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HomeMy WebLinkAboutGranite Rock Company - Insurance Certificate303644 f�C ®� 1 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MW/DDIYYYY) 5/19/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE'CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 endorsements . PRODUCER Construction & Real Estate Practice Wells Fargo Insurance Services USA, Inc. - CA Lic #: ODG8408 45 Fremont Street, Suite 800 CONTA T NAME PHONE I FAX 866 - 358 -1487 A/ o Ext : AIC No nooRESS: CertRequests @welisfargo.com INSURER(S)AFFORDINGCOVERAGE NAIC# San Francisco, CA 94105 -2259 INSURER A; American Contractors Ins Cc RRG 12300 INSURED Granite Rock Company INSURER B: Zurich American Insurance Co 16535 ACIG Insurance Company INSURER C : P Y 19984 PO Box 50001 INSURER 0: INSURER E: $ 5,000 A Watsonville, CA 95077 INSURER F: ULJv1 -KAGtB CFRTIFICATF NI IMRFR• 1 1 1883U.5 t7F\ACIr1111 WI IMQCO- Cwo H.1— THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND. CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED -BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE Dl UBR POLICY NUMBER POLICY EFF MMMD11YYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X GL17A00056 (Primary) 06101/2017 06/01/2018 EACH OCCURRENCE S 5,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 A X GL17B00056 06/01/2017 06/01/2018 PERSONAL & ADV INJURY $ 5,000,000 (Excess Follow Form 1) GEN'L AGGREGATE LIMIT APPLIES PER: PRO-. POLICY � JECT OTHER: GENERAL GENERAL AGGREGATE $ 5,000,000 A GL17C00056 Follow Form 2) 06/01/2017 06101/2018: PRODUCTS - COMP /OP AGG $ 5;000,000 . $ B AUTOMOBILELIABILITY X BAP347266916 06/01/2017 06/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY IN accident Per JURY ( ) $ HIRED x NON -OWNED AUTOS.ONLY AUTOS ONLY x PROPERTY DAMAGE ? accident) $ UMBRELLALIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB bED RETENTIONS S C -. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUWE YIN OFFICER/MEMBEREXCLUDEO? N. N/A WCA000019017 06/01/2017 06/01/2018 x STATUTE ETH- E.L. EACH ACCIDENT, 1,000,000 $ E.L..DISEASE -,EA EMPLOYEE S 1,000,000' (Mandato y in NH) If DESCRIPTION under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CA20481013,Additional Insured - Automatic Status City of Gilroy is named as additional insured as respects general liability and automobile liability per endorsements attached. VI11 G. City of. Gilroy Attn: Marilyn 7351 Rosanna Street Gilroy, CA 95020 -6141 ACORD 25 (2016103) 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 -201.5 ACORD CORPORATION. All riahts reserved. POLICY NUMBER: BAP347266916 COMMERCIAL AUTO CA 20 48 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered. Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does ' not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception .date of the policy unless another date is indicated below. 4arned Insured: Granite Rock Company Endorsement Effective Date: 06/01/2017 SCHEDULE Name Of Persons) or organization(s): City of .Gilroy is named as additional insured as respects automobile liability. Information required to com fete this Schedule, If not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under. the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 4810 13 m Insurance Services Office, Inc., 2011 Page 1 of 1 •cv90 1Al w660900 /0310410J000- 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) Is amended to Include as an insured any person or organlzalton shown in the above SCHEDULE (called additional insured), but only with respect to liability far 'bodily injury', 'property damage" or' personal and advertising Injury arising out of your premises or your operations for the additional Insured. B. The insurance provided to the additional insured is subject to the following limitations: I. Unless required by written contract, this insurance does not apply to'bodily injury' or "property damage" occurring after -rourwoW for the additional Insured has been completed or after that portion of your *W out of which the 'bodily injury" or *property damage' arises has been put to Its Intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to 'bodily Injury' or "property damage' arising out of the sole negligence, act or omission of the additional insured. 3. This Insurance does not apply to "bodily injury', 'property damage' or "personal and advertising Injury for which the . additional insured is obligated to pay damages by reason of the assumption of liability In a contractor agreement except to the extent that the additional Insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to *bodily Injury, 'property damage or "personal and advertising injury' arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, d(avAngs, opinions, reports, surveys, change orders, designs or specifications; or, b) Supervisory. Inspection or engineering services. This exclusion applies even t< the claims against any insured allege negligence or other wrongdoing in the supervision, hiring; employment, training or monitoring of others by that insured. