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HomeMy WebLinkAboutSilverado Contractors - Insurance Certificate/ 1-0 ACC>R® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 11717/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher& Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 CONTACT NAME:. PHONE FAX E -MAIL A DRESS, INSURERS AFFORDING COVERAGE NAIC # San Francisco CA 94111 INSURER A:Lexington Insurance Company 19437 $1,000,000 INSURED SILVCON -03 INSURERB:Wesco Insurance Company 25011 INSURERC:RSUI Indemnity Company 22314 Silverado Contractors, Inc. 2855 Mandela Parkway, 2nd Floor Oakland, CA 94608 INSURERD:Alaska National Insurance Company 38733 $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � ECT 7 LOC OTHER: GENERAL AGGREGATE INSURER E: PRODUCTS - COMP /OP AGG INSURER .F : Ded Per Occurrence $10,000 rnVCoer -ce rGOTICIr`ATC miIMRFo• 842117ARR R9=VICIr1N NIIMRFR- 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 /DDIYYYY L_ IMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE X❑ OCCUR Bodily In'./ Y Y 065463565 11/15/2014 11/15/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO PR EM S" (E. occu ante $100,000 X MED EXP (Any one person) $Excluded X Prop. Dam PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � ECT 7 LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 Ded Per Occurrence $10,000 B AUTOMOBILE LIABILITY X ANY AUTO AUTOS NED AUTOSULED NON -OWNED HIRED AUTOS AUTOS Y Y WPA102926003 11/1512014 11/15/2015 (Ea accident) SINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Comp /Coll Ded $1,000 C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NHA069872 11/15/2014 11/15/2015 EACH OCCURRENCE $10;000,000 X AGGREGATE $10,000,000 DED I X I RETENTION $ N/A $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNEWEXECUTIVE '❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y 14JWS09907 10/1/2014 10/1/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project #: 15 -PW -218 I Old Youth Center Project- 7400 Railroad St. ADDITIONAL INSURED(S): City of Gilroy L;LK I IrIL;A I r- MULUr-K 6ANL:1=LLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna St. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE V 78Sti -ZU14 AGUKU GUKFUKA I IUN. Au rlgnts reserves. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD _ 0.08750 ENDORSEMENT This endorsement, effective 12.01 AM 11/15/2014 Fors a part of policy no.: 065483565 Issued to: SILVERADO CONTRACTORS, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS (Based on CG2037 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional Insured Person(s) Location of Completed Operations or Organization(s) As required by written contract All locations Information required to complete this Schedule, if not shown above, WO 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 Lability for "bodily injury°, or "property damage" caused, in whole or in pant, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2 If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured WH not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: Inc., Wth its permission. Au Rights Reserved. 008750 1. Required by the contract or agreement; or 2 Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations All other germs and conditions of the policy remain the same. G Authorized Representative Offices, Inc., Wth b permission. AU Rights Reserved. 008750 ENDORSEMENT This endorsement, effective 1201 AM 11/15/2014 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION (Based on CG2010 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional insured Person(s) Location of Covered Operations or Organization(s) As required by written contract All locations Information required to complete this Schedule, if not shown above, will be shown in the Declarations A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions or 2 The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2 If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the-contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: Includes opyr4 oed In rmation the Insurance Services ege o Offices, Inc., with its permission. All Rights Reserved. 008750 This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the 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 intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project C. With respect to the insurance afforded to these additional insureds, the following is added to . Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most vue will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2 Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations Ali other terms and conditions of the policy remain the same. Authorized Representative Inchades Copyn.ghwd Intormfian crflhB Insurance Services Page Z01- i Offices, Inc., Wth its permission. All Rights Reserved. 