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Home My WebLink AboutGreyhound Lines - Insurance Certificate® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12/20/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Tana D. Stephenson Arthur J. Gallagher Risk Management Services, Inc. PHONE 212 -994 -7085 Fax 212- 994 -7047 A/C ° 250 Park Avenue E- DRESS: Tanya_Stephenson@ajg.com 3rd Floor INSURER(S) AFFORDING COVERAGE NAIC # New York NY 10177 INSURER A: National Union Fire Insurance Company of 19445 CLAIMS -MADE X❑ OCCUR INSURED INSURERB :Commerce and Industry Insurance Company 19410 Greyhound Lines' Inc. INSURER C: New Hampshire Insurance Company 23841 350 N. St. Paul Si. Dallas, TX 75201 INSURER D :American Home Assurance Company 19380 MED EXP (Anyone person) $ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMRER- 1068632192 REVISION NUMRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 3629887 12/31/2017 12/31/2018 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR MA TO RENTED PREMISES Ea occurrence $5,000,000 MED EXP (Anyone person) $ PERSONAL & ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY F7 PECOT- 7 LOC PRODUCTS - COMP /OP AGG $5,000,000 $ OTHER: A A A AUTOMOBILE LIABILITY ANY AUTO CA 1921794(AOS) CA1921795(MA) CA1921796 (VA) 12/31/2017 12/31/2017 12/31/2017 12/31/2018 12/31/2018 12'/31/2018 Ea accident SINGLE $5,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X PROPERTY DAMAGE Per accident) $ B X UMBRELLA LIAB X OCCUR 19452263 12/31/2017 12/31/2018 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ C D C C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUIIVE N OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC 014649556 (AOS,GA) WC 014649553 (CA) WC 014649552 (FL) WC 014649557 (MN) WC 014649555 (WI,MA) 12/31/2017 12/31/2017 12/31/2017 12/31/2017 12/31/2017 12/31/2018 12/31/2018 12/31/2018 12/31/2018 12/31/2018 X STATUTE ORH E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYEE $5,000,000 E.L. DISEASE - POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation: Policy #: WC 014649550 (AZ,IL,KY;NC,NJ,PA,UT,VA,VT) Policy Term: 12/31/17 to 12131/18 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 See Attached... CERTIFICATE HOLDER CANCELLATION City of Gilroy 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 REPRESENTATIVE © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD r ® acc�rzv CERTIFICATE OF L LIABILITY INSURANCE . DATE (M M/DD /YYYY) 12/27/2017 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(lies) must have ADDITIONAL. INSURED provisions or be endorsed.. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, .certain policies may require an endorsement: A statement on. this certificate does not confer ri hts to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor. CONTACT NAME:. Tanya D. Stephenson : PHONE 212.9947085 Fax 212 -994 -7047 . E -MAIL , Tanya Ste henson @ajg.COm INSURERS AFFORDING. COVERAGE NAIC # New York NY 101;77 INSURER A: National Union Fire Insurance Company of 19445 12/31/2017 INSURED INSURER B: New Ham shire Insurance Company 23841 INSURER C :American Home Assurance Company, 19380 Greyhound Lines, Inc. 350 N. St. Paul Dallas, TX 75201 1 INSURER D :Commerce and Indust Insurance Company 19410 INSURER E: INSURER F: $5,000,000 r`nVFRAr:FC f%CQTIG7r`ATC IUI IIIAQCQ R111Q1 FFXKd . ' mmille o%al IU1 fafin=M 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 LTA TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM /DD YYY POLICY EXP MM/DD /YY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 3629887 12/31/2017 12/31/2018 EACH OCCURRENCE $5,000,000 CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $5,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY' a JECT LOG GENERAL AGGREGATE $10,000,000 PRODUCTS . COMP /OP AGG $5,000,000 $ OTHER: A A A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS.ONLY X AUTOS ONLY. CA 1921794(AOS) CA1921795(MA CA1921796 (VA� 12/31/2017 12/31/2017 1213.1/2017 12/31/2018 12/31 /2018 12/31/2018 COMBINED N LE L $5,000,000 BODILY INJURY (Per person ) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ . D X UMBRELLA LIAB X OCCUR 28189402 12/31/2017 12/31/2018 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 •. EXCESS LIAB . CLAIMS -MADE DIED RETENTION $ $ B C B g B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F 7N (Mandatory In NH) . If yes, describe under DESCRIPTION OF OPERATIONS below NIA I WC 014649556 (AOS,GA) WC 014649553 CA) WC 014649552 X) WC, 014649557 MN WC .014649555 �WI,MAj 12/31/2017 12/31/2017 12/31/2017. 12/31/2017 12/31/2017 12131/2018 12/31/2018r 12/31/2018 12/31/2018 12/31/2018 vATPER STATUTE ERR E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYEd $5,000,000 E:L. DISEASE - POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS .I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) . Workers Compensation: Policy #: WC 014649550 (AZ,IL,KY,NC;NJ,PA,UT,VA;VT) Policy Term: 12/31/17 to 12/31/18. Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 See Attached... vats I trmom I C nVLUIMK GAIVL►tLLA I IVIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED' IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. USAy CA 95020 AA�U-- T�HORIZED REPRESENTATIVE 01 VUU -2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) : The ACORD. name and logo are registered marks of ACORD A� R®® EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DA12/21/20117" YES NO THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER CONTACT PERSON AND ADDRESS I PHONE 513- 657 -3116 COMPANY NAME AND ADDRESS NAIL NO: 19437 Commercial Lines - (513) 657 -3116 Lexington Insurance Company USI Insurance Services National, Inc. 3 Embarcadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX E-MAIL A/C No : ADDRESS. CODE: SUB CODE: POLICY TYPE AGENCY CUSTOMER In NAMED INSURED AND ADDRESS LOAN NUMBER POUCY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal 55601 025031395 804 Hangar Lane EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL Nashville, TN 37217 ITYES, LIMIT: DED: 12/31/2017 12131/2018 TERMINATED IF CHECKED ADDITIONAL NAMED INSURED( S1 FirstGroup America, Inc dba Greyhound Lines, Inc. etal THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION (ACORD 101 may be.attached if mores ace is required) M BUILDING OR DO BUSINESS PERSONAL PROPERTY Lexington Primary 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 EVIDENCE OF PROPERTY INSURANCE 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. CnVFRArAF INFnRMOTIAN DERV S INIIQI 192;:n I I RACIrt I I RRnAII I X I 4DGL`IAI COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: $100,000 CONTRACT OF SALE MORTGAGEE YES NO N/A ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: X I Actual Loss Sustained; # of months: BLANKET COVERAGE X AUTHORIZED REPRESENTATIVE Gilroy, CA 95020 If YES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE ATERRORISM- SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X ITYES, LIMIT: DED: FUNGUS EXCLUSION (If "YES ", specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X IfYES, LIMIT: $10,000,000 DED: $100,000 ORDINANCE OR LAW -Coverage for loss to undamaged portion of bldg X If YES, LIMIT: Included DED: Demolition Costs X If YES, LIMIT: $10,000,000 DED: $100,000 Incr. Cost of Construction X If YES, LIMIT: $10,000,000 DED: $100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached WIND / HAIL INCL ® YES ❑ NO Subject to Different Provisions: X If YES, LIMIT: $10,000,000 DED: per attached NAMED STORM INCL ® YES ❑ NO Subject to Different Provisions: X If YES, LIMIT: $10,000,000 DED: per attached PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST I ne P%wim .0 name ana logo are regimerea marKS OT AV VKU tV LUU3 -LU1 9 AL UKU GUKI -UKA I IUM. Au rignLs reservea. ACORD 28 (2016103) I IIIIIII IIIIII IIII IIII VIII IIIIII IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII �EPIO�Ax�r000ssarmwsworolo� 1106447 CONTRACT OF SALE MORTGAGEE LENDER'S LOSS PAYABLE LOSS PAYEE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: City Administrator 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95020 