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, Including statutes governing . additional insured coverage in the construction industry. C. This Insurance shall not exceed the scope of coverage, including Emits, of this policy and in. no event shall the Insurance provided to. the additional insured exceed the scope of coverage, including limits, requireed by the contract. If .a written contractor agreement requires that additional Insured status be provided by the use of specified edition dates of the 130 CG2010 and/or CG2037, then the terms of that endorsement are incorporated Into this endorsement as respects such additional Insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010a0kr CG2037 are required but . no edition dates are specified, the 04/13 editions shall apply. D. This insurance. is excess to any other insurance, whether primary, excess, contingent or on any other basis,, available to the additional Insured unless a written contract requires that this insurance be primary or primary and non - contributing. However, this . insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other Insurance as an additional insured. Nothing herein contained shall be held to vary, alter, valve or extend any.of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other then as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless; otherwise stated. (The information below is required only when this endorsement.ls issued subsequent to preparation of the policy.) Endorsement Effective: 6/1/17 Policy No.: GL17AO0056 Endorsement No.: Policy Effective: 6/1/17 Premium $ Insured: Granite Rock Company Insurance Company: American Contractors Ins Co RRG Countersigned By 303864 A �® CERTIFICATE of LIABILITY INSURANCE DATE (MMIDD/YYYY) 5119/2017 (MNWD THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 'BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Construction & Real Estate Practice Wells Fargo Insurance Services USA, Inc. - CA Lic #: OD08408 CONTACT NAME (AICNNo t. FNC No, 866- 358 =1487 E -MAIL CertRe oasts wellsfar o.com ADDRESS: 4 g 45 Fremont Street, Suite BOO INSURER(S) AFFORDING COVERAGE NAIC# San Francisco, CA 94105 -2259 INSURER A: American Contractors Ins Cc RRG 12300 INSURED INSURER B: Zurich. American Insurance Cc - 16535 Granite Rock Company ACIG Insurance Company INSURER C : P Y 19984 PO Box 50001 INSURER D CLAIMS MADE � OCCUR INSURER E: (Primary) Watsonville, CA.95077 INSURER F: PREMISES Ea occurrence COVFRAGFS CERTIFICATF MI IMRFR• II lbbbfb RRVISInki kii nuior-o- Caw halnw' 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 U POLICY NUMBER POLICY EFF MMIDDIYYYY . POLICY EXP MMfDD1YYYY LIMITS A X .COMMERCIALGENERALLIABILrrY X GL17A00056 06/01/2017 06/01/2018 EACH OCCURRENCE $ 5,000,000 CLAIMS MADE � OCCUR (Primary) PREMISES Ea occurrence $ 100,000 MED EXP (Anyone person), $ 5,000 A X GL17B00056 06/01 /2017 06/01/2018 PERSONAL B ADV INJURY $ 5,000,000, (Excess Follow Form 1) GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY � JECT. LOC OTHER: GENERAL AGGREGATE $ 5,000,000 A X GL17C00051i (Excess Follow Form 2) 06!01/2017 06/0172018 PRODUCTS - COMPIOPAGG $ 5,000,000 $ .B. AUTOMOBILE LIABILITY BAP347266916 06/01/2017 06/01/2018 COMBINEDSINGLELIMIT Ee acci dent $ 2,000,000. BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS.ONLY AUTOS BODILY INJURY (Per accident) $ x HIRED X. NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE. par .d. 13 UMBRELLALIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UA13 CLAIMS -MADE DED RETENTION $: C WORKERS CNIPENSA'110N, AND EMPLOY ERS: LIABILITY YIN 'ANYPROPRIETOR/PARTNEPJEXECUT1VE OFFICERIMEMBEREXCLUDED? N. ,N/A WCA000019017 06101/2017 06/01/2018: X. ST'A E I ERH I E.L. EACH ACCIDENT 1 000;000 $ E.L. DISEASE - EA EMPLOYEE S'. 1 000,000 (Mandatory in NH) If yes, describe. under DESCRIPTION OF OPERATIONS below - E.L. DISEASE - POLICY LIMIT S 1;000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) .Additional Insured - Automatic Status RE: Project No. 14 -PW -213, STPL- 5034 -025. City of Gilroy is named as additional insured as respects general liability per endorsement attached. v�r� r rrrvr+r c nvwcrc L.ANt{.,CLLA I.IVPI City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna St. Gilroy, CA 95020 AUTHORREDREPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988 -2015 ACORD CORPORATION. All.riahts reserved. ACORD 25 (2016103) 1111111111 IN 1111111111111111111111111111111111111111111111111111111111111111111. 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is. an Insured (Section 11) is amended to include as an Insured any person or organlzagon shown in the above SCHEDULE (called additional Insured), but only with respect to liability, for bodily injury', "property damage' or *personal and adverUsing injury' arising out of your premises or your operations for the additional Insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage' occurring after your work' for the additional Insured has been completed or after that portion of your work' out of which the 'bodily injury° or 'prop" damage' arises has been put to Its Intended use by any person or organization. 2. Unless required bywritten contract, this insurance does not apply to 'bodily injury* or "property damage" arising out of the. sole negligence, act or omisslon of the additional Insured. 3. This Insurance does not apply to "bodily Injury'. 'property damage' or *personal and advertising injury' for vdttch the additional insured is obligated to pay damages by reason of the assumption of [lablilty In a contract or agreement except to the extent that the additional Insured would have been obligated to pay such damages in the absence of the contract or. agreement. 