008750 ENDORSEMENT # 005 This endorsement, effective M01 AM 11 /15/2014 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By:LEX1NGTON INSURANCE COMPANY AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the policy: Subject to the Overall General Aggregate Limit staffed in Item 3 of the Declarations, the General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your "projects" away from premises owned by or rented to you. It is further understood and agreed that the following changes are made to the policy: (1) Item 3, Limits of Insurance in the Declarations is amended by the addition thereto of the following Limit: Overall General Aggregate Limit - $ 10,000,000 (2) SECTION 111- LIMITS OF INSURANCE is amended by the addition thereto of the following paragraph under paragraph 6. 7. The Overall General Aggregate Limit is the most va will pay under Coverages A and B for the sum of all Limits of Insurance as provided in this SECTION III regardless of the number of your "projects "; except for damages because of "bodily injury" and "property damage" included in the "products - completed operations hazard ". For the purpose of this endorsement; "project" means the work for which the Named Insured is responsible according to a contract between the Named Insured as the contractor or sub - contractor, and an owner, developer or general or sub - contractor. All other terms, and conditions remain unchanged. Authorized Representative OR Countersignature (in states where applicable) 008750 ENDORSEMENT # 009 This endorsement, effective 1201 AM 11115/2014 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY WAIVER OF SUBROGATION (BLANKET) It is agreed that we, in the event of a payment under this policy, waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a written contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. All other terms and conditions remain unchanged. r Authorized Representative OR Countersignature (In states.,where applicable) LEXOCC234 (11103) LX0485 008750 ENDORSEMENT # 008 This endorsement, effective 1201 AM 11 /15/2014 Forms a part of policy no.: 065463565 Issued to: 81LYERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY PRIMARYINON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non - contributing. All other terms . and conditions of the policy remain the same. Authorized Representative OR Countersignature (in states where applicable) LX9838 (08/05) 008750 Policy Number: WPA102926003 (2) Immediately send us copies of any re- quest, demand, order, notice, summons or legal paper received concerning the claim or °suit". (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit'. (4) Authorize us to obtain medical records or other pertinent information. (5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably require. c. If there is "loss' to a covered "auto" or its equipment you must also do the following: (1) Promptly notify the police if the covered °auto" or any of its equipment is stolen. (2) Take all reasonable steps to protect the covered "auto" from further damage. Al- so keep a record of your expenses for consideration in the settlement of the claim. (3) Permit us to Inspect the covered "auto" and "records proving the "loss° before its repair or disposition. (4) Agree to examinations under oath at our request and give us a signed statement of your answers. 3. Legal Action Against Us No one may bring a legal action against us un- der this Coverage Form until: a. There has been full compliance with all the banns of this Coverage Form; and b.. Under Liability Coverage, we agree in writ- ing that the "'insured" has an obligation to pay or until the amount of that obligation has finally been determined by Judgment af- ter trial. No one has the right under this poli- cy to bring us Into an action to determine the'insured's" liability. 4. Loss Payment — Physical Damage Coverages At our option we may. a. Pay for, repair or replace damaged or stolen property; b. Return the stolen property, at our expense. We wig pay for any damage that results to the "auto" from the theft; or Page 8of12 c. Take all or any part of the damaged or sto- len property at an agreed or appraised val- ue. If we pay for the "loss ", our payment will include the applicable sales tax for the damaged or sto- len property. . 5. Transfer Of Rights Of Recovery Against Others To us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover . damages from another, those rights are transferred to us. That person or or- ganization must do everything necessary to se- cure our rights and must do nothing after "acc:i - denf or °loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insofvency of the "insured" or the "insured's" estate will not relieve us of any abll- gations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally con- ceal or misrepresent a material fact concern- ing: a. This Coverage Form; b. The covered "auto "; c. Your Interest In the covered °auto'; or d. A claim under this Coverage Form.. 3. Liberalization If vr9e revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revi- sion Is effective In your state. 