured's operations. Project or Job #: MULUCK City of GilroyCommunity Development Department 7351 Rosanna Street Gilroy CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. D REPRESENTATIVE ice.�- ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 001258 AGENCY CUSTOMER ID: LOC #: ACCO ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED POLICY NUMBER CARRIER jNZC CODE EFFECTIVE DATE: AUDI I IVNAL. Kt:rdAfC1%b THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER FORM TITLE: GENERAL LIABILITY: *Additional Insured when required by written contract per Form: AP2009US 04-10 *Waiver of Subrogation as required by written contract per Form: CG2404 055-09 AUTOMOBILE: LIABILITY: * Additional Insured when required by written contract per Form: AP2009US 04-10 *Additional Insured when required by written contract per Form: AP2127US 08 -12 * Addittonal Insured when required by written contract per Forrn: AP2126US 01-08 *Waiver of Subrogation as required by written contract per Form: AP500411 -06 101 120091011 © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 001258 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS SECTION II — Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the °occurrence" of the "bodily injury" or "property damage." The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. The person or organization is only an additional insured with respect to liability arising solely out of "your work" or "your product" which is imputed to the Additional Insured. 2. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance stated in the Declarations. 3. This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products — completed operations hazard" unless you are required to provide such coverage by written contract or written agreement but only for the period of time required by the written contract or written agreement and only for "bodily injury" or "property damage" that occurs during the policy period arising out of "your work" or "your product ". 4. Any coverage provided by this endorsement to an Additional Insured shall be excess over any other valid and collectible insurance available to the Additional Insured whether primary, excess, contingent or on any other basis. 5. Where no coverage under this policy shall apply for the Named Insured, no coverage or defense shall be afforded to the Additional Insured. 6. This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of the Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2009US 0410 Page 1 of 1 001258 POLICY NUMBER: 000242448 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph S. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ® Insurance Services Office, Inc., 2008 Page 1 of 1 0 001258 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage I Limit of Insurance I I Additional Premium Hired Auto Liability $ 1 $1,000,000 1 $ 1 Included The insurance provided under SECTION I, - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "hired auto" by you or your "employees" in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to HIRED AUTO LIABILITY: SECTION II — WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a `hired auto" with your permission; and c. Any other person or organization, but only for their liability because of ads or omissions of an insured under a. or b. above. None of the following is an insured: (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, chili, parent, brother or sister of that co- "employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or °executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", otherthan an "auto business" you operate; AP2126US 01 -08 Page 1 of 2 001258 (4) The owner or lessee (of whom you are a sub lessee) of a "hired auto" or any agent or "employee" of any such owner or lessee; (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Hired Auto' means any "auto° you lease, hire or borrow. This does not include any "auto' you lease, hire or borrow from any of your "employees" or members of their households, or from any partner or "executive officer" of yours. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2126US 01 -08 Page 2 of 2 001258 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON -OWNED AUTO LIABILITY - EXCLUDING LOADING AND UNLOADING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Coverage Limits of Insurance Additional Premium Non -Owned Auto Liability $ 11000,000 $ Included The insurance provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. Use does not include "loading or unloading ", nor does it include the handling and placing of persons by an insured into, onto or from a "non -owned auto ". The Limit of Insurance shown in the Schedule above is the most we will pay for those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person other than you in the course of your business. The Limits of Insurance shown in the Schedule above are included within and are not in addition to the Limits of Insurance shown in the Declarations. Nothing in this endorsement shall increase the Limits of Insurance shown in the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Uninsured or Underinsured Motorist law; or (2) No Fault Law or similar act or law. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. B. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION 11— WHO IS AN INSURED, is replaced by the following: Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. For a "non -owned auto ", any partner or "executive officer" of yours, but only while such "non- . owned auto" is being used in your business; and c. Any other person or organization, but only for their liability because of acts or omissions of an insured under a. or b. above. None of the following is an insured: AP2127US 0 8-12 Page 1 of 2 001258 (1) Any person engaged in the business of his or her employer for "bodily injury" to any co- "employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury; (2) Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; (3) Any person while employed in or otherwise engaged in duties in connection with an "auto business ", other than an "auto business" you operate; (4) The owner of a "non -owned auto" or any agent or "employee" of any such owner, (5) Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION V — DEFINITIONS is amended by adding the following: 1. "Auto Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos ". 2. "Non -Owned Auto' means any "auto" you do not own, lease, hire or borrow which is used in connection with your business. However, if you area partnership, a °non -owned auto" does not include any "auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE (POLICY REMAIN UNCHANGED. AP2127US 08-12 Page 2 of 2 001258 POLICY NO. 000242448 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modes insurance provided under the following: The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 001258 1 0 A400R©► CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 5/14/20-14 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(les) 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 Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 San Francisco CA 94111 NAME: PHONE IFAX No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER Ajames Rover Insurance Company 12203 INSURED Nova Partners, Inc. 855 El Camino Real #307 Palo Alto, CA 94301 INSURER B;RePUbI6C Indemnity Company of Amed 2917A INSURER C : Lloyd's EACH OCCURRENCE INSURER D: PREMISES Ea occurrence INSURERS MED EXP (Any one on INSURER F: PERSONAL & ADV INJURY COVERAGES CERTIFICATE NUMBER: 7QA1717.1;RRA 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 SUBR POLICY NUMBER POLICY EFF WDD POLICY EXP MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT] OCCUR Y Y 000242447 /16/2014 /16/2015 EACH OCCURRENCE $1,000,000 PREMISES Ea occurrence $50,000 MED EXP (Any one on $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE 1 $2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC jECT PRODUCTS- COMP /OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NO OWNED X HIRED AUTOS X AUTOS Y Y 000242447 /16/2014 116/2015 Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ DAMAGE PROPERTY accident) (Per $ A X UMBRELLA LWB EXCESS LIAB X OCCUR CLAIMS -MADE 000243887 116/2014 /1612015 EACH OCCURRENCE $4,000,000 X AGGREGATE $4,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If es, describe under .DESCRIPTION. OF OPERATIONS below N/A 16649909 /1/2013 /1/2014 X WC 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 C Professional Liab. GIARK0323700 /24/2013 /24/2014 Ea. Claim 2,000,000 Ea. Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) RE: On Call Construction Management Services City of Gilroy, its officers and employees are named as Additional Insureds as respects to General Liability as required by written contract only as pertains to Insured's operations. Project or Job #: CERTIFICATE HOLDER GANVCLLAIAJN City of GilroyCommunity Development Department 7351 Rosanna Street Gilroy CA 95020 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988 -2070 ACORD CORPORATION. An rignts reserves. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 001001 Policy # 000242447 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO LIABILITY This endorsement modifies insurance proviced under the `ollowing: COMMERCIAL GENERA!_ LIABILI T Y COVERAGE SCHEDULE w.... _.._._— ------------- .. ...�....M _ _ ....._.. _ ........