4. This insurance does not apply to 'bodily Injury", 'property damage or "personal and advertising Injury' arising out of the rendering or failure to render any professional services by any insured, including:. a) The preparing, approving or falling to prepare or approve maps, drawings, opinions, reports, surveys, change orders,.designs or specifications; or, b) Supervisory, Inspectlon or engineering services. This exclusion applies even If the claims against!any Insured allege negligence or other wrongdoing in the supervision,. hiring. ;employment, training or monitoring of others; by that insured. 5. This endorsement shall not apply to a person or organization if any other additional Insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional Insured coverage In the construction industry. C. This Insurance shall not exceed the scope, of coverage, including limits, of this policy and in no event shall the Insurance provided.to the additional insured exceed the scope of coverage.. Including limits, required by the contract. If a written contract or agreement requires that additional Insured status be provided by the use of specified edition dates of the 130 CG2010 and/or CG2037, then the tears of that endorsement are incorporated Into this endorsement as respects such additional insured and shall supersede the. coverage grant and limitations In Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dates are specified, the 01113 editions shall apply. D. This insurance is excess to any other Insurance, whether primary, excess, contingent or on any other basis, available to the additional Insured unless a written contract requires that this insurance be primary or-primary and non- contributing. However. this insurance is always excess to other insurance; whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other Insurance as an additional insured. Nothing herein contained shall be held to vary, alter, walve or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other then as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwlse stated. (The information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective: 6/ 1 / 17 Policy No.: GL17AO0056 Endorsement No.: Policy Effective: 6/1/17 Premium $ Insured: Granite Rock Company insurance Company: American Contractors Ins Co RRG Countersigned By 111.1111111111111111111111111111111111111111111111111111111111111111111111111 IN 11111111 B01A19/009751010310/01W ACOItI �e CERTIFICATE OF LIABILITY INSURANCE DATE.IAoIAIDOIYYYY) CERTIFICATE. MAY' BE. ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES 'DESCRIBED HEREIN IS'SUBJECT' TO ALL THE TERMS; 9/292016 THlS CERTIFICATE I5 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 polioy(iss) must have ADDITIONAL INSURED provisions: or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions -of the policy, Certain policies may require an endorsement. A statement on this certificate does -not confer rights to the certificate holder in lieu of such endorsemt s . PRODUCER Construction & Real Estate Practice A A PHONE FAx No -. 866-358 -1487 Wells Fargo Insurance Services USA, Inc - CA Lid#: OD08408 E494WL CerlRequests@wellsfergo.com 959 Skyway Rd., 2nd FI GL16A00056 (Primary) 09!3012016 06/01/2017 INS AFFORDING COVERAGE NAIC 0 San Carlos, CA 94070 u+suRERA.. American Contractors Ins Co RRG 12300 .INSURED INSURER 8: Zurich. American Insurance Cc 16535 GraniteRock Company INSURER c: Allied World AssuranCato (US) 19489 PO Box 50001 nrsuRER'D; __ ACID Insurance Company 19984. INSURER E': Watsonville; CA $5077. INSURER F COVERAGES CERTIFICATE- NUMBER: 1Uy1t$U3y REVISION NUMBER See balow THIS IS-TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW.HAVE.SEEN ISSUED T.O. THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING.MY REQUIREMENT, TERM OR CONDITION OF,AW 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. LTRR. _TYPE OF INSURANCE - POLICYNUIImER Y '' Y LOFTS. A A X: CO C1ALC m eaEtALLIABIL CLAIMS4AADE � OCCUR X X X X GL16A00056 (Primary) 09!3012016 06/01/2017 EACH OCCURRENCE -' -- $ s,00o,o0D DAMAGE TURENTF PREMISES Ea ooae�ence S 100,000 IVIED EXP'(Any one person) s x.000 GL16B00056 08/30/2016 06/01/2017 PERSONAL B ADV INJURY S SAW= (Excess Follow Form -1) GEN'L AGGREGATE UMIT APPLIES PER: POLICY a ECT . ❑ LOG oTriE R . GENERAL AGGREGATE S 6000,000 GL16C00056 (Excess'Follow Form 2) 9/30/2016 05/01/2017 - - PRODUCTS - COMPIOP AGG S' 6000,000 s B _AUTOMOS11:EUaeIUTY X BAP347266915 09/30/2.016 06/012017 S 2,000,000 X ANY AUTO aODILY INJURY (Per person) S OWNED SCHEDULED AUTOS ONLY. AUTOS BODILY INJURY (Per, accident). _ _ . -- - -_ S ' - - X. ".HIRED. x, NON =OWNED AUTOS ONLY AUTOS ONLY PROPFJiTY.OAMAGE. $ C X. UMBRELLI1LJAa x OCCUR 03086260 09/302016 06/012017 EACH OCCURRENCE $ 10,000000 AGGREGATE -- . "S -- 40,000,00Q EXCESS LIA6 CLAIMS -MADE •OED. RETENTIONS. - - S. D wORxERS'cQMPENSATM AND ENIPLOYERS' LIABILITY Y ! N 'ANYPROPRIETORIPARTNEWEXECU?1VE AFFICERJMEMBEREXCLUDED7 C fMandarory in N11) M yyeeae,.describe under DESCRIPTIONOFOPERATIONS'below N/A X WCA000019016 09/302016 06/012017 x STATUTE R E.L. EACH 1CH ACCIDENT $ 1,000 000 ' EL DISEASE - EA EMPLOYE .,5.. 7 ,OOD 000 - _ - - E.L. DISEASE- POLICY.LIMIT_ $. 