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HomeMy WebLinkAboutPlaceWorks - Insurance Certificate1 ® ACOe�® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06129/2017 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services 17901 Von Kansan Avenue, Suite 1100 (949) 399 -5800, License #0437153 Irvine, CA 92614 CONTACT NAME PHONE FAX A/c No E -MAIL ADDRESS X COMMERCIAL GENERAL LIABILITY Attn NewportBeach CertRequest @marsh com/F 212- 948-0323 980627 -01 -01 -17 -18 INSURERS AFFORDING COVERAGE NAIC # INSURER A - Crum & Forster Specialty Insurance Co 44520 INSURED Placeworks INSURER B Travelers Property Casualty Company Of America 25674 CLAIMS -MADE X OCCUR Dba The Planning Center INSURER C. INSURER D Design Community & Enviomment 3 MacArthur Place, Suite 1100 $ 50,000 X Santa Ana, CA 92707 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: LOS- 001721259.13 REVISION NUMBER:6 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DDY/YYYY EXP /YYYY MM DDY LIMITS A X COMMERCIAL GENERAL LIABILITY X X EPK118128 07/01/2017 07/01/2018 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE X OCCUR DAMAGE T RENTED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person) $ 5,000 BI & PD Ded $5,000 PERSONAL & ADV INJURY $ 5,000,000 GEN L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 5,000,000 POLICY ❑ PRO LOC JEC7 PRODUCTS - COMP /OP AGG $ 5,000,000 Contractors Pollution $ 5,000,000 FX OTHER B AUTOMOBILE LIABILITY X X BA7E37616717CAG 07/0112017 07101/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per a.,dent $ NON -OWNED HIRED AUTOS AUTOS Comp /Coll Deductibles $ $1,000 B UMBRELLA LIAB X OCCUR EX6J3287561743 07/0112017 07101/2018 EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED) (Mandatory in NH) N/A UB7E37616717 07/01/2017 07/0112018 X IPER OTH- STATUTE ER E L EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000,000 A Errors & Omissions- Claims Made EPK118128 07101/2017 07/0112018 Each Claim/Aggregate 5,000,000 Retro Dates See 2nd Page DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re Job #1036, Gilroy High Speed Train Visioning Project The City of Gilroy, officers, representatives, agents, and employees are included as additional insured where required by written contract with respect to General and Auto Liability This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability Waiver of subrogalion is applicable where required by written contract with respect to General and Auto Liability The City of Gilroy Attn Rick Smelser, City Engineer 7351 Rosanna St Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Rosalynda Martinez 0% @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE "�'"' 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 poll Ies must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services 17901 Von Karman Avenue, Suite 1100 CONTACT NAMN: PHOEC No): E-MAIL ADDRESS: (949) 399.5800; License #0437153 Irvine, CA 92614 COMMERCIAL GENERAL LIABILITY X X INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Crum & Forster Specialty Insurance Cc 44520 980627 -01 -01 -15-16 INSURED Placeworks INSURER B : Travelers Property Casualty Company Of America 25674 INSURER C Dba: The Planning Center INSURER D: Design Community & Enviomment 3 MacArthur Place, Suite 1100 $ 50,000 X Santa Ana, CA 92707 INSURER E: INSURER F :. COVERAGES CERTIFICATE NUMBER: LOS -001721259 -10 REVISION NUMBER:6 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 'CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X EPK - 109158 07/01/2015 - 07/0112016 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE M OCCUR DAMA E T Rf= TED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person ) $ 5,000 BI & PD Ded. $5,000 PERSONAL & ACV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I $ 8,000,000 X POLICY ❑ JET- 71 LOC PRODUCTS - COMP /OP AGG $ 5,000,000 Contractors Pollution $ 5,000,000 OTHER: B AUTOMOBILE LIABILITY X X BA7E37616715CAG 07/01/2015 07/01/2016 COMBINED SINGLE LIMIT ,, Es accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS I BODILY INJURY (Per accident) $ I PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS $_ B • UMBRELLA LIAR X OCCUR EX- 7E376167- TIL -15 07/01/2015 07/01/2016 EACH OCCURRENCE $ 4,000,000' X AGGREGATE $ 4,000,000 EXCESS "LIAB CLAIMS -MADE DED I I .RETENTION$ $ B I WORKERS COMPENSATION AND. EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Fq (Mandatory in NH) NIA UB- 7E37616-7 -15 07101/2015- 07/01/2016 X STATUTE OR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ . 1,000,000 If es, describe under .DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Errors & Omissions - Claims Made EPK - 109158 07/01/2015 07/01/2016 Each Claim /Aggregate 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Gilroy, officers,, representatives, agents, and employees are included as additional insured where required by written contract with respect to General, and Auto Liability. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability. Waiver of subrogation is applicable.where required by written contract with respect to General and Auto Liability. The City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Rick Smelser, City Engineer THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna St. ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 .AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services John Graef �. ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ;r Policy Number: BA- 7E376161- 15 -CAG COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modes insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine- rights, duties, and what Is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COVERAGE - INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1,, Who Is An Insured, of SECTION 11 - LIABILITY COV- ERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT 1. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional Insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section III. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph AA., Who Is An Insured, of SECTION II - LI- ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION II - LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 02 12 0 2010 The Travelers indemnity Company Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc with its permission. COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, . rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that Is leased, hired, rented or borrowed with a driver Is not a covered "auto ". D. EMPLOYEES AS INSURED The following Is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any "employee" of yours Is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11 LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola - tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION ll — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (b) in Para- graph B.T., Policy Period, Coverage Territory, of SECTION IV -- BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, .hire, rent or borrow without a driver for a period of 30 days or less and that Is not an "auto" you lease, hire, rent or borrow from any of your ''employees' , partners. (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) 'With respect to any claim made or "suit" brought outside the United Staten of America, the territories and possessions of the United States of America, :Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tie any such claim or "suit" and keep us advised of all proceedings and ac- tions. (It). Neither you nor any other involved "insured" will make any settlement without our consent. (Ili) We may, at our discretion,. participate in defending the "insured" against, or in the settlement of, any claim or "suw,. (iv) We will reimburse the insured" for sums that the "insured" legally must pay as damages because of 'bodily injury". or "property damage to which this insurance applies, that the 'Sn- sured" pays with our consent, but only up to the limit described in. Para- graph C., Limit Of Insurance; of SEC- TION II — LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred With our consent for your investiga- Von of such claims and your defense of the "insured" against any such "suit!', but only up to and included within the limit described in Para- graph. C., :Limit Of Insurance; of SECTION 11 — LIABILITY COVER - AGE, and not in addition to such limit. Our duty to make such payments ends when we have used.-up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance :available Page 2 of 4 0 2010 The Travelers Indemnity Company CA T3 53 031.2 Includes copyrighted material of Insurance Services Me, Inc. with its permission. 'r to the "insured" whether primary, excess contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter - ritorles and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and . Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., De- ductible, of SECTION III — PHYSICAL:DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage ff the glass Is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III -- PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". L PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION 111 — PHYSICAL DAMAGE COVERA- GE: We will pay up to $50 per day to a maximum of $9;500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. COMMERCIAL AUTO J. PERSONAL EFFECTS The following is added. to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured "; and (2) In or onyour covered "auto ". This coverage applies only in the event of a total theft of your covered "auto ". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph 8.3.; Exclu- sions, of SECTION III -- PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in is covered "auto" you own that In- flate due to a cause other than a cause of "loss" set forth in Paragraphs. A.1.b. and AA.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The afrbags.were not intentional.ly.inflated. We will pay up to a maximum of $1,000 for any one "loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following Is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident'' or "loss ep= plies only when the "accident" or "loss" is known to: (a) You (If you are an Indlvldual); (b) A partner (if you are a partnership); (c) A member (d you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss " -. CA T3 53 0212 0 2010 The Travelers Indeff" Cor pany Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss ", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph .113.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information :given by you shall not prejudice your rights under this insurance. How -. ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal, Page 4 of 4 0 2010 The Travelers Indemnity Company CA 13 53 02.12 includes copyrighted material of Insurance Services Office, Inc. vAth Its permission. Ap- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ® OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s) The City of Gilroy 7351 Rosanna St. Gilroy, CA 95020 SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability caused, in whole or in part, by `your work' for that insured which is performed by you or by those acting on your behalf. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0111 -0211 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Oraanization(s) The City of Gilroy 7351 Rosanna St. Gilroy, CA 95020 A. SECTION III - WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you; or by those acting on your behalf. This insurance shall be primary and non - contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of "your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0118 -0211 Page 1 of 1 ACORD® CCO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DWYYYY) 06/29/2015 - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk 8 Insurance Services 17901 Von Kerman Avenue, Suite 1100 (949) 399 -5800; License #0437153 Irvine, CA 92614 CONTACT NAME: ME. PHONE FAX 'C. No): E-Ma IL ADDRE INSURERS AFFORDING COVERAGE NAIC # INSURER A: Crum & Forster Specialty Insurance Co 44520 960627 -01 -01 -15-16 INSURED Placeworks INSURER 8: Travelers Property Casualty Company Of America 25674 $ 5,000,000 Dba: The Planning Center INSURER C: INSURER D: Design Community 8 Enviomment 3 MacArthur Place, Suite 1100 RNTED PRAEMISET EaE occurrence) Santa Ana, CA 92707 INSURER E: X BI ,B PD Ded. $5,000 INSURER F : f`AV1P0ArFS CFRTIFICATF NIIMBER- LOS - 001721259-08 REVISION NUMBER:6 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. I�TR TYPE OF INSURANCE J= SUER POLICY NUMBER MMIDD�Y POLICY Y LIMITS A X COMMERCIAL GENERAL LIABILITY X X EPK- 109158 07/01/2015 07/01/2016 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE a OCCUR RNTED PRAEMISET EaE occurrence) $ 50,000 X BI ,B PD Ded. $5,000 MED EXP (Anyone person) $ 5,000 PERSONAL 8 ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMP /OP AGG $ 5,000,000: X POLICY PRO LOC JECT OTHER: Contractors Pollution $ 5,000,000 B AUTOMOBILE LIABILITY X X BA7E37616715CAG 07/01/2015 07/01/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NON OWNED HIRED AUTOS AUTOS Rr O acEcitleDAMAGE nt $ B UMBRELLA UAB X OCCUR EX- 7E376167- TIL -15 07/01/2015 07/01/2016 EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ 1 $ B WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE YIN OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N/A UB- 7E37616 -7 -15 07/01/2015 07/0112016 X STRTUT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yyes, describe under DESCRIPTION OF OPERATIONS below A Errors 8 Omissions - Claims Made EPK - 109158 07/01/2015 07/0112016 Each Claim/Aggregate 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Re: Job #1036, Gilroy High Speed Train Visioning Project The City of Gilroy, officers, representatives, agents, and employees are included as additional insured where required by written contract with respect to General and Auto Liability. This insurance is primary and non- contributory over any existing insurance andlimited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability. Waiverof subrogation is applicable where required by written contract with respect to General and Auto Liability. CFRTIFICATF HAI r1FR CANCELLATION The City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Rick Smelser, City Engineer THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna St. ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh Risk 8 Insurance Services John Graef. C 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Policy Number: COMMERCIAL AUTO BA- 7E37616/-15 -GAG THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement, The following listing is a general cover- age description only, Urnitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsoment and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COVERAGE - INDEMNITY BASIS G, WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who is An Insured, of SECTION ii - LIABILITY COV- ERAGE; Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the I80th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT 1. PHYSICAL DAMAGE TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "Property damage" occurs and that is in effect during the policy period, to be named as an addi= tional Insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.S., Who Is An Insured, of SECTION It - Lt- ABILITY COVERAGE; The following is added to Paragraph c. In A.I., An "employee" of yours is an "insured" while Who Is An Insured. of SECTION it - LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contractor agreement between you and ness. that person or organization, that is signed and CA T3 53 0212 0 2010 The Travelers indemnity Company Page 1 of 4 Includes copyrighted malarial of insurance Services Office, inc. mm its permission. COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION .IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow, and .