9t I ne P%wim .0 name ana logo are regimerea marKS OT AV VKU tV LUU3 -LU1 9 AL UKU GUKI -UKA I IUM. Au rignLs reservea. ACORD 28 (2016103) I IIIIIII IIIIII IIII IIII VIII IIIIII IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII �EPIO�Ax�r000ssarmwsworolo� 1106447 103353 REMARKS: (Continued from Pagel): RE: Loan P 55601 Lease Code: 1-891352 -011-01 Re: 7250 Monterey Street, Gilroy, CA SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 5 %, 250,000 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS US[ Insurance CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 720 East Pete Rose Way, Suite 400 AFFORDED BY THE POLICIES BELOW. Cincinnati, Ohio 45202 Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers on additional supplement Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Program limits: $ $75,000,000 Limit of Insurance per occurrence The following sublimity are part of and not in addition to the policy Limit of Liability $ $75,000,000 Earth Movement annual Aggregate for Earth Movement including New Madrid, Pacific Northwest and California $ $75,000,000 Flood Including SFHA - Annual Aggregate $ $75,000,000 Per occurrence for named storms Program Deductibles $ $100,000 Per occurrence except: 5 %, 250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 %, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum 5%, $100,000 minimum Wind and Hail Named Storms Coverage Enhancements Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company 11111111111111111111111111111111 IN 11111111111111111111111111111111111111111111111111111 -EP101A21/00052A/04A)aQRMW SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE USI Insurance. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Primary $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lexington Insurance Company 100% 025031395 Total 100% $15,000,000 xs $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyd's of London 54.50% B05OTN17NA27460 QBE 20.0% B0507N 17NA27430 $25,000,000 xs $25,000,000 12/31/17- 12/31/18 Participation % Policy Number Axis 10% B0507N 17NA27440 Lloyds 64.50% B0507N 17N A 27420 $65,000,000 xs $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyds of London 25.5% B0507N 17NA27470 $25,000,000 xs $25,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyd's of London 57.5% B0507N 16NA20340 Axis UK 10% B0507N16NA20330 $25,000,000 xs $50,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyds of London 74.5% B0507N 17NA27450 Limits Total Property Limit per occurrence $75,000,000 See Above Policy Numbers (subject to sub - limits and exclusions) Terrorism 12/31/17- 12/31 /18 Participation . /a Policy Number $75,000,000 100% 80507 P 17GTO4250 Lloyds of London 11111111111111111111111111111111 IN 11111111111111111111111111111111111111111111111111111 -EP10iA21/0W524105/05QM/0/V A`��® EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE( !s/ /2112 17 ,y212017 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE 513 - 657 -3i 16 CONTACT PERSON AND ADDRESS COMPANY NAME AND ADDRESS NAIL No: g4$7 Commercial Lines - (513) 657 -3116 Lexington Insurance Company USI Insurance Services National, Inc. 3 Embareadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX E-MAIL RE AfC No : ADDRE SS: CODE: SUB CODE: POLICY TYPE AGENCY CUSTOMER 10 M NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal IS DOMESTIC TERRORISM EXCLUDED? 025031395 600 Vine Street, Suite 1400 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL Cincinnati, OH 45202 X 12/31/2017 12/31/2018 TERMINATED IF CHECKED ADDITIONAL NAMED INSURED(S1 FirstGroup America, Inc dba Greyhound Lines, Inc. etal THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION fACORD 101 maV be attached If more SDace IS reauirea) I& tSUILUINU UK 131 CUSINrbb F'r_KJUNAL YKUrr -K I T Lexington Primary THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE 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. /`nVCDAf_C IKICnRWIATInAI 0=011 C M01 loon I I DAC1r I I DDnen X C0C ('1A1 COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: $100,000 CONTRACT OF SALE MORTGAGEE YES NO N/A ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy IfYES, LIMIT: X I Actual Loss Sustained; # of months: BLANKET COVERAGE X IfYES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE AUTHORIZED REPRESENTATIVE X Attach Disclosure Notice / DEC IS THERE A TERRORISM - SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X IfYES, LIMIT: DED: FUNGUS EXCLUSION (If- YES ", specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X IfYES, LIMIT: $10,000,000 DED: $100,000 ORDINANCE OR LAW -Coverage for loss to undamaged portion of bldg X If YES, LIMIT: Included DED: Demolition Costs X IfYES, LIMIT: $10,000,000 DED: $100,000 Incr. Cost of Construction X IfYES, LIMIT: $10,000,000 DED: $100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached WIND / HAIL INCL ® YES ❑ NO Subject to Different Provisions: X IfYES, LIMIT: $10,000,000 DED: per attached NAMED STORM INCL ® YES ❑ NO Subject to Different Provisions: X IfYES, LIMIT: $10,000,000 DED: per attached PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AnnITInNAI INTEREST I ne AGUKU name ana logo are registerea marKS OT AUUKU W ZUU3 -ZUT b AGUKU UUKI -UKA I IUN. An ngnts reservea. ACORD 28 (2016103) I IIIIIII IIIIII IIII IIII VIII IIIIII IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII �P1o�AZ+r000z�srosros+oro/ao• 1106137 CONTRACT OF SALE MORTGAGEE LENDER'S LOSS PAYABLE LOSS PAYEE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: Inga Alonzo 7351 Rosanna St. AUTHORIZED REPRESENTATIVE Gilroy, CA 95023 I ne AGUKU name ana logo are registerea marKS OT AUUKU W ZUU3 -ZUT b AGUKU UUKI -UKA I IUN. An ngnts reservea. ACORD 28 (2016103) I IIIIIII IIIIII IIII IIII VIII IIIIII IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII �P1o�AZ+r000z�srosros+oro/ao• 1106137 103353 REMARKS: (Continued from Pagel): Evidence of Coverage 1106137 A__._ Agency: U S I Insurance 720 East Pete Rose Way, Suite 400 Cincinnati, Ohio 45202 Insured: Firstgroup America, Inc. 600 Vine Street, Suite 1400 Cincinnati, OH 45202 Program Limits: SUPPLEMENT TO CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Insurers on additional supplement INSURER B: INSURER C: INSURER D: INSURER E: $ $75,000,000 Limit of Insurance per occurrence The following sublimits are part of and not in addition to the policy Limit of Liability $ $75,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacific Northwest and California $ $75,000,000 Flood Including SFHA - Annual Aggregate $ $75,000,000 Per occurrence for named storms Program Deductibles $ $100,000 Per occurrence except: 5%,250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 %, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum 5 %, $100,000 minimum Wind and Hail Named Storms Coverage Enhancements Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company u..W_._ SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE USI Insurance. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Pri mary $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lexington Insurance Company 100% 025031395 Total 100% $15,000,000 xs $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyd's of London 54.50% B0507N17NA27460 QBE 20.0% B0507N17NA27430 $25,000,000 is $2.5,000,000 12/31/17 - 12/31/18 Participation % Policy Number Axis 10% B0507N17NA27440 Lloyds 64.50% B0507N 17N A27420 $65,000,000 xs $10,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyds of London 25.5% B0507N 17NA27470 $25,000,000 xs $25,000,000 12/31/17- 12 /31/18 Participation , Policy Number Lloyd's of London 57.5% B0507N 16NA20340 Axis UK 10% B0507N16NA20330 $25,000,000 xs $50,000,000 12/31/17- 12/31/18 Participation % Policy Number Lloyds of London 74.5% B0507N 17NA27450 Limits Total Property Limit per occurrence $75,000,000 See Above Policy Numbers (subject to sub - limits and exclusions) Terrorism 12/31/17- 12/31/18 Particination % Policy Number $75,000,000 100% B0507P 17GTO4250 Lloyds of London 11111111111111111111111111111111 IN 11111111111111111111111111111111111111111111111111111 -EP101A21/0002151050W0/01W ACQR�® EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE (MMIDDNYYY) - ��. 