1'000000. DESCRIPTION OF OPERATIONS I LOCATIONS I.VBItCLES (ACORD 101. AddWonal Remarks Schedule, may be atmchod N more space is regmred) CA20481013,ACId Additional Insured- Automatic Status,WC040306 (Ed'. 04 -84) RE: BIDDING PURPOSES ONLY FOR EIGLE,BERRY STREET RESURFACING PROJECT - PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional Insured as respects general liability' and automobile liability per endorsement attached. THE CITY OF G.ILROY, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS,'EMPLOYEES, AGENTS AND VOLUNTEERS ATTN: RISK MANAGER 7351 ROSANNA STREET GILROY, CA 95020 SHOULD -ANY, OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 'IN - ACCORDANCE WITH THE POLICY PROVISIONS. The ACORD name and logo are registiere'd marks of ACORD ®1988 -2015 ACORD CORPORATION. AA rights -r- 9-seryed. ACORD 25 (2016103) I ��I �I �' �� �I ��,��•I�: �IL�� �� � IN� �I � +cvealaxt+roainerozroaroro�aa . ° . POLICY NUMBER: BAP347266915 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE FPOUCY.,PLEASE READ FTCAREFULLY. DESIGNATED INSUR IT Y' FOR COVERED AU. TOS LIABILITY COVERAGE This endorsement modifies Insurance provided under the following: AUTO DEALERS COVERAGE FORM BLJ$INES 1. 1 -.-- - S AUTO QOVERAGEFORM MOTOR CARRIER COVERAGE FORM With. respect to. coverage provided by. this endorsement, the provisions of the Coverage Form. apply unless modified by this endorsement. This endorsement Identifies person(s) or organizations) who are "Insureds" for Coveted AutiDSLI"Ity C6veragd under. the Who Is An Insured provision of the 'Coverage Form.. This endorsement does not alter. coyierage . provided in the Coverage Form. This endorsement changes the policy effective on. the Inception date of the policy unless another date Is. Indicated Wow. N11 -Od irOUMd-' GraniteRock Company Endorserneffl-Effeethe Date: o9nom16 SCHEDULE Name Of Person(s) Or Orgmization(s): - RE:* BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT - PROJECT NO. 14-PW-213.. The City of Gilroy, its officers, elected or appointed officials, employees, agents and Volunteers are named as.additional insured. as respects automobile liability. be shown ]n the Each person or organization'shown In the Schedule Is an "Insured" for Covered Autos Liability Coverage, but only 'to the iodent that person or organization qualifies as 'an `Insured" under the Who Is An Insured provision ponitainedAn Paragraph A.I. of Section 11 'Coveted Autos LWIfty Coverage In the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2 of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 0 Insurance Services Office, Inc., 20I I Page 1. of I i�u'A�ee�oent�A�ww� .�� ADDITIONAL INSURED — AUTOMATIC STATUS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are reared .by ,contract to include as an additional insured on this policy If the contract Is executed prior to the loss. A. Who is an insured (Section 11) Is amended to hnoitxle as an Insured any person ororganlzatim shown In the above SCHEDULE (called additional Insured). but only with respect to tiab8ity far ° bodfiy ir4ury',' property damage° or "personal and advartisiigt injury° arising out of your premises or your operaftns.for the additional Insured: B. The insurance provided to the additional insured is subject to the following Qrnitetions: 1. Unfasa required by written contract, this insurance does not apply to "bodily ?4uy or 'property damage* occuimng after `your work° for the additional ensured has beencompleted or after that portion of'your worts" out of wthidh the "bodilyinjtry° or "property damps" arises has been put to Is intended use by any person or organization. 2. Unless required by written contract, this Insurance does not apply to bodily ir#ury" or "property damage" arising out of the sate negligence, ad or-omission of the additional inured. 3. . This Insurance does not apply to "bodily injury 'property damage" ar'persohal and. advertising injury" for which the additional insured is obligated to pay damages by reason af.the "assumption' of ilability In a contract of agreement except to the exWd 2=1 the additional insured would have been obligated to pay such damages to the absence of the contract or agreement 4: This insurance does not apply to "bac ft injury",''properly damage or "personal end advertising injury" arising art of the rendering or failure to render any professional. services by any insured, including: a) The preparing, approving or falling to-prepare-or approve maps. drawings, opliftm reports. surveys, surge orders. designs or spedficatimw or, b) Supervisory, inspection or engineering services. This exclusion applies even if the ciehns against any insured stage negligence or other wrongdoing in the supervision, idrW employment, training or monitortr of others by that insured. 5. This endorsement shall not apply to a person or organization If any other additional Insured endorsement attached to this policy specifically applies to that person or organization. 