(2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ": D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION U - LIABILITY COW ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION It — LIABILITY COVERAGE: (2) Up. to $3,000 for cost of ball bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to fumish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION 11— LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "Insured" at our request, including actual loss of earnings up to $500 a day .be• cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COW ERAGE — INDEMNITY BASIS The following, replaces Subparagraph (6) in Para- graph B.Z., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (6) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you .lease, hire, rent or borrow without a, driver far a period of 30 days or less and that is not an "auto" you lease, hire; rent or borrow from any of your "employees ", partners (If you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the. United States of America, Puerto Rico and Canada: (I) You must arrange to defend the "in- sured" against, and investigate or.set- tie any such claim or "suit" and keep us advised of all proceedings. and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "Insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally, must pay as damages. because of "bodily injury" or "property damage" to which this insurance applies;.:that the "in- sured" pays with our consent, but only up to the limit described in Para - graph C., Limit Of Insurance, of SEC - TION 11— LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limit Of Insurance, of SECTION If -- LIABILITY COVER- AGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses.. (b) This insurance is excess over any valid and collectible other insurance, available Page 2 of 4 ® 2010 The Travelers indemnity Company CA T3 63 0212 Includes coWkjhW meteriai of insurance Services Office, Inc, with b permission. to the "insured" whether primary, excess contingent or on any other bas's. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not Invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you compiled with the compulsory in- surance requirements. (d) It is understood that we are not.an admit- ted or authorized insurer outside the United. States of America, its territories and possessions, Puerto Rico and Can- ada.. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws ofothercountries relating to insurance. G. WAIVER OF DEDUCTIBLE - GLASS The following is added to. Paragraph D., De- ductible, of SECTION 111 - PHYSICAL DAMAGE COVERAGE: No deductible. for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE LOSS OF USE - INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b:, toss Of Use Expenses, of SEC- TION III -- PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for one "accident ". PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III - PHYSICAL DAMAGE COVERA- GE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. COMMERCIAL AUTO J. PERSONAL EFr-F -cTS The following is added to Paragraph AA., Cover- age Extensions, of SECTION III - PHYSICAL_ DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss".' to wearing ap- parel and other personal effects which are. (1) Owned by an "insured "; and (2) In or on your covered "auto". This coverage applies only in: the event of a total theft of your covered "auto ". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions ; of SECTION III - PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply: to "loss" to one or more airbags in a covered "auto' you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only a. If that "auto" is a covered "auto" for Compre- hensive.Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated.. We will pay up to a maximum of $1,000 for any one "loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT. OR LOSS The-following is added to Paragraph A.2.a., of SECTION IV - BUSINESS AUTO CONDITIONS. Your duty to give us or our authorized representa- tive prompt notice of the "accident or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other.or- ganization); or (e) Any �ernployee" authorized by you to give no- tice of the "accident' or "loss". CA T3 53.02 12 0 2010 The Travelers Indemnity Company Page 3 of '4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission.. COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS:. 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "lose', provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person. or organization designated in, .such contract. N. UNINTENTIONAL. ERRORS OR OMIS91OINS The following is added 1to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not: affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal. Page 4 of 4 0 2010 The Travelers Indemnity Company CA T3 53 02'12 Includes copyrlgMed matedal.of insurance Services {Mice, inc, with its permission. Crum'fi��:�!�p'-.Forster part eF the FA[AFRX group THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the fallowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organizations) Where Required By Written Contract SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional Insured the. person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability caused, in whole or impart, by "your wont" for that Insured which Is performed by you or by those acting on your behalf. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. ENOI I1 -0211 Page 1 of 1 Crun�&!