4. No Benefit To Belles — Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provi- sion of this Coverage Form. ® I80 Properties, Inc., 2005 CA 00 0103 06 ❑ .008750 policy Number: WPA102926003 5. Other Insurance a. For any covered "auto" you own, this Cov- erage Form provides primary insurance. For any covered 'auto" you don't own, the in- surance provided by this Coverage Form is excess over any other collectible insurance. However, while ,a covered "auto" which Is a "trailer" Is connected to another vehicle, the Liability Coverage this Coverage Form pro - Ades for the "trailer" is: (1) Excess while k is connected to a motor vehicle you do not own. (2) Primary while it is connected to a cov- ered "auto" you own. b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or bbrrow is deemed 10 be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver Is not a covered "auto". c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability as- sumed under an "insured contract". d. 1Nhen this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the lim- its of all the Coverage Forms and policies covering on the same basis. 8. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the bal- ance, if any. the due date for the final pre- mium or retrospective premium is the date shown as the due date on the bill. If the es- timated total premium exceeds the final premium due, the first Named Insured will get a refund. b. If this policy is issued for more than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy. CA 00 0103 06 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "acci- dents" and "losses" occurring: a. During the policy period shown in the Deda- rations; and b. Within the coverage territory. The coverage territory is: a. The United States of America, b. The territories and possessions of the Unit- ed States of America; c. Puerto Rico; d. Canada; and e.• Anywhere in the world it (1) A covered "auto" of the private passen- ger type Is leased, hired, rented or bor- rowed without a driver for a period of 30 days or less; and (2) The °insured's" responsibility to pay damages is determined in a "suit' on the merits, in the United States of America, the territories and possessions of the United Stales of America, Puerto Rico, or Canada or in a settlement we agree to. We also cover "loss" to, or "accidents" InVohr- Ing, a covered "auto" while being transported between any of these places. B. Two Or More Coverage Forms Or Poll cies issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any com- pany affiliated with us apply to the some "aool dent", the aggregate maximum Limit of Insur- ance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply, to any Coverage Form or policy issued by us or an af- filiated company specifically tc apply as excess Insurance over this Coverage Form. SECTION V— DEFINITIONS A. "Accident" includes continuous or repeated expo- sure to the same conditions resulting in "bodily in- jury" or "property damage ". B. "Auto" means: 1. A land motor vehicle, "trailer* or semitrailer de- signed for travel on public roads; or ® ISO Properties, Inc., 2003 . Page 9 of 12 ❑ 008750 Hvf.v7v4 POLICY NUMBER: WPA102926003 COMMERCIALAUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies Insurance provided under the fallowing: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE'FORM MOTOR CARRIER COVERAGE FORM YRUCKERS CoVERAGE FORM With (aspect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement, .This endorsement Identities person(s) or organizations) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form.°This endorsement does not alter coverage provided In the Coverage Form. This endorsement changes the policy effective on the Inception date of the policy unless another date Is Indl- cated below. Endorsement Effective: 11 /15/2014 Countersigned By: LdRepresentative) Named Insured: SILVERADO CONTRACTORS, INC. SCHED(L.E Name of Person(s) or organizatfon(s): ANY PERSON OR ORGANISATION WHOM YOU HAVE AGRBED IN A MITTEN. CONTRACT, RXEMEiD PRIOR TO LOSS, TO NAME As ADDITIONAL INSF)RED. (If no entry appears above„: information required to complete this endorsement will be shown In the Declarations as applicable to the endorsement.) Each person or organizatigir-shovn In the Schedule Is an "insured" for Liability Coverage, but only to the Went that person or organization qualifies as an "Insured" under the Who Is An Insured Provision contained In Seddon II of the Coverage Form. CA 24 48 02 88 WAIVER OF SUBROGATION APPLIES Copyright, insurance Services Office, Inc:, 1998 FILE Page 1 of 1 CI 008750 AVINGURANCE COMPANY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (this agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) il'wilF1 You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Any person or organization for whom the insured has agreed, by written contract, to furnish