0. The insurance afforded herein only apptles.to the extent permitted by applicable: state law. Including statutes governing additional insured coverage in the construction industry. C. • This insurance shall not exceed the Scope of coverage. Including Wrtlts, of this policy and In no event shell the insurance provided to the additional insured eiceeed the scope of coverage, IncitedIM limits, required by the contrac L if a written contract crag am requires that poltbune[ gmured status be provided by the cse of specified edition dates of the ISO (x,2410 and/or CiG2007, than the ' tenn8 of that endorsement are incorporated into this andorsemerd as respects such additional insured and shap:supersede the coverage•grant and limitations in Suctions A. and B. of this endorsemmt In the event that 002010 and/or CGM7 are required but no edition dates are specified. the 04M 3 editions shall apply. D. The Insurance. is excess to any other trssurance, whether. primary, excess, contingent or on any other basis, available to the . additional Insured unless a written contract requires Ghat this Insurance be primary cr;pdmary and non- contribi ttig.. However, this insurarwe•is always excess to other insurance, whether primary. excess. contingent or on any other baste, when the additional . Insured has been added to the other Insurance as an additional Insured. Nolhing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the menlioned Polar, other than as above stated. This endorsement changes the policy to which it is attached and Is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective: 9/30/16 Policy No.: GL16AO0056 Policy Effective: 9/30/16 Insured: Granite Rods Company Insurance Company: American Contractors insurance Company Risk Retention Group Countersigned'By Endorsement No.: Premium $ 829 isiies,�taoea�wnosr .�._ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEPJENT— CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (Thls agreement applies only to the e)dentthat you perform work under a Written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium.lbr this endorsement shag be 0. 00000 % of the C 11omia workers' compersiation premium otherwise due on euch remuneration. Schedule Person or Organization Job Description Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery against I This endorsement changes the policy to which .1 is attached and is efflic".on the date issued unless gtherwise stated.., {The Information lWow Is required only when this endorsement is-Issued subsequent to preparation of the.policy.) Endorsement Effective: 9/30/16 Policy No. WCA000019016 Endorsement No. Insured: Granite Rock Company Premium $ insurance Company: ACIG Insurance Company Countersigned by WC 04 03 06 (Ed. 04-84) i■ii�i��ent,Nr�on�r .�.� 16 „a►►co�° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6/10/2016- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED Provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does-not confer rights to the.certificate holder in lieu of such endorsement(s). PRODUCER Risk Strategies Company CON NAAMEc Risk Strategies Com an PHONE 949- 242 -9240 FAX Ne 2040 Main Street, Suite 450 Irvine, CA 92614 ADDRESS: S OUn risk -strate ies.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co of Amer 25674 www.risk- strategies.com CA DOI License No. OF06675 INSURED MNS Engineers, Inc. 201 N. Calle Cesar Chavez, Suite 300 - INSURER.B.:..AXIS Insurance Company 37273 INSURER C: CLAIMS MADE OCCUR INSURER D:. Santa Barbara CA 93103 INSURER E: DAMAGE TO PREMISES Ea occurrren�ce INSURER F: MED.EXP (Any one person) COVFROGFS CFR'riiii TF NIIMRFR` anar2A21 RFVISION NLIMRFR- 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 WVITH RESPECT TO iNHICH 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. ILT R LTR TYPE OF INSURANCE J= ADDLSUBR POLICY NUMBER MAD EFF POLICY IYY Y LIMITS A �/', COMMERCIAL GENERAL LIABILITY 68022171-895 6/14/2016 6/14/2017 EACH OCCURRENCE $ $1,000,000 CLAIMS MADE OCCUR DAMAGE TO PREMISES Ea occurrren�ce $ $1,000,000 MED.EXP (Any one person) '$ $10,000 PERSONAL & ADV INJURY $ $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ $2.000,000 POLICY ❑ JET 17 LOC PRODUCTS - COMP/OP AGG $ $2,000,000 I is OTHER: A AUTOMOBILE LIABILITY BA22201-967. 6/14/2016 6/14/2017 COM�BBII `NdED SINGLE LIMIT nt) E. $ $1,000,00 BODILY INJURY (Per person) $ ANY AUTO OWNED S AUTOS ONLY AUTOS CHEDULED . BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Par. $ HIRED NON-OWNED AUTOS ONLY ✓ AUTOS ONLY $ A UMBRELLA LIAB OCCUR CUP8E545094 6/14/2016 6/14/2017 EACH OCCURRENCE $ $5,000,000 AGGREGATE $ $5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION SO $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE YIN UB3240T745 6/14/2016 6/14/2017 V STATUTE OT E.L. EACH. ACCIDENT $ $1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYEE $ $1,000,00 0 MCRIIPTION OF OPERATIONS below E.L. DISEASE - POLICY, LIMIT $ $1,000,000 B Professional Liability MBZ794824012016 6/14/2016 6/1412017 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Projects as on file with the insured including but not limited to CM Services - Eigleberry Street Resurfacing Project. City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insureds on the general & auto liability policies. General Liability insurance is primary and non - contributory. The above policies contain a 30-day notice provsion for non - renewal & Cancellation, 10-day notice for non - payment of premium. City of Gilroy Public Works Division 7351 Rosanna St. Gilroy CA 95020 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 4UTHORIZED REPRESENTATIVE Michael Christian ©1988 -2015 The ACORD name and logo