-iPIF A pan of ors,ter the Fhnu? X Sip THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART by A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additlonal insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by. you, or by those acting on your behalf. This insurance shall be primary and non - contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of "your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any *claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0118 -0211 Page 1 of 1 ACORLfl® CERTIFICATE OF LIABILITY INSURANCE DATE 07/22//2014 2014 /YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services 17901 Von Karmen Avenue #1100 CONTACT NAME: PHONE FAX No): E -MAIL ADDRESS: (949) 399 -5800 License #0437153 Irvine, CA 92614 X X EPK- 104545 INSURERS AFFORDING COVERAGE NAIC # INSURER A : Crum & Forster Specialty Insurance Co 44520 980627 -01 -01 -14-15 INSURED Placeworks INSURER B: Travelers Property Casualty Company Of America INSURER C : Dba: The Planning Center INSURER D: $ 50,000 Design Community & Enviornment 3 MacArthur Place, Suite 1100 $ 5,000 PERSONAL & ADV INJURY Santa Ana, CA 92707 INSURER E: X BI & PD Ded. $5,000 INSURER F: COVERAGES CERTIFICATE NUMBER: LOS- 001600512 -06 REVISION NUMBER:3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY X X EPK- 104545 07/0112014 07/01/2015 EACH OCCURRENCE $ 5,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR DAMAGE To RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 5,000,000 X BI & PD Ded. $5,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPiOPAGG $ 5,000,000 X POLICY Ll PRO LOC Contractors Pollution $ 5,000,000 B AUTOMOBILE LIABILITY X X BA- 7E376167- TCT -14 07/0112014 07/01/2015 (CEO, ccident SINGLE LIMIT a 1,000,000 X __- BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS B UMBRELLA LIAB X OCCUR EX- 7E376167- TIL -14 07/01/2014 07/01/2015 EACH OCCURRENCE $ 4,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 4,000,000 DED RETENTION $ $ B WORKERS COMPENSATION UB- 7E37616 -7 -14 07/01/2014 07/01/2015 X WCSTATU- OTH- TORY I FR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N /A E.L. EACH ACCIDENT $ 1,000'000 E . DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT 1,000,000 $ A Errors & Omissions - Claims Made EPK - 104545 01101/2014 0710112015 Each Claim /Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Re: Job #1036, Gilroy High Speed Train Visioning Project The City of Gilroy, officers, representatives, agents, and employees are included as additional insured where required by written contract with respect to General and Auto Liability. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability. Waiver of subrogation is applicable where required by written contract with respect to General and Auto Liability. The City of Gilroy Attn: Rids Smelser, City Engineer 7351 Rosanna St. Gilroy, CA 95020 GANGtL.L.A I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk 3 Insurance Services John Graef ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 0266- 01 -00- 0002279 -0002- 0007209 Policy Number: BA7E376167TCT-14 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE ­ This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered, A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COVERAGE -INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION If - LIABILITY COV- ERAGE-. Any organization you newly acquire or farm dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT 1. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL EFFECTS K. AIPBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS execrated by you before the "bodily injury" or „property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualities as an "insured" under the Who Is An Insured provision contained in Section 11, C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.I., Who Is An Insured, of SECTION 11 - LI- ABILITY COVERAGE; The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION 11 - LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 02 12 9 2010 The Travelers 'ndernnity Company Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 0266- 01 -00- 0002279- 0003 - 0007210 COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV - BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease. hire, rent or borrow, and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11 - LIABILITY COV- ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION Il - LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to fumish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION 11- LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, Including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO - LIMITED WORLDWIDE COW ERAGE - INDEMNITY BASIS The following replaces Subparagraph (6) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV - BUSINESS AUTO CONDI- TIONS: (6) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees ", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (1) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured " will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "Insured" against, or in the settlement of, any claim or "suit ". (iv) We will reimburse the "insured" for sums that the "insured " legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limit Of Insurance, of SEC- TION II - LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limit Of Insurance, of SECTION 11 - LIABILITY COVER- AGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available Page 2 of 4 ® 2010 The Travelers indemnity Company CA T3 53 0212 hcludes copyrlght+ed material of Insurance Services Office, Inc. with its permission. 0266- 01 -00- 0002279 -0004- 0007211 to the "insured" whetter primary, excess contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE -- GLASS The following is added to Paragraph D., De- ductible, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE —INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III -- PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident ". t. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVERA- GE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. COMMERCIAL. AUTO J. PERSONAL EFFECTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION Ili — PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are; (1) Owned by an "insured "; and (2) in or on your covered "auto ". This coverage applies only in the event of a total theft of your covered "auto ". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph B.3.; Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and AA.c., but only: a. If that "auto" is a covered "auto!' for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,040 for any one "loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV -- BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany): (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss ". CA T3 53 02 12 C 2010 The Travelers Indemnity Company Page 3 Of 4 includes copyrighted material of Insurance Services Office, iric. +.vith its permission. 0266- 01 -00- 0002279 -0005- 0007212 COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A-S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TION& 5. Transfer Of Rights Of Recovery Against Others To Us We waive any Tight of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident'* or "loss", provided that the "accident" of "loss" arises out of operations contemplated by such contract The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph 8.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS. The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation of non-renewal. Page 4 of 4 -V 2010 The Travelers Indemnity Company CA T3 53 02 12 Includes copyrighted material ofinsurance Services OffiM mc. with its permission. 0266- 01 -00- 0002279- 0006 - 0007213 Crum Forster part of the group THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Where Required By Written Contract or urganization(s) SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability caused, in whole or in part, by "your work" for that insured which is performed by you or by those acting on your behalf ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0111-0211 Page 1 of 1 0266- 01 -00- 0002279- 0007 - 0007214 Crum , Forster part of the FAIRFAX group PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) Where Required by Written Contract A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf. This insurance shall be primary and non - contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "dGmages` arising out of "your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, EN0118 -0211 Cage 1 of 1 0266 - 01-00- 0002279 - 0008 - 0007215 /- , ® A`OR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 0710 „20,4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services 17901 Von Karman Avenue #1100 CONTACT NAME: PHONE FAX C _ __ A/C-Nol: ADDRESS: INSURERS AFFORDING COVERAGE NAIC # (949) 399 -5800 License #0437153 Irvine, CA 92614 INSURER A: Crum & Forster Specialty Insurance Co 44520 980627- 01- 01 -14 -15 INSURED Placeworks INSURER B: Travelers Property Casualty Company Of America $ 5,000,000 X COMMERCIAL GENERAL LIABILITY Dba: The Planning Center INSURER C : INSURER D: Design Community & Enviornment 3 MacArthur Place, Suite 1100 50,000 $ MED EXP (Any one person) Santa Ana, CA 92707 INSURER E: CLAIMS -MADE [i] OCCUR INSURER F : rnW=0AnI=Q r FRTIFIr_ATF NIIRARFR• I01,;- 001600512 -06 REVISION NUMBER:2 v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INRR SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD /YYYY LIMITS A GENERAL LIABILITY X X EPK- 104545 07/01/2014 07/01/2015 EACH OCCURRENCE $ 5,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea oc currence 50,000 $ MED EXP (Any one person) $ 5,000 CLAIMS -MADE [i] OCCUR PERSONAL & ADV INJURY $ 5,000,000 X BI & PD Ded. $5,000 GENERAL AGGREGATE $ 5,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 5,000,000 Contractors Pollution $ 5,000,000 X POLICY PRO LOC I B AUTOMOBILE LIABILITY X X BA- 7E376167- TCT -14 07/01/2014 07/01/2015 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per parson; $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED OW SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ - B UMBRELLA LIAB X OCCUR EX- 7E376167- TIL -14 07/01/2014 07/01/2015 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ B WORKERS COMPENSATION UB- 7E37616 -7 -14 07/01/2014 07/01/2015 X WC STATIU- I TRY LIM TS I OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? F W N ] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000 $ E L. DISEASE - POLICY LIMIT 1.000,000 $ A Errors & Omissions - Claims Made EPK- 104545 07/01/2014 07/01/2015 Each Claim/Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Job #1036, Gilroy High Speed Train Visioning Project The City of Gilroy, officers, representatives, agents, and employees are included as additional insured where required by written contract with respect to General and Auto Liability. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability. Waiver of subrogation is applicable where required by written contract with respect to General and Auto Liability. r`FRTIFIr`ATF 41n1 r1FR CANCELLATION The City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Rick Smelser, City Engineer THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna St. ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services John Graef- —GQ� -- © 1988 -2010 ACORD GORPORA I ION. All rlgnts reservea. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Z099L00-Z000-L"9000.00-LO-ZOZO