- —��... - -- Coves I f Lim_ it of Insurance - Additional Premium Hired Auto Liability_.._ _.... -..._ 7-no insurance orovided unde, SECTION t, - COVERAGES, COVERAGE A 130DILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury*' or 'property damage* arising out of the ma-rtenarce or use of a "#Brad auto" by you or your °employees° in the oourso of your business. The Limit of Insurance s *own in the ScheJu:e above is the most we will pay for those sums that the insured beacmes legally obligated to pay as damages because of "bodily jrjuuy" or " property damage" aril ng out of the ose of a °hired auto" oy you o- your 'employees" in the course of your business. The Limits of Insurance sown :n the. Schedule above are included +Rhin and are not In addition to the Limits of Insurance shown in the Declaraticns clothing in this enctorsemetit shsl increase the Limits of Insurance shown in the Deda.atlons_ A. Solely Wth respect to HIRED AUTO LIABILITY: SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, is amended by adding the following exclusions: This insurance does not apply to: "Bodily injury" or "property damage" arising out of any: (1) Un`ns:ured or Under_nsured MUloristlaw; or (2) No Fa;a): Law or similar act or awl. "Property damage" to: (1) Property owned or being transported by, or rented o- loaned to Lrie insured; or (2) Property in the carp, cusmdy o- control• of the insured_ S. Solely with respect to HIRED AUTO LIABILITY: SECTION Il — WHO IS AN INSURED, is replaced by the following: Each cf the follewinc is an Insured Linder this endorserrleat tc the extent set form below: a. You; b. Any other person using a "hired auto" with your perr'seor: and c. Any other person or organization, but only for their liability because of acts or omisasons of an insured under a. or b. above. None of the following Is an insured: (1) Any person engaged in the business of his or her employer for'-bodily injury' to any co- "employee of such person inju -ed in the course of employment, or to the spouse, chile, parent, brother or s3st of that :: - employaa" as a consequence of such " bodiy injury`, or for any obfgattn to share damages with or repay someone else who must pay damages because of the Injury; (2) Any partner or "executive officer for any "autr." owned by su&- partner or officer or a member of his or he- household; (3) A.iy person whde emp'oyac In or otnanwise engaged in duties In connect -on with an "auto business ", other than an "auto business" you operate; AP2126US 31 -08 Page 1 of 2 001001 (4) 'ffle owner or lessee (of whom you are a sub iewsee) of a "hired "o w any ngeni or "ornp'uyee' ce any such owner or lessee; (5) Ariy pa son: w urUanizaiilon kx:ha widuct of arty currant ix ,c&t partnership or jo+nf venture that's not shown- as a Named Insured In Iho -.cdarstiois. C. Solely wrth respect to HIRED AUTO LIABILITY: SECTION V — DEFINITIONS :s amended by adding the tollota ng: 1. 'Auto Business' meRrs hie business or ocm-,)ation of se;i,ng. repairing, servicing; storing or parkint) "autos '. 2. 'Hired kite means any 'auto' you lease, fore or borrow. Th's does not include any `auto' you lease, hire or borrow from any of yot:r -employees' cr members of Meir households, cr from any partner or "executive cR- cer" of you s. ALL OTHER TERMS AND CONDITIDNS OF THE POLICY REMAIN UNCHANGED. AP2126US 41 -08 Page 2 of 2 001001 Policy # 000242447 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, NON -OWNED AUTO LIABILITY This endorsement modifies insurance urovided under the following: COMMERCIAL GENERAL'LIASILITY GOVERAGE SCHEDULE Caveraiie Limits of Insurance ` Ad�ifiional Psemiurn Non -Owped Auto L•abilil _ nciuded _Y The insomrico provided under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, applies to "bodily injury" or "property damage" arising out of the vse of a 'nor- -owned auto" by any person ctne- than you in the course of your business. The Lirrkt of Ins'arance shown in the Schedule above -s the most we will pay for Ime sums that the 1- lsured becomes legally obhgatnd tc nay as damages because of "bodily injury' or " property camage 11 arising cu: of the use of a t non- ov�ned auto" by ary person other than you in the ccurse of your businsss. The Limits of Insi.rance shown In ti-e Schedu :e above are included withi: and are not in addition to :he Limits of Hsu -ante shown In the Dec €aratiols. Nothing in this endorsement stall increase the Limits of Insurance shown Ir the Declarations. A. Solely with respect to NON -OWNED AUTO LIABILITY: SECTION f — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exctuslions, is amended by adding the followng exchasio -s: This insurance does pct apply to - 'Bodily injary" cr "propoNly damage "'arising out of any: (1) uninsured or Underinsured Motorist law; or (2) Na Fault Law or similar act or law. 'Property damage' to: (1) Property owned or beinq ;ransoorted by, or rented or Joened to the :nsu-ed; or (2) Property in the cars, custody or control of the insured. B. SoleEy wlfit respect to NON-OWNED AUTO LIABILITY: SECTION 11— WHO IS AN INSURED, is replaced by the following: Each of the following Is an insured under tt-is endorsement to the extent set fnrti below: a. You; b. For a 'non-owned auto ", any partner ar `execullva nfficer' cf yours, but only whse sucxr "non - owned auto° is being usea In your business; and c. Any other persor: or organization, bt:t only for their 4iablfity txwcause of acts or omissions of an insured under a. or b. above Done of the fo loving is an insured: (t) Any person engaged in the business of his or her amp!oyer for 'bodily Injury" to any co- "employee " of such person Injured in :he course of empioyment, a.