are registered marks of ACORD 30352423 1 1'6 -17 GL- AL- UMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I Page 1 of 6 reserved. Insured: MNS Engineers, Inc. Policy No.: 68022171-895 Effective Date: 6/14/2016 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers PROJECT /LOCATION OF COVERED OPERATIONS: CM Services, Eigleberry Street. Resurfacing Project PROVISIONS A. The following is added to WHO IS AN INSURED (Section II): The person or organization shown in the Schedule above is an additional insured on this Coverage Part, but only with respect to liability for "bodily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the rendering of or failure to render any "professional services ". limits shown in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that, for the additional insured shown -in the Schedule, the insurance provided to that additional insured under this Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or e. The limits of insurance afforded to the agreement requiring insurance" for such additional insured shall be the limits additional insured. But this insurance still is which you agreed in that "contract or excess over valid and collectible other agreement requiring insurance" to insurance, whether primary, excess, provide for that additional insured, or the contingent or on any other basis, that is CG D3 82 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 30352423 1 16-17 GL- AL- UMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I Page 2 of 6 available to the additional insured when the additional insured is also an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the project, or at the location, shown in the Schedule above, performed by you, or on your behalf, under a 'contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement under which you are required to include the person or organization shown in the Schedule as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" is caused by an offense committed: After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. CG D3 82 09 07 © 2007 The Travelers Companies, Inc. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 30352423 1 16 -17 GL- AL- OMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I Page 3 of 6 Page 2 of 2 Insured: MNS Engineers, Inc. COMMERCIAL AUTO Policy No. BA2220L967 Effective Date:6/14/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT Person or Organization: City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers 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 oe 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. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS- INCREASED LIMITS E. TRAILERS - INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and 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 IL B. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: EQUIPMENT —INCREASED LIMIT I. WAIVER OF DEDUCTIBLE -GLASS J. PERSONAL EFFECTS K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 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 ". C. EMPLOYEES AS INSURED An "employee" of yours is an "insured" while operating a covered "auto" hired or rented The following is added to Paragraph A.1.; Who Is under a contract or agreement in that "em- An Insured, of SECTION II — LIABILITY COW ployee's" name, with your permission, while ERAGE: CA T4 20 0710 2010 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office. Inc with its permission. 30352423 1 16 -17 GL- AL- UMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I Page 4 of 6 COMMERCIAL AUTO 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. D. 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. G 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. E. TRAILERS - INCREASED LOAD CAPACITY The following replaces Paragraph C.I. of SEC- TION 1- COVERED AUTOS: 1. "Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph A-4., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto ", then the Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in any one "accident" to a hired, rented or borrowed "auto" is the lesser of: (a) $50.000: (b) The actual cash value of the damaged or stolen property as of the time of the "loss" or (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto ". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee ". 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 COVER- AGE: 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. H. AUDIO, VISUAL AND OATA ELECTRONIC EQUIPMENT INCREASED LIMIT Paragraph C.2.. Limit Of Insurance, of SEC - TION III - PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE -GLASS The following is added to Paragraph D., Deducti- ble, 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. J. PERSONAL EFFECTS The following is added to Paragraph. AA., Cover- age Extensions, of SECTION III - PHYSICAL. DAMAGE COVERAGE: Personal Effects Coverage 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 ". (c) The cost of repairing or replacing the This coverage only applies in the event of a total damaged or stolen property with other theft of your covered "auto ". property of like kind and quality. No deductibles apply to Personal Effects cover - (2) An adjustment for depreciation and physical age. condition will be made in determining actual cash value in the event of a total "loss ". Page 2 of 3 _02010 The Travelers Indemnity Company. All rights reserved. CA T4 20 0710 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 30352423 1 16 -17 GL- AL- DMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I. Page 5 of 6 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. AUTO LOAN LEASE GAP The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total 'loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the "loss "; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. 