12/22/2016 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY'AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR.NEGATIVELY AMEND,.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT. CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE 513_657 -3250 CONTACT PERSON AND ADDRESS COMPANY NAME AND ADDRESS NAIC NO: 19437 Commercial Lines - (513) 657 -3116 Lexington Insurance Company Wells Fargo Insurance Services USA, Inc. 3 Embarcadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 FAX A/C N,): 666-492 -3100 ADDRESS: sara.horn@wellsfargo.com IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH CODE: SUB CODE: POLICY TYPE AGENCY CUSTOMER ID #: NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal 55601 025031395 804 Hangar Lane If YES, LIMIT: DED: EFFECTIVE DATE EXPIRATION DATE .Nashville, TN 37217 CONTINUED UNTIL X 1213112016. 12/31 /2017 TERMINATED IF CHECKED ADDITIONAL NAMED INSUREDS) FirstGroup America, Inc dba Greyhound Lines, Inc. etal THIS REPLACES PRIOR EVIDENCE DATED; PROPERTY INFORMATION (ACORD 101 _rnay be attached if more space is required) IN BUILDING OR I& BUSINESS PERSONAL PROPERTY Lexington Primary 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 EVIDENCE OF PROPERTY INSURANCE 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. r_0VFROGFimmRMOTIf]N: ocou c IAICI loch I oeclr I I I MC".r, X ooen ni COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: $100,000 CONTRACT.OF SALE MORTGAGEE YES NO NIA ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: X I Actual Loss Sustained; # of months:. BLANKET COVERAGE X AUTHORIZED REPRESENTATIVE Gilroy, CA 95.020 If YES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE X Attach Disclosure Notice ! DEC IS THERE ATERRORISM- SPECIFIC EXCLUSION? IS DOMESTIC TERRORISM EXCLUDED? X X LIMITED FUNGUS COVERAGE X If YES, LIMIT: DED: FUNGUS EXC ,PVON (If "YES ", specify organization's form used) X -- -...- REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN .(IfApplicable) X If YES, LIMIT: $10,000,000 DED: $10.0,000 ORDINANCE OR LAW -Coverage for loss to undamaged portion of bldg X If YES, LIMIT: Included DED: Demolition Costs X If YES, LIMIT: $10,000,000 DED: $100,000 Incr. Cost of Construction X If YES, LIMIT: $10,000,000 DED: $100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: $10,006,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached WIND / HAIL INCL ® YES ❑ NO Subject to Different Provisions: X If YES, LIMIT: $10,000,000 DED: per attached NAMED STORM INCL ® YES ❑ NO Subject to Different Provisions: .X. If YES, LIMIT: $10,000,000 DED: per attached PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X GANGtLLA 1 ION SHOULD .ANY OF THE, ABOVE DESCRIBED. POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AIJLA I W FIAL.IIY 1 tKtS I nv ewvlw sue-1W anaa IWVW alu IGalalalau Mama YI /1VVR1J %,jLVu.i -[V70 ALVKY %.(lKYIJKAI WIV. All rlgnts reSerVeQ. ACORD 28 (2016103) 1004259 I IIIIIII IIIIILIII ill VIII IIIIII IIII VIII VIII VIII IIIILIIIII IIII IIiI VIII IIII IIII IIII •EPI01 A22N00820N2N3NAtDN• CONTRACT.OF SALE MORTGAGEE LENDER'S LOSS PAYABLE LOSS PAYEE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: City Administrator 7,351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95.020 o nv ewvlw sue-1W anaa IWVW alu IGalalalau Mama YI /1VVR1J %,jLVu.i -[V70 ALVKY %.(lKYIJKAI WIV. All rlgnts reSerVeQ. ACORD 28 (2016103) 1004259 I IIIIIII IIIIILIII ill VIII IIIIII IIII VIII VIII VIII IIIILIIIII IIII IIiI VIII IIII IIII IIII •EPI01 A22N00820N2N3NAtDN• 103353 REMARKS: (Continued from Pagel): RE: Loan #: 55601 Lease Code: L891352 -01L01 Re: 7250. Monterey Street, Gilroy, CA 1004259 oosa�x Program Limits: $ $75,000,000 Limit of Insurance per occurrence The following sublimits are part of and not in addition to the policy Limit of Liability $ $75,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacific Northwest and California $ $75,000,000 Flood Including SFHA - Annual Aggregate $ $75,000,000 Per occurrence for named storms Program SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Wells Fargo Insurance Services USA, Inc. CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 720 East Pete Rose Way, Suite 400 AFFORDED BY THE POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE Earthquake California INSURER A: Insurers on additional supplement Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: 5 0%, $1,000,000 INSURER E.: Program Limits: $ $75,000,000 Limit of Insurance per occurrence The following sublimits are part of and not in addition to the policy Limit of Liability $ $75,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacific Northwest and California $ $75,000,000 Flood Including SFHA - Annual Aggregate $ $75,000,000 Per occurrence for named storms Program Deductibles $ $100,000 Per occurrence. except: 5 %, 250,000 minimum Earthquake California 20 /0, $100,000 minlmum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 0%, $1,000,000 Flood SFHAlocation' minimum $100,000 Flood all other locations minimum 5%, $100,000 minimum Wind and Hall Named Storms Coverage Enhancements Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement coat value while parked at scheduled locations Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company I�IIhIp1�YIIIWII�lIIIWIIIIIGI� ,n1 .22_DM3M3..0* Agency: Wells Fargo Insurance Services USA, Inc. 720 East Pete Rose Way, Suite 400 Cincinnati, Ohio 45202 Insured: Firstgroup America, Inc. 600 Vine Street, Suite 1400 Cincinnati, OH 45202 SUPPLEMENT. TO CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below INSURER B: INSURER C: INSURER D: INSURER E: Primary $10,000,000 12/31/16- 12/31/17 p Participation % Lexington Insurance Company 100% Total 100% $15,000,000 xs $10,000,000 12/31/16- 12/31/17 Participation % Lloyd's of London 47.50% QBE 20.0% $40,000,000 xs $10,000,000 12/31/16- 12/31/17 Participation Axis 10% $65,000,000 xs $10,000,000 12/31/16- 12/31/17 Participation Lloyds of London 22.5% $25,000,000 xs $25 pUU.O11U 12/31/16- 12/31/17 Participation 'Yo Lloyd's of London 57.5% Axis UK 10% 525,000,000 xs $50.000,000 12/31/16 - 12/31117 Participation IN, Lloyds of London 77.5% Limits Total Property Limit per occurrence $75,000,000 (subject to sub - limits and exclusions) Terrorism 12/31/16- 12/31/17 Participation $75,000,000 100% Lloyds of London 007414 Policy Number 025031395 Policy Number B0507N 16NA20300 B0507N 16NA20350 Policy Number MCG784898 -16 Policy Number B0507N 16N20310 Policy Number B0507N 16N A20340 B0507N 16NA20330 B0507N 16NA20320 See Above Policy Numbers Policy Number B0507P16GT03550 A ®® ��... CERTIFICATE OF LIABILITY INSURANCE DATE (MMroDrrrYY) 12/2112016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor NAME: Tana D. Stephenson PHONE 212-994-7085 FAX 212- 994 -7047 E -MAIL . Tanya_Stephenson@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # New York NY 10177 INSURER A: National Union Fire Insurance Corn a 19445 12131/2016 INSURED INSURERB:COmmerce and Industry Insurance Com 19410 INSURER c:New Hampshire Insurance Company 23841 Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 INSURER D :American Home Assurance Company 19380 PREMISES Ea occ nce INSURER E: INSURER F: $ CnVFRAGFS CFRTIFICATE NUMBER- 981976064 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 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 INSD WVD POLICY NUMBER POLICY EFF MMIDDNY POLICY EXP MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 3629887 12131/2016 12/3112017 EACH OCCURRENCE 85,000,000 . CLAIMS -MADE X❑ OCCUR PREMISES Ea occ nce $5,000,000 MED EXP (Any one Person) $ _ PERSONAL & ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY 7 JECT FX] LOC PRODUCTS - COMP /OP AGG $5,000,000 I $ OTHER: A A A AUTOMOBILE LIABILITY X ANY AUTO CA1921794 (AOS) CA1921795(MA) CA1921796 (VA) 12/31/2016 12131/2016 12/31/2016 12/31/2017 12/31/2017 12/31/2017 Ea accident) $5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY TYUAMAh�E- Per accident $ Is