- to the spouse, c h,ld, parent, brotner or s!sterof thet co-"employee" as a corsequerce of such "todl-y injury", or for any opligetion to share de-naces with or : spay someone else wno most qty damages because of We injury: (2) Any partner or "executive officer" for any "auto" orated by such partner or officer or a rremoer of his or har household; AP2127US 01 -108 Page 1 of 2 001001 (3) Any persun while employed 4: or othrirw'so ungarged it duties in wnnedivl with or tar. busiress", other than an "auto business" you uperate; (4) The owner of a 'nor-owned auto' ur any agent or'ornployee" of any sueh owner. (5) Any aerscn or organization for the conduct of any current or past partnership or jo nt venture that is not shcown as a Named Insured in the Declarations. C. Solo y with respect to NON -OWNED AUTO LIABILITY- SECTION V — DEFINITIONS is amended by addi g the folkpwtng 1. 'Auto Business' means the buskess or occupation of sell!ng, repairing. servicing. stor'rg ur porkirg `autos ". 2. "Non -Owned Auto" mears any 'auto" you do not own lease, h re or bo row whic h is Llsed in connectloi with your busiress_ Haw,ever, if you area partnership a "ncn -owned auto" does not irduda any 'auto" owned by any partner. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2127US 0 1 -48 Page 2 of 2 001001 Policy # 000242447 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance prcvided under the lo-lowing: ALL COVERAGE PARTS The Co•npany agrees to waive any r :ght of recov'y against any person or or;lanlzation, as reqt;°red by written contras -, because of payments we make for injury cr damage which ss lirrite d to liability Orectly caused by 'your work" which Is Imputed to suc`i persoi or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US '11-06 Page 1 of i 001001 Policy # 000242447 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFOLLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This andorsement nodiires insurance provided under the following: ALL COVERAGE PARTS SECTION it — Who Is An Insured is amended to Include any person or organization you are required to include as an additional Insured on this ;olicy by written contract or written agreement in effect during this oolicy period and executed prior to the "Decurrence" of the 'bodily injury" or .property damage The insurance provided to the Ad .1tional Insured urder this endorsement is limited as follows: 1. The osrsafi or crganization is only an adal ioral r!sired wit.. espee. to liabi ity arising solely o. it of "your ~pork" or 'your product' kind =cwt is imputod to the Addlt!anal Insured. 2. In `he event that the I_i-nits of lnsuraroe provided by this policy exceed 1#,e Li-nits of Insurance inquired by the written cortract or ,Mitten agreement, tho insurance provided by this erdorsement shall be tim-ted to the L:rn =*s of Insurance required oy the written contra1 or wri#:er. agreamert This endorsement sho I not increase this Limits of Insurance hated in .he Dec4arations. 3. This insurance does not apply to "bodily injury" or ' property damaged arising oat of "your work" or "your product included in the'prod .jcts — completed operations hazard" unless you are required to nrcvide such coverage by written contract or written agreement but only fcr the period of time requ -red by the written eon"ct or written agreement and only for " bodity injury" or 'property damage" that occurs during the pol.*cy period arising out of "your work" or "your product". 4. Any coverage provided by this endorsement to an Additional Insured shalt be excess over any other valid and collectible insurance available bo the Additional Insured whether prmary, excess, contingent or on any ofF.or basis uriess a written contract or written agreement specifical -y requires that th-s insurance apply on a primary and noncontributory basis. S. Where no coverage shall apply herein for the Named Insured, no coverago or defense shall be afforded to the Additional Insured. 6. This insurance sloes not apply to "bodily injury" or "property dsmage" arising out of the sole negligence of ti?e Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP2009US 02 -06 Page 4 of 1 001001 AGENCY CUSTOMER ID: LOG �• AC' RD' ADDITIONAL MMARKS SCHEDULE Page of AGENCY NAMED BOWED POLICY NUMBER CARRIER NAIC CODE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: GENERAL LIABILITY: 'Additt ona Insured whet requi ired by wtten oontract per Form: AP2009US 02 -06 "Waiver of S.ibrogatior as required by written contract per Form: Aa5004US ' 1 -06 AUTOMOBILE LIABILITY: 'Addit one InSLrec whet requi ed by witten contract per Forms: AP2126US 01-08 & AP2127US C1-C8 *Waiver of S.ibrogatior as required by written contract per Form: Aa5004US '1-06 F-T0161 :103 [+] [k�1111.1i li 3 i +Ifl i:[do]:11191617161 JA 1[*] 0 W- 11ft'if l l� The ACORD name and logo are registered marks of ACORD 001001