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HomeMy WebLinkAboutFarotte Construction Co. - Insurance Certificates282086 AC R'L® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 12/30/2015 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 endoreeme s . PRODUCER Construction $ Real Estate Practice CONTACT NAME: PHONE I FAx (866) 358 -1487 WC, No. Extis A/C No): Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 E-IMIL e nests wellsfar ADDRESS CertR o.COm 4 @ 9 INSURERS AFFORDING COVERAGE NAIL # 959 Skyway Road INSURER A: State Compensation Insurance Fund 35076 San Carlos, CA 94070 INSURED INSURER 6: Farotte Construction Co., Inc. INSURER C : 80 Casey Street INSURER D $ INSURER E: GENERAL AGGREGATE $ INSURER F $ Gilroy, CA 95020 COVERAGES CERTIFICATE NUMBER: 9963407 REVISION NUMBER: See below THIS 1S 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. JNSR LTR TYPE OF INSURANCE POLICY NUMBER MM/DCDrYYYY MM /D /YYri LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7 OCCUR EACH OCCURRENCE $ DAMAGE TO RENTFIY___ PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D JECT 71 LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS CO eBl. D SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPER PTY DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS WORKERS COMPENSATION EMPLOYERS' LIABILITY Y /N ANY PROPRIETOR /PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS. below NIA 19628042016 1/1/2016 1!112017 X PER OT E.L. EACH ACCIDENT 1 $ ,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required) Re: All California Operations. V I:K 1 IrIL;A I t MULUCK GANt4tLL.A I IUN City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Roseanna Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 11111111111 IIIIIIIIIIIIIII111111111111111111 .cY801A3000329W02/0y0/00,0. a� °® CERTIFICATE OF LIABILITY INSURANCE DATE /22010 010 Y) 122 !31 /31 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 Construction & Real Estate Practice NAME PHONE FAX (650) 4134497 Wells Fargo Insurance Services USA, Inc. - CA Lic #: OD08408 A/C No ADDRESS: CertRe uests wellsfar o.com ADDRESS: q CertRequests@welisfargo.com 959 Skyway Rd., 2nd FI PRODUCER FAROTCONS CUSTOMER ID San Carlos_ CA 94070 INSURED Farotte Construction Co., Inc. 80 Casey Street Gilroy, CA 95020 INSURER (S) AFFORDING COVERAGE INSR LTR NAI( INSURER A: Interstate Fire & Casualty Co. SUBR 22829 INSURER B: General Insurance Company of America POLICY EXP M DD/YYYY 24732 INSURER C: State Compensation Insurance Fund GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 35076 INSURER 0: SGL1002206 3/1/2010 INSURER E COVERAGES CERTIFICATE NHMRER- 22J1 /Yb RFVI3ION Nt1MRFR• See below 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 MWDD/YYYY POLICY EXP M DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR SGL1002206 3/1/2010 3/1/2011 EACH OCCURRENCE $ 1,000,000 AMA E N 1E1_ PREMISES Ea occurrence $ 000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 24CC2772071 3/1/2010 3/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PFX73095085 03/01/10 03/01/11 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILI Y Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) H describe under DESCRIPTION OF OPERATIONS below N/A 667618711 1/1/2011 1/1/2012 WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All California Operations. (:AN(rLLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Building Department 7351 Roseanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA 95020 © 1988 -2009 ACORD CORPORATION. All rights reserved. AGORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ^ 282086 A�R 1p® DATE ( /30 /2013 CERTIFICATE OF LIABILITY INSURANCE 12/30/2013 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 poiicy(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 CONTACT NAME: Construction & Real Estate Practice PHONE FAX No. Exn: _ Arc No : (866) 358 -1487 Wells Fargo Insurance Services USA, Inc. - CA Lic #: OD08408 E-MAIL ADDRESS: CertR nests g ellsfar o.com 959 Skyway Road INSURER(S)AFFORDINGCOVERAGE NAICS San Carlos, CA 94070 INSURER A: State Compensation Insurance Fund 35076 INSURED INSURER 13: Farotte Construction Co., Inc. INSURER C 80 Casey Street INSURER Gilroy, CA 95020 I INSURER F: I 1 COVERAGES CERTIFICATE NUMBER. 