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 exe- cuted prior to any "accident' or 'loss ", pro - vided that the "accident' or 'loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 0710 x:2010 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. 30352423 1 16 -17 GL- AL- UMB -WC -PL I Sherry Young 1 6/10/2016 11:32:32 AM (PDT) I Page 6 of 6 Page 3 of 3 3038" ACORD0 CERTIFICATE OF LIABILITY INSURANCE DATE (MgIDDIYYYY) 9/29/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions: or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Construction & Real Estate Practice Wells Fargo Insurance Services USA, Inc - CA Lic#: OD08408 CONTACT NAME: PHNN C o No: 866 358 -1487 E-MAIL D ADDRESS: CertRequests@wellsfargo.com 959 Skyway Rd., 2nd FI INSURER (S) AFFORDING COVERAGE NAIC # San Carlos, CA 94070 INSURER A: American Contractors Ins Co RRG 12300 INSURED GraniteRock Company INSURER B: Zurich American Insurance CO 16535 INSURER C: Allied World Assurance Co (US) 19489 PO Box 50001 INSURER D: ACIG Insurance Company 19984 INSURER E. Watsonville, CA 95077 INSURER F GL16B00056 COVFMY[:1 -_% CFRTIFICOTF IUIINIRFR• lU'Jl SU.15M 170111CIrl1U \II IMI2C0• Cnn holnw - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE 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 TERMSi EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I R' LT LTR TYPE OF INSURANCE L R POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS. A A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR X X X X GL16E100056 (Primary) 09/30/2016 06/01/2017 EACH OCCURRENCE $ 5,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 GL16B00056 09/30/2016 06/01/2017 PERSONAL & ADV INJURY $ 5,000,000 (Excess Follow Form 1) GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JET F-1 IOC OTHER:. GENERAL AGGREGATE $ 5,000,000 GL16C00056 (Excess Follow Form 2) 913012016 06/01/2017 PRODUCTS - COMPIOP AGG $ 5,000,000 S B AUTOMOBILE LIABILITY X BAP347266915 09130/2016 06/01/2017 COE accMaINident S ED INGLE LIMIT $ 21000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S r X. HIRED . X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE. (par ci ant $ C X. UMBRELLALIAB X OCCUR 03086260 09/30/2016 06/01/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABI ITY YIN ' ANYPROPRIETOR/PARTNEPJEXECUTIVE OFFICER/MEMBEREXCLUDED? C NIA X WCAO00019016 09/30/2016 06/01/2017 X STR T_E 'ER'_ E.L. EACH ACCIDENT -_ $ 1,000,000 _ _ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes., describe under DESCRIPTION OF OPERATIONS below - E.L. DISEASE - POLICY LIMIT $ 1;000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CA20481013,ACIG Additional Insured - Automatic Status,WC040306 (Ed. 04 -84) RE: BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT - PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insured as respects general liability and automobile liability per endorsement attached. THE CITY OF GILROY, ITS OFFICERS, ELECTED OR APPOINTED SHOULD ANY, OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: RISK MANAGER ACCORDANCE WITH THE POLICY PROVISIONS. 7351 ROSANNA STREET I AUTHORIZEDREPREsENTAnvE GILROY, CA 95020 I I The ACORD name and logo are registered marks of ACORD ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD „' ° "03' I�IIIfl119�II�IIMN11Nlll����� ...__�_. POLICY NUMBER: BAP347266915 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED. INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE.FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Cove rage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on. the inception date of the policy unless another date is indicated below. Named lnsured: GraniteRock Company Endorsement Effective Date: 09/30/2016 SCHEDULE Name Of Persons) Or Organlzatlon(s): RE: BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insured as respects automobile liability. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "Insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "Insured" under the Who Is An Insured provision contained. In Paragraph A.1. of Section II Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required .by .contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) Is amended to Include as an Insured any person or organization shown In the above SCHEDULE (called additional Insured), but only with respect to liability for "buddy irqury°, '"property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional Insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily irqury" or property damage" occurring after "your work° for the additional insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2, Unless required by written contract, this insurance does not apply to "bodily trqury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily Injury ", "property damage° or "personal and advertising injury" for which the additional Insured is obligated to pay damages by reason of the assumption of liability In a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications: or, b) Supervisory, inspection or engineering services. This exclusion applies even If the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by, that insured. 