B X UMBRELLA LIAB X OCCUR 19452263 12/3112016 12/31/2017 EACH OCCURRENCE $35,000,000 AGGREGATE $35,000,000 EXCESS I CLAIMS -MADE 7 DED RETENTION,$ $ C D C C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y /N ANY PROPRIETOR/PARTNER /EXECUTIVE N OFFICER/MEMBER EXCLUDE 07 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC 014649556 (AOS,GA,OR,TX) WC 014649553 (CA) WC 014649552 (FL) WC 014649557 (MN) WC 014649555 (WI,MA) 12/31/2016 12/31/2016 12/3112016 12/31/2016 12131/2016 12/31/2017 12/31/2017 12131/2017 12/31/2017 12/31/2017 X STATUTE ERH E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYE $5,000,000 E.L. DISEASE - POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Workers Compensation: Policy #: WC 014649554 (AZ,IL,NC,NH,NJ, PA,UT,VT) Policy Term: 12/31/16 to 12/31/17 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841): Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 See Attached... GtK I It'IGA I t HULUtK GANt;hLLA I WIN City of Gilroy 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. REPRESENTATIVE ® 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016 /03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ACR ®O ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMEDINSURED Greyhound-Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: r1v VI I Iv ltl/1G RGIYI/'1R RJ F HIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of Gilroy, its officers, representatives, agents and employees are included as additional insured(blanket end't) solely with respect to General and Automobile liability coverages as evidenced herein on a pprimary /non- contributory basis as required by written contract with respect to Lease Agreement. A waiver of subrogation applies as required by written contract. Notice of Cancellations. 30 days written notice /10 days for non -pay ACORD 101 (2008/01) ® 2008 ACORD The ACORD name and logo are registered marks of ACORD All riahts 1 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 2/2 1/2 01 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor CONTACT ME Tana D. Stephenson PHONE 212-994-7085 FAX 212-994-7047 E-MAIL . Tanya —Stephenson 9ajg.com INSURERS AFFORDING COVERAGE NAIC s New York NY 10177 INSURERA:National Union Fire Insurance Coma 19445 12/31/2016 INSURED INSURER B: Commerce and Industry Insurance Com 19410 INSURER c:New Hampshire Insurance Company 23841 Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 INSURER D:American Home Assurance Company 19380 PREMISES Ea occurrence) INSURER E: INSURER F: $ COVERAGES CERTIFICATE NUMBER: 1279940479 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 MfODIYYYY POLICY EXP M/DD/YY LIMITS A . X COMMERCIAL GENERAL LIABILITY GL.3629887 12/31/2016 12/3112017 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X OCCUR PREMISES Ea occurrence) $5,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $5,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY [ 7X PECOT- F 7X LOC PRODUCTS - COMP /OP AGG $5,000,000 $ OTHER: A A A AUTOMOBILE LIABILITY X . ANY AUTO CA1921794 (AOS) CA1921795 (MA) CA1921796 (VA) 12/31/2016 12/31/2016 12131/2016 12131/2017 12/31/2017 12/31 /2017 Ea accident $5,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ OWNED SCHEDULED .AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY TFOPERlP15AMA�E- Per accident $ E B X UMBRELLA LIAB X OCCUR 19452263 12/31/2016 12131/2017 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS MADE DIED RETENTION $ $ C D C C C WORKERS coMPENSATION AND EMPLOYERS' LIABILITY y /N ANY PROPRIETOR/PARTNER /EXECUTIVE N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below N /A WC 014649556 (AOS,GA,OR,TX) WC 014649553 (CA) WC 014649552 (FL) WC 014649557 (MN) WC 014649555 (WI,MA) 12/31/2016 12/31/2016 12/31/2016 12/31/2016 12/31/2016 12/31/2017 12/31/2017 12/3112017 12/3112017 12/31/2017 X STATUTE ERH E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYEE $5,000,000 E.L. DISEASE - POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Workers Compensation: Policy #: WC 014649554 (AZ,IL,NC,NH,NJ, PA,UT,VT) Policy Term: 12/31/16 to 1.2/31117 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841)", Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 See Attached... City of Gilroy 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. AAUUTHHO�RI�ZED REPRESENTATIVE 0 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name:and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC #: A R ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMEDINSURED Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AUUI I IUIVAL KtMAKKJ F HIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ORM NUMBER: 25 FORMTITLE: CERTIFICATE OF LIABILITY INSURANCE City of Gilroy, its officers, representatives, agents and employees are included as additional insured(blanket end't) solely with respect to General and Automobile liability coverages as evidenced herein on a pprimary /non - contributory basis as required by written contract with respect to Lease Agreement. A waiver of subrogation applies as required by written contract. Notice of Cancellations. 30 days written notice /10 days for non -pay ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 103353 .Q►tCO1rPl7® EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE 2/22/2/16 12/22/2016 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER CONTACT PERSON AND ADDRESS PHONE , 513 -657 -3250 COMPANY NAME AND ADDRESS NAIC NO: 19437 Commercial Lines - (513) 657 -3116 Wells Fargo Insurance Services USA, Inc. 720 East Pete Rose Way Suite 400 Cincinnati, OH 45202 FAX Nn1- 866-492 -3100 :�r_a. sara.hor CODE: SUB CODE: CUSTOMER ID #: NAMED INSURED AND ADDRESS FirstGroup America, Inc dba Greyhound Lines, Inc. eta[ 600 Vine Street, Suite 1400 Cincinnati, OH 45202 ADDITIONAL NAMED INSUREDS FirstGroup America, Inc %a Greyhound Lines, Inc. etal Lexington Primary Lexington Insurance Company 3 Embarcadero San Francisco, CA 94111 .Com I IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH LOANNUMBER POLICY NUMBER 025031395 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12/3112016 12/31/2017 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: is required) ® BUILDING OR ® BUSINESS PERSONAL PROPER' 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 EVIDENCE OF PROPERTY INSURANCE 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. CAVFRA[AF INFnRMATInN Deeu e , ,ci io n Y COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: $100,000. CONTRACT OF. SALE MORTGAGEE YES NO N/A ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: X I Actual Loss Sustained;.# of months: BLANKET COVERAGE X AUTHORIZED REPRESENTATIVE If YES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE Ti.- Ar^Dr% X Attach Disclosure Notice / DEC IS THERE A TERRORISM-SPECIFIC EXCLUSION? IS DOMESTIC TERRORISM EXCLUDED? X X LIMITED FUNGUS COVERAGE, X IfYES, LIMIT: . DED: FUNGUS EXCLUSION (If' YES', specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X If YES, LIMIT: $10,000,000 DED: $100,000 ORDINANCE OR LAW - Coverage for loss to undamaged portion of bldg X If YES, LIMIT: Included DED: Demolition Costs X If YES, LIMIT: $10,000,000 DEC): $100,000 Incr. Cost of Construction X If YES, LIMIT: $10,000,000 DED: $100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached WIND / HAIL INCL ® YES ❑ No Subject to Different Provisions: X If YES, LIMIT: $10,000,000 DED: per attached NAMED STORM INCL ® YES ❑ NO Subject to Different Provisions: X If YES, LIMIT: $10,000,000 DED: per attached PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AnniTIn N A'I I NTFD FCT CONTRACT OF. SALE MORTGAGEE LENDER'S LOSS PAYABLE LOSS PAYEE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: Inga Alonzo 7351 Rosanna St. AUTHORIZED REPRESENTATIVE Gilroy, CA 95023 91( Ti.