this waiver. This endorsement changes the policy to which I is attached and, unless otherwise stated, is effective on the date issued at 1201 A.M. standard time at your marling address shown in the policy. The Information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective October 1, 2014 Insured Sihrerado Contractors, Inc. Countersigned By Veto& mar" WC 04 03 06 (04 84) Policy No. 14J WS 09907 Endorsement No. Arthur J. Gallagher/San Francisco 008750 AGENCY CUSTOMER ID: _ LOC #: A ®® ADDITIONAL REMARKS SCHEDULE Page Of AGENCY NAMED INSURED POLJCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL. REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: The Producer will endeavor to mail 30 days written notice to the Certificate Holder named on the certificate if any policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. GENERAL LIABIILITY Additional Insured - Owners, Lessees or Contractors Scheduled Person or Organization LX4315 (06114) Additional Insured - Owners, Lessees or Contractors Completed Operations LX4316 (06/14) Primary Insurance Clause Endorsement LX9838 (08105) Waiver of Subrogation LEXOCC234 (11103) AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT LX9695 (02104) AUTO LIABILITY Designated Insured CA20480299 Waiver of Subrogation CA00010306 WORKERS COMPENSATION Waiver of SubrogationWCD40306 (04 84) ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 008750 AC40RAD® CERTIFICATE OF LIABILITY INSURANCE 166�' DATE (MM /DD/YYYY) 1 10/1/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, 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 CONTACT NAME: PHONE FAX E-MAIL INSURERS AFFORDING COVERAGE NAIC # San Francisco CA 94111 INSURER A:Lexin on Insurance Company 19437 $1,000,000 INSURED SILVCON -03 INSURERB:Wesco Insurance Company 25011 Silverado Contractors, Inc. INSURERC:RSUI Indemnity Company 22314 2855 Mandela Parkway, 2nd Floor Oakland, CA 94608 INSURERD:Alaska National Insurance Company 38733 $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT FI LOC OTHER: GENERAL AGGREGATE INSURER E: PRODUCTS - COMP /OP AGG INSURER F Ded Per Occurrence $10,000 COVERAGES CERTIFICATE NUMBER- 990717056 RFVISInN NIIMRFR- 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. INISR LTR TYPE OF INSURANCE INSD yWD POLICY NUMBER POLICY EFF I POLICY EXP LIMAS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR Bodily Ini./ Y Y 065463565 1/15/2013 11/15/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO NTED PREMISES (Ea Rocxuce $100,000 X MED EXP (Any one person) $Excluded X Prop. Darn PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT FI LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 Ded Per Occurrence $10,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED S AUTI ULED HIRED NON-OWNED AUTOS Y Y WPA102926002 1!15/2013 11/15/2014 Fa $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROP DAMA Per accident $ Comp/C011 Ded $1,000 C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NHAD65636 1/15/2013 11/15/2014 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 DED X I RETENTION N/A $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY - Y / N ANY PROPRIETOR/PARTNER/DECUTNE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under .DESCRIPTION OF OPERATIONS below N/A y 14JWS09907 011/2014 10/1/2015 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 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project #- 15-PW -218 I Old Youth Center Project - 7400 Railroad St. ADDITIONAL INSURED(S): City of Gilroy GtK I IF IGA 1 t KULI0t -K GANGELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna St. Gilroy CA 95020 AUTHORED REPRESENTATIVE 4� ACORD 25 (2014101) ©1988 -2014 ACORD CORPORATION. All riahts reserved. The ACORD name and logo are registered marks of ACORD 006888 POLICYNUMBER: 065463565 ENDORSEMENT# 008 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the follovng: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract (If no entry appears above, information required to complete this endorsement vbll be shown in the Declarations as applicable to this endorsement.) A Section 11 - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2 Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All vork, including materials, parts or equipment furnished in connection with such vork, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of Which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project CG 20 10 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 ❑ LX905 006888 POLICYNUMBER: 065463565 ENDORSEMENT# 009 COMMERCIAL GENERAL LIABILITY CG 20 37 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the- following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract Location And Description of Completed Operations: Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement) Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your vwrk" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products - completed operations hazard ". CG 20 37 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 D LX9604 006888 ENDORSEMENT # 003 This endorsement, effective 1201 AM 11 /15/ 2013 Forms a part of policy no.: 065453565 Issued to: SILVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the policy: Subject to the Overall General Aggregate Limit stated in Item 3 of the Declarations, the General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your "projects" av%ay from premises owned by or rented to you. It is further understood and agreed that the following changes are made to the policy: (1) Item 3, Limits of Insurance in the Declarations is amended by the addition thereto of the following Limit: Overall General Aggregate Limit - $ 10, 000, 000 (2) SECTION III- LIMITS OF INSURANCE is amended by the addition thereto of the following paragraph under paragraph 6. 7. The Overall General Aggregate Limit is the most we will pay under Coverages A and B for the sum of all Limits of Insurance as provided in this SECTION III regardless of the number of your "projects "; except for damages because of "bodily injury" and "property damage" included in the "products - completed operations hazard ". For the purpose of this endorsement, "project" means the work for which the Named Insured is responsible according to a contract between the Named Insured as the contractor or sub- contractor, and an owner, developer or general or sub - contractor. All other terms and conditions remain unchanged. D/ - �tO4 )?AdJ-f� Authorized Representative OR Countersignature (In states where applicable) LX9695 (02/04) 006888 ENDORSEMENT # 007 This endorsement, effective 12:01 AM 11 /15/ 2013 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY WAIVER OF SUBROGATION (BLANKET) It is agreed that wa, in the event of a payment under this policy, waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a wrWmn contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) LEXOCC234 ( 11/03) LX0485 006888 ENDORSEMENT # 006 This endorsement, effective 12:01 AM 11 / 15/ 2013 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non - contributing. All other terms and conditions of the policy remain the same. D W J F Authorized Representative OR Countersignature (In states where applicable) LX9838 (08/05) 006888 Policy Number; WPA102926002 (2) Immediately send us copies of any re- quest, demand, order, notice, summons or legal paper received concerning the claim or "suit ". (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit ". (4) Authorize us to obtain medical records or other pertinent information. (5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably require. c. If there is "loss" to a covered "auto" or its equipment you must also do the following: (1) Promptly notify the police if the covered "auto" or any of its equipment is stolen. (2) Take all reasonable steps to protect the covered "auto" from further damage. AI- so keep a record of your expenses for consideration in the settlement of the claim. (3) Permit us to inspect the covered "auto" and records proving the "loss° before its repair or disposition. (4) Agree to examinations under oath at our request and give us a signed statement of your answers. 3. Legal Action Against Us No one may bring a legal action against us un- der this Coverage Form until: a. There has been full compliance with all the terms of this Coverage Form; and b_ Under Liability Coverage, we agree in wilt- ing that the "insured" has an obligation to pay or until the amount of that obligation has finally been determined by judgment af- ter trial. No one has the right under this poli- cy to bring us into an action to determine the "insured's" liability. 4. Loss Payment — Physical carnage Coverages At our option we may a. Pay for, repair or replace damaged or stolen property; b. Return the stolen property, at our expense. We will pay for any damage that results to the "auto" from the theft; or Page 8of12 c. Take all or any part of the damaged or sto- len property at an agreed or appraised val- ue. If we pay for the "loss ", our payment will include the applicable sales tax for the damaged or sto- len property. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or or- ganization must do everything necessary to se- cure our rights and must do nothing after "acci- dent" or °foss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obli- gations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured ", at any time, intentionally con- ceal or misrepresent a material fact concern- ing: a. This Coverage Form; b. The covered "auto "; c. Your interest in the covered "auto", or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revi- sion is effective in your state. 