7092459 RFVISION N(IMRFR• coo holy., 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 MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—I OCCUR EACH OCCURRENCE $ REMI SES Ea DAMAGE TO RENTED PREMISES occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS COMBINED SINGLE LIMIT III acciden,_- - --..— - - BODILY INJURY (Per person) ---- $ BODILY INJURY (Peraccident) PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED) (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below N / A 6676187 1/1/2014 1/1/2015 X WC STATU- OTH- ORYIJM! E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re. All California Operations. LaK I II-IUA I t HULUtK I;ANGtLLA I IUN City of Gilroy I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Roseanna Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE 00342 The ACORD name and logo are registered marks of ACORD © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 111111111111111111 IN 11111111111111111111111111111111111111111111111111111111111111111111 111111111111111111111111 creooa�o,00lo7a,oz,oz,o,o,o,o 282086 °® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDl12 12/26/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Construction & Real Estate Practice PHONE FAX (AC, (650) 413-4497 No Wells Fargo Insurance Services USA, Inc. CA Lic #: OD08408 ADDRESS: CertRequests @wellsfargo.com 959 Skyway Road INSURERS AFFORDING COVERAGE NAIC 0 San Carlos, CA 94070 INSURER A: State Compensation Insurance Fund 35076 INSURED INSURER 8: Farotte Construction Co., Inc. INSURER C: 80 Casey Street mmiaca n Gilroy, CA 95020 I INSURER F: I I COVERAGES CERTIFICATE NUMBER: 5368051 REVISION NUMBER: Gaa hair),, 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 EFF MMM/uDCDY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE L7 OCCUR I EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I PRO- LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DIED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? � (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 6676187 1/1/2013 1 /1 /2014 X WC STATU- I JOTH- TORY LIMITS I ER E.L. EACH ACCIDENT $ 1,000,G00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All California Operations. L;LK I It-ICA 1 E HULUtzK CANCELLATION City of Gilroy Attn: Building Department 7351 Roseanna Street Gilroy, CA 95020 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988 -2010 ACORD CORPORATION. All rights reserved. FAROFCONS A,IC"R" CERTIFICATE OF LIABILITY INSURANCE I DAT 12/29/2/29/D/2011 11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Construction & Real Estate Practice PHONE F aAX C No : (650) 413 -4497 Wells Fargo Insurance Services USA, Inc. - CA Lic #: OD08408 E-MAIL e ests esfa ADDRESS CrtR eqU wllr o.COm @ 9 959 Skyway Rd., 2nd FI INSURERS AFFORDING COVERAGE NAIC e San Carlos, CA 94070 INSURER A„ Interstate Fire 8r Casualty Co. 22829 INSURED INSURER B ; General Ins_ urance Company of America 24732 Farotte Construction Co., Inc. INSURER ens p State Compensation Insurance Fund 35076 : 80 Casey Street INSURER E: I Gilroy, CA 95020 I INSURER F: I I COVERAGES CERTIFICATE NUMRFR- 3741171 RFVISION NIIMRFR, cPA halr .., 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. NSA TYPE OF INSURANCE ADDLSUBR _- POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM /DD MM /DD/YYYY A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY Fv� SGL1002206 3/1/2010 3/1/2011 EACH OCCURRENCE $ 1,000,000 $ 50,000 _ D I O RENTED (Ea occurrence) _PREMISES _ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC $ B AUTOMOBILE LIABILITY 24CC2772071 3/1/2010 3/1/2011 COMBINED SINGLE LIMIT aaccident) 1,000,ODO X $ ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) P t id ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) _ $ — $ A UMBRELLA UAS JxX OCCUR PFX73095085 03/01/10 03/01/11 EACH OCCURRENCE $ 3,000,000' _ AGGREGATE $ 3,000,000 XCESS LIAR CLAIMS -MADE $ —��DIED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N/A 667618712 1/1/2012 1/1/2013 WC STATU- 7-70 T HC --- E.L. EACH ACCIDENT - - - - - -- -- $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All California Operations. CERTIFICATE HOLDER CANCELLATION City of Gilroy I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn. Building Department I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Roseanna Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE 00 20 The ACORD name and logo are registered marks of ACORD © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 111111111111111111 I 11111111111 IN 11111111111111111111111111111111111111111111111111111 cveosa2sioousavn�ioamrmom . 