- Ar^Dr% 103353 REMARKS: (Continued from Pagel): Evidence of Coverage 1003916 oo,M2 SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 5%,250,000 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Wells Fargo Insurance Services USA, Inc. CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 720 East Pete Rose Way, Suite 400 AFFORDED BY THE POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE 5 %, $1,000,000 INSURER A: Insurers on additional supplement Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45302 INSURER D: 5 %, $100,000 INSURER fi: Program Limits $ $75,000,000 Limit of Insurance per occurrence The following sublimits are part of and not in addition to the policy Limit of Liability $ $75,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacift Northwest and California $ $75,000,000 Flood Including SFHA-Annual Aggregate $ $75,000,000 Per occurrence for named storms Program Deductibles $ $100,000 Per occurrence except: 5%,250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 %, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum 5 %, $100,000 minimum Wind and Hail Named Storms Coverage Enhancements Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company ._ 111111111111111 loll 1111111111111 _____.. SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE Wells. Fargo Insurance Services USA, Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Primary $10.000.000 12/31/16- 12131/17 Participation % Policy 'Number Lexington Insurance Company 1000/0 025031395 Total 100% $15.000,000 xs $10,000,000 12/31/16 - 12/31/17 Participation % Policy Number Lloyd's of London 47.50% B0507N 16NA20300 QB E 20.0% B0507N 16N A 20350 $40,000,000 x5 $10,000000 12/31/16- 12/31/17 Participation % Policy Number Axis 10'yo MCG784898 -16 $05,000,000 xs $10,000,000 12/31/16- 12/31/17 Participation % Policy Number Lloyds of London 22.5% B0507N 16N20310 $25,000.000 xs $25,000,000 12/31/16- 12/31/17 Participation % Policy Number Lloyd's of London 57.5% BO507N 16NA20340 Axis UK 10% B0507N 16NA20330 $25.000.000 xs $50.000.000 12/31/16- 12/31/17 Participation % Policy Number Lloyds of London 77.5% B0507N 16NA20320 Limits Total Property Limit per occurrence $75,000,000 See Above Policy Numbers (subject to sub - limits and exclusions) Terrorism 12/31/16 - 12/31/17 Participation o/o Policy Numbcr $75,000,000 100% B0507P16GT03550 Lloyds of London 0015" 'A11.1 ACORDi EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DA 12/223/2015 YES NO THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE 513 - 657 -3250 CONTACT PERSON AND ADDRESS _LAIC..-N9-F-X0; COMPANY NAME AND ADDRESS NAIC NO: 19437 Commercial Lines - (513) 657 -3116 Lexington Insurance Company Wells Fargo Insurance Services USA, Inc. 3 Embarcadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX 866 -492 -3100 E-MAIL sara.hom wellsfar o.com _LAIC, No _ ADDRESS @ g CODE: SUB CODE: POLICY TYPE _ AGENCY-- - - - - -- - - --- - - -- CUSZOMER.ID NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal 55601 025031395 804 Hangar Lane LIMITED FUNGUS COVERAGE EFFECTIVE DATE EXPIRATION DATE If YES, LIMIT: DED: Nashville, TN 37217 X 12/31/2015 12/31/2016 CONTINUED UNTIL TERMINATED IF CHECKED DI NAL MED INSU ED( iirs��roup�Amenca, �nc d is Greyhound Lines, Inc. eta! THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION Use REMARKS on page 2, if mores ace is required) DU BUILDING OR kJ BUSINESS PERSONAL PROPERTY Lexington Primary 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 EVIDENCE OF PROPERTY INSURANCE 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. CAVFRAGF INFORMATInN PPPII R INRI IRFn I I RACK I I RRnAn I X RPFCIAI COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: $100,000 MORTGAGEE LENDERS LOSS PAYABLE YES NO NIA © BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: X I Actual Loss Sustained; # of months: BLANKET COVERAGE X 7351 Rosanna Street Gilroy, CA 95020 If YES, indicate value(s) reported on property identified above: $ 10,000,000 TERRORISM COVERAGE X Attach Disclosure Notice/ DEC IS THERE A TERRORISM- SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X If YES, LIMIT: DED: FUNGUS EXCLUSION (If "YES ", specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X If YES, LIMIT: $10,000,000 DED: $100,000 ORDINANCE OR LAW - Coverage for loss to undamaged portion of bldg X If YES, LIMIT: DED: - Demolition Costs X If YES, LIMIT: $10,000,000 DED: $100,000 Incr. Cost of Construction X If YES, LIMIT: $10,000,000 DED: $100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: $10,000,000 DED: per attached WIND / HAIL INCL ❑ YES ❑ NO Subject to Different Provisions: X if YES, LIMIT: $10,000,000 DED: per attached NAMED STORM INCL ❑ YES ❑ NO Subject to Different Provisions: If YES, LIMIT: DED: PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AOnITiONAL INTFRFST The ACORD nWpp, and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 2$ (2014101) 892556 ICI IIII VIII I�ili III! �II VIII lull VIII Iu� VIII IIII IIII) VIII IIII IIII •EPIWA231000660/02l03 000/0' Uu u MORTGAGEE LENDERS LOSS PAYABLE CONTRACT OF SALE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: City Administrator AUTHORIZED REPRESENTATIVE 9e-- /I^/- 7351 Rosanna Street Gilroy, CA 95020 The ACORD nWpp, and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 2$ (2014101) 892556 ICI IIII VIII I�ili III! �II VIII lull VIII Iu� VIII IIII IIII) VIII IIII IIII •EPIWA231000660/02l03 000/0' Uu u 103353 REMARKS: (Continued from Pagel): RE: Loan #: 55601 Lease Code: L891352 -01L01 Re: 7250 Monterey Street, Gilroy, CA 892556 003782 Agency: Wells Fargo Insurance Services USA, Inc 720 East Pete Rose Way, Suite 400 Cincinnati, Ohio 45202 Insured: Firstgmup America, Inc. 600 Vine Street, Suite 1400 Cincinnati, OH 4.5202 Program Limits $ Program Deductibles $ Coverage Enhancements 00178] SUPPLEMENT TO CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Insurers on additional supplement INSURER B: INSURER C: INSURER D: INSURER E: $50,000,000 Limit of Insurance per occurrence The following sublimits are part of and not in addition to the policy Limit of Liability $50,000,000 Earth Movement annual Aggregate for Earth Movement including New Madrid, Pacific Northwest and California $50,000,000 Flood including SFHA- Annual Aggregate $50,000,000 Per occurrence for named storms $100,000 Per occurrence except: 5 %, 250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5%, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum. 5%, $100,000 minimum Wind and Hail Named Storms Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Schedule of Locations on file with company Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company ■I11i911N1Y1111111111111111 Yl1 ._ _ _ __ SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Wells Fargo Insurance Services USA, Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Firstgroup America, Inc. INSURER B: 600 Vine Street. Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Primary $10.000.000 12131/15- 12/31/16 Participation % Policy Number Lexington Insurance Company 100% 025031395 Total 100% $15.000.000 xs $10.000.000 12/31/15- 12/31/16 Participation % Policy Number Lloyd's of London 70.3% NI5NA1545O Lloyd's of London 19.7% N15NA15490 Axis 10% MCG784898 -15 Total 100% $25.0Nl.OINI no $25.IOUNNI 12!31/15. 