4. No Benefit To Bailee — Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provi- sion of this Coverage Form. ® ISO Properties, Inc., 2005 CA 00 0103 06 ❑ 006888 Policy Number: WPA102926002 5. Other Insurance a. For any covered "auto" you own, this Cov- erage Form provides primary insurance. For any covered "auto" you don't own, the in- surance provided by this Coverage Form is excess over any other collectible insurance_ However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Liability Coverage this Coverage Form pro- vides for the "trailer" is: (1) Excess while it is connected to a motor vehicle you do not own. (2) Primary while it is connected to a cov- ered "auto" you own. b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability as- sumed under an "insured contract".. d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the lim- its of all the Coverage Forms and policies covering on the same basis_ 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the bal- ance, if any. The due date for the final pre- mium or retrospective premium is the date shown as the due date on the bill. If the es- timated total premium exceeds the final premium due, the first Named Insured will W a refund. b. If this policy is issued for mare than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy. CA 00 0103 06 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "acci- dents" and "losses" occurring: a. During the policy period shown in the Decla- rations; and b. Within the coverage territory. The coverage territory is: a. The United States of America; b. The territories and possessions of the Unit- ed States of America; c. Puerto Rico; d. Canada; and e. Anywhere in the world if (1) A covered "auto" of the private passen- ger type is leased, hired, rented or bor- rowed without a driver for a period of 30 days or less; and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. We also cover "loss" to, or "accidents" involv- ing, a covered "auto" while being transported between any of these places. 8. Two Or More Coverage Forms Or Policies Issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any com- pany affiliated with us apply to the same "acci- dent", the aggregate maximum Limit of Insur- ance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply to any Coverage Form or policy issued by us or an af- filiated company specifically to apply as excess insurance over this Coverage Form. SECTION V — DEFINITIONS A. "Accident" includes continuous or repeated expo- sure to the same conditions resulting in "bodily in- jury" or "property damage". B. "Auto" means: 1. A land motor vehicle, 'trailer" or semitrailer de- signed for travel on public roads; or © ISO Properties, Inc.,, 2006 Page 9 of 12 ❑ 006888 ADnV7VG POLICY NUMBER: WPA102926002 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless mcdl- fied by this endorsement, This endorsement Identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date Is indi- cated below. Endorsement Effective: 11/15/2013 Counterstgned By, uth dRepresentative), Named Insured: SILVERADD CONTRACTORS, INC. SCHEO�LE 1 Dame of Person(s) or org wization(s); ANY PERSON OR ORGANIZATION WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT, EXECUTED PRIOR TO LOSS, TO NAME AS ADDITIONAL INSURED. (If no entry appears above,; information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement) Each person or organization shown in the Schedule Is an "Insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. WAIVER OF SUBROGA77ION APPLES CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 El Fi LE 006888 Akwka NaUonal I N S U R A N C E COMPANY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) Blanket Waiver: You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Any person or organization for whom the insured has agreed, by written contract, to furnish this waiver. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 1201 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective October 1, 2014 Insured Silverado Contractors, Inc. Countersigned By 661%;6 Rama WC 04 03 06 (04 84) Policy No. 14J WS 09907 Endorsement No. Arthur J. Gallagher /San Francisco 006888 AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM 1S A SCHEDULE TO ACORD FORM, FORM FORM TITLE: The Producer will endeavor to mail 30 days written notice to the Certificate Holder named on the certificate if any policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. GENERAL LIABIILITY Additional Insured - Owners, Lessees or Contractors Scheduled Person or Organization CG2010 1001 Additional Insured - Owners, Lessees or Contractors Completed Operations CG2037 1001 Primary Insurance Clause Endorsement LX9838 (08/05) Waiver of Subrogation LEXOCC234 (11/03) AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT LX9695 (02104) AUTO LIABILITY Designated Insured CA20480299 Waiver of Subrogation CA00010306 Excess: Follows Primary Forms Subject to Policy Term, Conditions 8 Exclusions WORKERS COMPENSATION Waiver of Subrogation WC040306 (04 84) 101 (2008101) 2008 ACORD CORPORATION_ All riohts reserved The ACORD name and logo are registered marks of ACORD 006888