11 FAROTCONS ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE /DD/YYYY) MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 3/10/2010 3110 PRODUCER Construction & Real Estate Services F 650 839 -6964 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Wells Fargo Insurance Services USA, Inc. - CA Lic #: OD08408 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 305 Walnut Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LIMITS A Redwood City, CA 94063 INSURERS AFFORDING COVERAGE NAIC # INSURED Farotte Construction Co., Inc. INSURER A: Interstate Fire & Casualty Co. 22829 INSURER B General Insurance Company of America 24732 80 Casey Street INSURER C: State Compensation Insurance Fund 35076 X COMMERCIAL GENERAL LIABILITY INSURER D: Gilroy, CA 95020 INSURER E: I � CLAIMS MADE IJ OCCUR COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR NSR TYPE OF INSURANCE POLICY NUMBER DATIEYMMIDD(YYE ) DATE MM/ /YY EXPIRATION POLICY DD LIMITS A GENERAL LIABILITY SGL1002206 3/1/2010 3/1/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PI Is 50,000 X COMMERCIAL GENERAL LIABILITY I � CLAIMS MADE IJ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PR- JECOT F7 LOC B AUTOMOBILE X LIABILITY ANY AUTO 24CC2772071 3/1/2010 3/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY PFX73095085 03/01/10 03101/11 EACH OCCURRENCE $ 10,000,000 X OCCUR FI CLAIMS MADE AGGREGATE $ 10,000,000 $ DEDUCTIBLE $ RETENTION $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETr1R /PARTNER!EXECUTIVE 667618710 767618710 1/1/2010 1/1;2010 1/1/2011 VV2011 DRY LIMIT 01R E.L. EACH ACCIDENT $ 1,C00,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Re: All California Operations. CtK I WIUA I t MULLItK CANGLLLATION ­1 vay 'Nut c Ivi iwi rrgyl I iCl u City of Gilroy Attn: Building Department 7351 Roseanna Street Gilroy, CA 95020 ArnRn 9s t7nni /nm 4 _s i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL BANiIQGPYQfK)MMAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 3XT7AXX)8ffi10M)GO(9NAKK IDmP106E> Q(® x�Dts> oxtott�ot�( m�alea> at �oDa�( xxx> tsax >txz�eml�uta66(Xr�xr�scarD(x AUTHORIZED REPRESENTATIVE IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 -S (2001108) 2 of 2 #S915260IM915043 FAROTCONS ®r„ CERTIFICATE OF LIABILITY INSURANCE DATE 2/ACOR 1 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 12 /22 /2009 PRODUCER Construction & Real Estate Services F 650 839 -6964 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Wells Fargo of California Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR POLICY EFFECTIVE DAT MM /OD/W ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 305 Walnut Street A Redwood City, CA 94063 INSURERS AFFORDING COVERAGE NAIC # INSURED Farotte Construction Co., Inc. INSURER A: Interstate Fire & Casualty Co. 22829 INSURER B: Safeco Insurance Company $ 50,000 80 Casey Street INSURER C: State Compensation Insurance Fund 35076 INSURER 0: Gilroy, CA 95020 INSURER E: COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DAT MM /OD/W POLICY EXPIRATION DATE MM /DDIYY LIMITS A GENERAL LIABILITY SGL1001737 3/1/2009 3/1/2010 EACH OCCURRENCE $ 1.000,000 PRE' SEESTOlF RENTED $ 50,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY S 1.000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PE� LOC B AUTOMOBILE X LIABILITY ANY AUTO 02CE1872142 03/01/09 03/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ I H ANY AUTO $ AUTO ONLY: AGG A EXCESS /UMBRELLA LIABILITY PFX00082057530 03/01/09 03/01/10 EACH OCCURRENCE $ 10,000,000 X OCCUR F-1 CLAIMS MADE AGGREGATE $ 10,000,000 S $ DEDUCTIBLE $ RETENTION $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 667618710 767618710 1/1/2010 111/2010 1/1/2011 1/1/2011 WC LIMIT OTH- E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re: All California Operations. L.tK I It-ILA I t MULUtK GANGtLLA I IUN ' p1 vay 1. 111 — � v r ayu I n City of Gilroy Attn: Building Department 7351 Roseanna Street Gilroy, CA 95020 A(`r%or1 9S f,)nn1 /no% n _t n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 2N*9ACMX)MMAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BaIRAObX[.SO(mIX)Sff AUTHORIZED REPRESENTATIVE n Amon rnonr�o nrrr�u wnoa IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 -s (2001/08) 2 of 2 #S915260/M915043