12/31/16 Participation % Policy Number Lloyd's of London 60.3% N15NA15460 Lloyd's of London 19.7% N15NA15490 Lloyd's of Lond - Axis 10% N15NA15470 Axis I 01ye MCG784898 -15 Total 100% Limits Total Property Limit per occurrence $50,000,000 See Above Policy Numbers (subject to sub -limits and exclusions) Terrorism 12/31/15- 12/31/16 Participation % Policy Number $50,000,000 100% P14GT02290 Lloyds of London W3794 ACOR ®® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 12/16/2015 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 Risk Management Services, Inc. 250 Park Avenue 3rd Floor CONTACT Tana D. Stephenson PHONE 212-994-7085 FAX 212 994 -7047 AIC, E -MAIL ADDRE55, Tanya_Stephenson@ajg.com INSURER (S) AFFORDING COVERAGE NAIC4 New York NY 10177 INSURER A:Insurance Company of State of PA 19429 12/31/2015 INSURED INSURER B: New Hampshire Insurance Company 23841 Greyhound Lines, Inc. INSURER c: National Union Fire Insurance Coma 19445 350 N. St. Paul St. Dallas, TX 75201 INSURER D: Commerce and Industr y Insurance Com 19410 . RENTED- PREMISES Ea occurrence INSURER E: INSURER F: $ r0VF9Ar:FS CFDTIFICATF NI IMRFD• 1100851967 DF\ /ISIf1W NI IMRFD- 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 ADDLISUBRF INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 094 -93 -89 12/31/2015 12/31/2016 EACH: OCCURRENCE $5,000,000 CLAIMS-MADE X❑ OCCUR RENTED- PREMISES Ea occurrence $5,000,000 MED EXP (Anyone person) . $ PERSONAL & ADV INJURY $5;000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY JE� a LOC PRODUCTS - COMPIOP AGG $5,000,000 $ OTHER: C C A AUTOMOBILE LIABILITY ANY AUTO ALITOS ED SCHEDULED HIRED AUTOS X NON -OWNED AUTOS CA 949248 (AOS) CA4584447 (MA) CA4584448 (VA) 12/31/2015 12/31/2015 12/31/2015 12/31/2016 12/31/2016 12/31/2016 Ea BINFD $5,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X Per accident E S D X UMBRELLA LIAB X OCCUR 19086731 12/31/2015 12/31/2016 EACH OCCURRENCE $2,000,000 AGGREGATE $2;000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ is B, B B B B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/y ANY PROPRIETOR/PARTNER/EXECUME OFFICERIMEMBER EXCLUDED? � (Mandatory in NH)' If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC 001705104, (OR) WC001705104(TX) WC001705104 (AOS) WC 001 70 50 99 (CA) WC001 7 0 51 01 (1M) WC 001705095 (FL) 12/31/2015 12/31/2015 12/31/2015 12/31/2015 12/31 /2015 12/31/2015 12/31/2016 12/31/2016 12/3112016 12/31/2016 12/31/2016 12/31/2016 X STATUTE �RH E.L. EACH ACCIDENT $5,000;000 E.L. DISEASE - EA EMPLOYE $5,000,000 E.L. DISEASE.- POLICY LIMIT $5,000,000 B B B Workers Compensation Workers Compensation Workers Compensation WC001705101 (MA) WC044216117 (MN) 1705100 (IL,NC,NH,UT,VT,) 12/31/2015 12/31/2015 12/3112015 12/31/2016 12/31/2016 12/31/2016 Same as Above WCPolicy E.L. Disease -Ea Emp 5,000,000 E.L. Disease- Policy 5,000,000' DESCRIPTION.OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation: Policy #:.1105104 (AZ,GA) & WC 001705100 (NJ,PA) Policy Term: 12/31/15 to 12/31/16 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident/ E.L. Disease -Ea Employee / E.L. IDisease- Policy Limit - $5,000,000 See Attached... City of Gilroy 7351 Rosanna Street Gilroy CA 95020 USA I.AIVGtLLA 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 -2014 ACORD CORPORATION., All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD AC AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Greyhound Lines, Inc. 350 N. St. 'Paul St. Dallas, TX 75201 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of Gilroy, its officers, representatives, agents and employees are included as additional insured(blanket end't) solely with respect to General and Automobile liability coverages as evidenced herein on a primary /non - contributory basis as required by written contract with respect to Lease Agreement. A waiver of subrogation applies as required by written contract. Notice of Cancellation: 30 days written notice /10 days for non -pay ACORD 101 (2008101) I ® 2008 ACORD CORPORATION_ All riehfc rpcerverl_ The ACORD. name and logo are registered marks of ACORD ACOR P CERTIFICATE OF LIABILITY INSURANCE �.� DATE(140N/DDIYYYY) F12/16/2015 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 Risk.Management Services, Inc. 250 Park Avenue 3rd Floor CONTACT NAME: Tanya D. Stephenson PHONE 212-994-7085 FAX 212 994 -7047 DDRES . Tanya_Stephenson @ajg.com INSURER AFFORDING COVERAGE NAIC s New York NY 10177 INSURER A: Insurance Company of State of PA 19429 12/31/2015 INSURED INSURER B: New Hampshire Insurance Company 23841 Greyhound Lines, Inc. INSURER c: National Union Fire Insurance Coma 19445 350 N. St. Paul T Dallas, T X 75201 1 INSURER D: Commerce and Industry Insurance Com 19410 DAMAGE70 TED PREMISES Ea occurrence INSURER E: INSURER F: $ COVERAGES CERTIFICATF NIIMRFR• 1432046335 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. INSR LTR TYPE OF INSURANCE INSD WVD - POLICY NUMBER POLICY EFF MIDD/YY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 094 -93 -89 12/31/2015 12/31/2016 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE70 TED PREMISES Ea occurrence .$5,000,000 MED EXP (Any one person) $ I PERSONAL & ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $10,000,000 POLICY JECOT- F 7X LOC PRODUCTS - COMP /OP AGG $5,000,000 8. OTHER: C C A AUTOMOBILE LIABILITY ANY AUTO CA4584447 (MA) CA 949248 (AOS) CA4584448 (VA) 12/31/2015 12/31/2015 12/31/2015 12/3112016 12/31/2016 12/31/2016 Ea accident $5,000,000 X BODILY INJURY (Per person) $' BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS HIRED AUTOS X NOWOWNED AUTOS X DAMAGE Per accident $ $ D X UMBRELLA LIAB X OCCUR 19086731 12/31/2015 12/31/2016 EACH OCCURRENCE $35,000,000 AGGREGATE $35,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ g B B B B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC 001705104 (OR) WC001705104(TX) WC001705104 (AOS) WC 001705099 (CA) WC001 7 05 101 (WI) WC 001705095 (FL) 12131/2015 12/31/2015. 12/31/2015 12/31/2015 12/31/2015 12/31/2015 12/31/2016 12/31/2016 12/31/2016 12/3112016 12/31/2016 12/31/2016 x PER oTH- STATUTE ER E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYEd $5,000,000 E.L. DISEASE - POLICY LIMIT $5,000,000 B B Workers Compensation Workers Compensation Workers. Compensation WC044216117 (MN) WC001705101 (MA) 1705100 (IL,NC,NH,UT,VTJ 12/31/2015 12131/2015 12/31/2015 12/31/2016 12/31/2016 12/31/2016 Same as Above WCPolicy E.L. Disease -Ea Emp 5,000,000 E.L. Disease - Policy 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation: Policy #: 1705104 (AZ,GA) & WC 001705100 (NJ,PA) Policy Term: 12/31/15 to 12/31116 Carrier Name :'NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. !Disease- Policy Limit - $5,000,000 See Attached... L,cm 1 if• il.A i G r1ULUtK t ANN tLLA I IUN City of Gilroy 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 REPRESENTATIVE ® 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and :logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of.Gilroy,. its officers, representatives, agents and employees are included as additional insured(blanket end't) solely with respect to General and Automobile liability coverages as evidenced herein on a primary/non- contributory basis as required by.written contract with respect to Lease Agreement. A waiver of subrogation applies as required by written contract. of Cancellation: 30 days written notice /10 days for non -pay ® 2008 ACORD CORPORA The ACORD name and logo are registered marks of ACORD All rights reserved. ACCME'� CERTIFICATE OF LIABILITY INSURANCE 16* / DATE(MM/DD/YYYIr) 1 5/15/2015 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 INSUREII 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 Risk Management Services, Inc. 250 Park Avenue 3rd Floor CNO TE CT Tana D. Stephenson PNONE 212 -994 -7085 FAX 212- 994 -7047 AIC. EMAIL . Tanya_ Stephenson @ajg.com INSURERS AFFORDING COVERAGE NAIC # New York NY 10177 INSURER A: Insurance Company of State of PA 19429 12/31/2014 INSURED INSURER B: National Union Fire Ins Co Pittsbur 19445 INSURERC:Commerce and Industry Insurance Com 19410 Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 INSURERD:New Hampshire Insurance Company 23841 DAMAGE TO RERTEIT- PREMISES Ea occurrence INSURER E: INSURER F: $ COVERAGES CERTIFICATE NUMBER_ 813155456 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 INSD WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY GL 0949389 12/31/2014 12/31/2015 EACH OCCURRENCE $5,000,000 CLAIMS -MADE FX OCCUR DAMAGE TO RERTEIT- PREMISES Ea occurrence $5,000,000 MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY F_X] jE Q 7 LOC PRODUCTS - COMP /OP AGG $5,000,000 $ OTHER: B B A B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS N AUT SEED CA4584447 MA A j CA 949248 ( O CA4882242 (VA) CA 949248 (ADS) 232014 2/31/2014 2/3112014 1/2015 1231/20 1213 1/2015 12131/2015 Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X Per accident DAMAGE $ C X UMBRELLA LIAR X OCCUR 19961742 2/31/2014 12/31/2015 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ A D D D D D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFlCERlMEMBER EXCLUDED? (Mandatory In MR) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC 001705104 (OR) WC001705104 (TX) WC001705104 (ADS) ( WC 001705099 (CA) WC001705101 (WI) WC 001705095 (FL) 2/31/2014 2/31/2014 2/31/2014 12/31/2014 2131/2014 2/31/2014 12/31/2015 12131/2015 12/31/2015 12131/2015 12131/2015 12/31/2015 ER X STATUTE ER E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA MPLOYEd $5,000,000 E.L. DISEASE -POLICY LIMIT $5,000,000 D D D Workers Compensation Workers Compensation WC001178530 (WI) WC044216117 (MN) 1705100 (IL,NC,NH,UT,VT, 2/31/2014 2/31/2014 2/31/2014 12/3112015 12131/2015 1213112015 Same as Above WCPolicy E.L. Disease -Ea Emp 5,000,000 E.L. Disease - Policy 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Workers Compensation: Policy #: 1705104 (AZ,GA) $ WC 001705100 (NJ,PA) Policy Term: 12/31/14 to 12/31/15 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 See Attached... City of Gilroy 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. REPRESENTATIVE n 1991 1d ACORN All rights reserved ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 002258 AGENCY CUSTOMER ID: LOC #: ACCT ADDITIONAL REMARKS SCHEDULE 16.1 ...r Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Greyhound Lines, Inc. 350 N. St. Paul St. Dallas, TX 75201 POLICY NUMBER CARRIER TAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE of Gilroy, its officers, representatives, agents and employees are included as additional insured(blanket end't) y with respect to General and Automobile liability coverages as evidenced herein on a primary/non - contributory as required by written contract with respect to Lease Agreement. A waiver of subrogation applies as required by an contract. of Cancellation: 30 days written notice /10 days for non -pay ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 002258 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 12/29/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the 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 Risk Management Services, Inc. 250 Park Avenue 3rd Floor CONTACT CT Tanya D. Stephenson PHONE , 212- 994 -7085 Fa't 212- 994 -7047 E -MAIL . Tanya_ Stephenson @ajg.com INSURERS AFFORDING COVERAGE NAIC # New York NY 10177 INSURER A: Insurance Company of State of PA 19429 12/31/2014 INSURED INSURER B:New Hampshire Insurance Company 23841 Greyhound Lines, Inc. INSURERC:National Union Fire Ins Co Pittsbur 19445 350 N. St. Paul Street Dallas, TX 75201 INSURERD:COmmerce and Industry Insurance Com 19410 DAMA E TO RENTED PREMISES Ea occurrence INSURER E: INSURER F: $ COVERAGES CERTIFICATE NUMBER: 909040256 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 IN" WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 0949389 12/31/2014 12/31/2015 EACH OCCURRENCE $5,000,000 CLAIMS -MADE ❑X OCCUR DAMA E TO RENTED PREMISES Ea occurrence $5,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY 1-1 �ECOT- [ X] LOC PRODUCTS - COMP /OP AGG $5,000,000 $ OTHER: C C A AUTOMOBILE LIABILITY ANY AUTO AUTOS OWNED SCHEDULED CA4584447 MA ( ) CA 949248 (AOS) CA4882242 (VA) 12/31/2014 12/31/2014 12/31/2014 12/31/2015 12/31/2015 12/31/2015 Ea accident SINGLE $5,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ D X UMBRELLA LIAB X OCCUR N 19961742 12131/2014 12/31/2015 EACH OCCURRENCE $35,000,000 AGGREGATE $35,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ A B B B B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes „descrbe under DESCRIPTION OF OPERATIONS below N/A WC 001705104 (OR) WC001705104 (TX) W0001705104 (ADS) WC 001705099 (CA) WC001705101 (WI) WC 001705095 (FL) 12/31/2014 12/31/2014 12/31/2014 12/31/2014 12/31/2014 12/31/2014 12/31/2015 12/31/2015 12/31/2015 12/31/2015 12/31/2015 12/31/2015 X, STA UTE I I ERH E.L. EACH ACCIDENT $5,000,000 E.L. DISEASE - EA EMPLOYE $5,000,000 E.L. DISEASE - POLICY LIMIT $5,000,000 B B B Workers Compensation Workers Compensation WC44216118(MN) WC001178530 (MA) 1705100 (IL,NC,NH,UT,VT, 12/31/2014 2/31/2014 12/31/2014 12/31/2015 12/31/2015 12/31/2015 .. Same as Above WCPolicy E.L. Disease -Ea Emp 5,000,000 E.L. Disease - Policy 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Workers Compensation: Policy #: 1705104 (AZ,GA) & WC 0017051.00 (NJ,PA) Policy Term: 12/31/14 to 12/31/15 Carrier Name: NEW HAMPSHIRE INS CO (NAIC #:23841) Limits: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease - Policy Limit - $5,000,000 City of Gilroy, its officers, representatives, agents and employees are included as additional insured(blanket end't) See Attached... City of Gilroy 7351 Rosanna Street Gilroy CA 95020 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 007941 AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Greyhound Lines, Inc. 350 N. St. Paul Street Dallas, TX 75201 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE with respect to General and Automobile liability coverages as evidenced herein on a primary/non- contributory as required by written contract with respect to Lease Agreement. A waiver of subrogation applies as required by i contract. s of Cancellation: 30 days written notice /10 days for non -pay ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 007941 vnga1 A��® AAA EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE Y) YES 130/20/4 12/30/2014 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME; PHONE rj13 -6S7 -3250 CONTACT PERSON AND ADDRESS COMPANY NAME AND ADDRESS NAIC NO: 1943] Commercial Lines - (513) 657 -3116 Lexington Insurance Company Wells Fargo Insurance Services USA, Inc. 3 Embarcadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX N,): 866 -492 -3100 ADDRESS: Sara.hom@wellsfargo.Com CODE: SUB CODE: POLICY TYPE AGENCY ER ID CUST NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal 1S DOMESTIC TERRORISM EXCLUDED? 025031395 804 Hangar Lane EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL Nashville, TN 37217 If YES, LIMIT: DED: 12/31/2014 12/31/2015 TERMINATED IF CHECKED tp1 ls{�roL NAME IN �E Na Greyhound Lines, Inc. etal THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION Use REMARKS on page 2, if more space is required) DU BUILDING OR X.I BUSINESS PERSONAL PROPERTY Lexington Primary 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 EVIDENCE OF PROPERTY INSURANCE 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. CnVFRACP INFORMATInN PERU c [M-qI IrzFn I I RACK I I RPnnn I X I RP;:r.w COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: 100,000 MORTGAGEE LENDERS LOSS PAYABLE YES NO WA ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: Actual Loss Sustained; # of months: BLANKET COVERAGE X 7351 Rosanna Street. Gilroy, CA 95020 If YES, indicate value(s) reported on property identified above: $ 10,000,000 TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE A TERRORISM-SPECIFIC EXCLUSION? X 1S DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X If YES, LIMIT: DED: FUNGUS EXCLUSION (If "YES ", specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X If YES, LIMIT: 10,000,000 DED: 100,000 ORDINANCE OR LAW - Coverage for loss to undamaged portion of bldg X If YES, LIMIT: DED: - Demolition Costs X If YES, LIMIT: 10,000,000 DED: 100,000 - Incr. Cost of Construction X If YES, LIMIT: 10,000,000 DED: 100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: 10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: 10,000,000 DED: per attached WIND / HAIL INCL ❑ YES ❑ No Subject to Different Provisions: X If YES, LIMIT: 10,000,000 DED: per attached NAMED STORM INCL ❑ YES ❑ NO Subject to Different Provisions: If YES, LIMIT: DED: PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST The ACORD nqMp and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 28 (2014101) 771960 I � �� IUI WI �� •EPIWA3a00059810?/0WO/010• MORTGAGEE LENDERS LOSS PAYABLE CONTRACT OF SALE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: City Administrator AUTHORIZED REPRESENTATIVE 7351 Rosanna Street. Gilroy, CA 95020 J ,� The ACORD nqMp and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 28 (2014101) 771960 I � �� IUI WI �� •EPIWA3a00059810?/0WO/010• 103353 REMARKS: (Continued from Pagel): Lease Code: L891352 -01 L01 Re: 7250 Monterey Street, Gilroy, CA 771960 Donn Agency: Wells Fargo Insurance Services USA, Inc. 720 East Pete Rose Way, Suite 400 Cincinnati, Ohio 45202 Insured: Firstgroup America, Inc. 6W Vine Street, Suite 1400 Cincinnati, OH 4,5202 Program Limits $ $ $ Program Doductiblcs Coverage Enhancements OM23 SUPPLEMENT TO CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Insurers on additional supplement INSURER B: INSURER C: INSURER D: INSURER E: $50,000,000 Limit of Insurance per occurrence The following sublimity are part of and not In addition to the policy Limit of Liability $50,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacific Northwest and California $50,000,000 Flood Including SFHA- Annual Aggregate $50,000,000 Per occurrence for named storms $100,000 Per occurrence except: 5%,250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 %, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum 5 %, $100,000 minimum Wind and Hall Named Storms Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Schedule of Locations on file with company Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and In the Primary Blanket Policy per Schedule on File with Company 111111111111-11111 It 11110 1111111 o ..�_.. Lloyds or London 0=24 SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Wells Fargo Insurance Services USA, Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Frstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Primary $10.000.000 12/31/14 - 12/31/15 Participation % Policy Number Lexington Insurance Company 100% 025031395 Total 100% $15ANA00.xs $10.000.000 12/31/14 -11/ MS Participation % Policy Number Lloyd's of London 82.5% N14NA13960 Lloyd's of London 7.5% N14NA13961 Axis 10% MCG784898 -14 Total 100% $25.40),000 No $25A00.Wo 12/31 /14 - 12/31/15 Participation % Policy Number Lloyd's of London 72.5% N14NA13962 Lloyd's of London 7.5% N14NA13961 Lloyd's of Lond - Axis 10% N14NA13963 Axis jg'Q MCG784898 -14 Total 100% Total Property Limit per occurrence Limits $50,0001000 Sec Above Policy Numbers (subject to sub - limits and exclusions) Terrorism 12/31 /14 - 12/31 /15 Participation % Policy Number $50,000,000 100% P140T02290 Lloyds or London 0=24 A� LY EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE Y) YES 12/30/20014 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE CONTACT PERSON AND ADDRESS , 513- 657 -3250 C o COMPANY NAME AND ADDRESS NAIC NO: 19437 Commercial Lines - (513) 657 -3116 Lexington Insurance Company Wells Fargo Insurance Services USA, Inc. 3 Embarcadero 720 East Pete Rose Way Suite 400 San Francisco, CA 94111 Cincinnati, OH 45202 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX N. I: 866 -492 -3100 ADDRESS: sara.hom@welisfargo.com CODE: SUB CODE: POLICY TYPE AGENCY C NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER FirstGroup America, Inc dba Greyhound Lines, Inc. etal 025031395 600 Vine Street, Suite 1400 LIMITED FUNGUS COVERAGE EFFECTIVE DATE EMRATON DATE If YES, LIMIT: DED: Cincinnati, OH 45202 X 12/31/2014 12/31/2015 CONTINUED UNTIL TERMINATED IF CHECKED /�pp1��p THIS REPLACES PRIOR EVIDENCE DATED: irDsf(i uro pNmeDnlcaUFn�a Greyhound Lines, Inc. etal YKUYEK1 Y INI'UKMAI ION use KEMiAKK5 on page l IT more space Is re ufrea DU BUILDING UK lCJ bU51NE55 FER50NAL PROPERTY Lexington Primary 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 EVIDENCE OF PROPERTY INSURANCE 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. f`nVCDAGC IMCnD\AATInW 0=11 a 1k1c1 corn I I DAQI � I I DDnnn X cDCriA� COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,000,000 DED: 100,000 MORTGAGEE LENDERS LOSS PAYABLE YES NO NIA ® BUSINESS INCOME ® RENTAL VALUE X City of Gilroy If YES, LIMIT: Actual Loss Sustained; # of months: BLANKET COVERAGE X 7351 Rosanna St. Gilroy, CA 95023 If YES, indicate value(s) reported on property identified above: $ 10,000,000 TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE A TERRORISM-SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X If YES, LIMIT: DED: FUNGUS EXCLUSION (If "YES ", specify organization's form used) X REPLACEMENT COST X AGREED VALUE _ X COINSURANCE X If YES, % EQUIPMENT BREAKDOWN (If Applicable) X If YES, LIMIT: 10,000,000 DED: 100,000 ORDINANCE OR LAW - Coverage for loss to undamaged portion of bldg X If YES, LIMIT: DED: - Demolition Costs X H YES, LIMIT: 10,000,000 DED: 100,000 - Incr. Cost of Construction X If YES, LIMIT: 10,000,000 DED: 100,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: 10,000,000 DED: per attached FLOOD (If Applicable) X If YES, LIMIT: 10,000,000 DED: per attached WIND / HAIL INCL ❑ YES ❑ NO Subject to Different Provisions: X If YES, LIMIT: 10,000,000 DED: per attached NAMED STORM INCL ❑ YES ❑ NO Subject to Different Provisions: If YES, LIMIT: DED: PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AnnITIONAt INTFRFST The ACORD ning and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 28 (2014101) 771966 IN 1 III 11111 •EPI01A30/00059"2/031010/010' MORTGAGEE LENDERS LOSS PAYABLE CONTRACT OF SALE LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS City of Gilroy Attn: Inga Alonzo AUTHORIZED REPRESENTATIVE 9( 01 7351 Rosanna St. Gilroy, CA 95023 The ACORD ning and logo are registered marks of ACORD © 2003 -2014 ACORD CORPORATION. All rights reserved. ACORD 28 (2014101) 771966 IN 1 III 11111 •EPI01A30/00059"2/031010/010' 103353 REMARKS: (Continued from Pagel): Evidence of Coverage 771966 ams. Agency: Wells Fargo Insurance Services USA, Inc. 720 East Pete Rose Way, Suite 400 Cincinnati, Ohio 45202 Insured: Firstgroup America, Inc. 600 Vine Street, Suite 1400 Cincinnati, OH 45202 Program Limits S Program Deductibles Coverage Enhancements 007559 SUPPLEMENT TO CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Insurers on additional supplement INSURER B: INSURER C: INSURER D: INSURER E: $50,000,000 Limit of Insurance per occurrence The following sublimits are part of and not In addition to the policy Limit of Llability $50,000,000 Earth Movement annual Aggregate for Earth Movement Including New Madrid, Pacific Northwest and California $50,000,000 Flood Including SFHA - Annual Aggregate $50,000,000 Per occurrence for named storms $100,000 Per occurrence except: 5%,250,000 Earthquake California minimum 2 %, $100,000 minimum Earthquake New Madrid, Pacific Northwest and Foreign High Hazard Zones 5 %, $1,000,000 Flood SFHA location minimum $100,000 Flood all other locations minimum 5 %, $100,000 minimum Wind and Hall Named Storms Waiver of Subrogation included where required by written contract Owned or Leased Vehicles are covered at Replacement cost value while parked at scheduled locations Schedule of Locations on file with company Blanket Loss Payee is included where required by written contract Limits are Per Occurrence and in the Primary Blanket Policy per Schedule on File with Company e11r1111111111111111111111 u1111e11 _..� SUPPLEMENT TO CERTIFICATE OF INSURANCE Agency: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Wells Fargo Insurance Services USA, Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED B_ Y THE 720 East Pete Rose Way, Suite 400 POLICIES BELOW. Cincinnati, Ohio 45202 Insured: INSURERS AFFORDING COVERAGE INSURER A: Insurers outlined below Firstgroup America, Inc. INSURER B: 600 Vine Street, Suite 1400 INSURER C: Cincinnati, OH 45202 INSURER D: INSURER E: Primary $10.000.000 12!31/14 - 11131/15 Particivation % Policy Number Lexington Insurance Company 100% 025031395 Total 100% $15.000.000 xs $10.000.000 12/31/14- 12/31/15 Participation % Pollcv Number Lloyd's of London 82.5% N14NA13960 Lloyd's of London 7.5% N14NA13961 Axis 10% MCG784898 -14 Total 100% $25AWA1Kl xs $25.4KKljllKl 11!31/14. 12/31/15 Participation % Policy Number Lloyd's of London 72.5% N14NA13962 Lloyd's of Landon 7.5% N 14NA13961 Lloyd's of Lond -Axis 10% N14NA13963 Axis j� MCG784898 -14 Total 100% Total Property Limit per occurrence Limits $50,000,000 Sec Above Policy Numbers (subject to sub -limits and exclusions) Terrorism 12/31 /14- 12/31/15 Particioadon % Policy Number $50,000,000 100% P14GT02290 Lloyds of London 003560