5. This endorsement shall not apply to a person or organization if any other additional Insured endorsement attached to this policy specifically applies to that person or organization. 5. The insurance afforded herein only applies. to the extent permitted by applicable state law, Including statutes goveming additional Insured coverage In the construction industry. C. This insurance shall not exceed the scope of coverage, Including limits, of this poli6y and in no event shall the insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional Insured status be provided by the use of specified edition dates of the ISO CG2010 and/or CG2037, then the terms of.that endorsement are Incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dates are specified, the 04113 editions shall apply. D. This Insurence.ls excess to any other Insurance, whether primary, excess, contingent or on.any other basis, available to the . additional insured unless a written contract requires that this insurance be primary or primary and non- oontributlhg. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional Insured has been added to the other Insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherMse stated.. (The Information below Is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 9/30/16 Polley No.: GL16A00056 Endorsement No.: Policy Effective: 9/30/16 Premium $ Insured: Granite Rode Company Insurance Company: American Contractors insurance Company Risk Retention Group Countersigned By WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT —CALIFORNIA We have the right to mover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work .described in the Schedule. The additional premium for this endorsement shall be 0.00000 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery against Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, (The Information below is required only when this endorsement is issued subsequent to preparation of the.pollcy.) Endorsement Effective: 9/30/16 Policy No. WCA000019016 Endorsement No. Insured: Granite Rock Company Insurance Company: ACIG Insurance Company Countersigned by WC 04 03 06 (Ed. 04 -84) Premium $ 'CY 803A2 8/00 7 729/05/050010V 303844 AlC"R !t 1® l..V II L/ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/0D/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 6/9 /2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Construction & Real Estate Practice PH/ONE A/C C. A No): 866-358-1487 Wells Fargo Insurance Services USA, Inc - CA Lic #: OD08408 E-MAIL CertRequests @wellsfargo.com 959 Skyway Rd., 2nd FI -ADDRESS: INSURERS AFFORDING COVERAGE NAIC # San Carlos, CA 94070 INSURER A American Contractors Ins Co RRG 12300 INSURED INSURER B: Zurich American Insurance CO 16535 GraniteRock Company INSURER C: Allied World National Assurance Co. 10690 PO Box 50001 INSURER D: ACIG Insurance Company 19984 INSURER E: Watsonville, CA 95077 INSURER F: PERSONAL 3 ADV INJURY COVERAGES CERTIFICATE NUMBER: 10562543 REVISION NUMBER: 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. ILTR R TYPE OF INSURANCE A POLICY NUMBER MM/DDmYY POLICY EXP MMI D/YYYY LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 111 OCCUR X X X X GL15A00056 GL15B00056(GL XS) 09/30/2015 09/30/2015 09/30/2016 09130/2016 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 3 ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO- POLICY a ECT 7] LOC PRODUCTS - COMPIOP AGG $ 4,000,000 $ OTHER. B AUTOMOBILE LIABILITY X BAP347266914 09/30/2015 09/30/2016 E. acciden SINGLE LIMIT $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ C X UMBRELLA LIAB X OCCUR 03086260 09/3012015 09/30/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS-MADE DEO I RETENTIONS $ D AND EMPLOYERS' AND EMPLOYERS' LIABILrrY YERS' LIABILITY A ILIT ANY PROPRIETOR /PARTNER /EXECUTIVE YIN OFFICER /MEMBER EXCLUDED? IN (Mandatory in NH) NIA X WCA000019015 09/30/2015 09/30/2016 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) CA20481013,Additional Insured - Automatic Status,WC040306 (Ed. 04 -84) RE: BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT - PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insured as respects general liability and automobile liability per endorsement attached. u r-m I Ir m A I t RULUtK L.AIVGtLLA 1 IUN THE CITY OF GILROY, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS ATTN: RISK MANAGER 7351 ROSANNA STREET 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 The ACORD name and logo are registered marks of ACORD @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional insured has been completed or after that portion of your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury", "property damage" or 'personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions: reports, surveys, change orders, designs or specifications: or, b) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured. 5 This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. C. This insurance shall not exceed the scope of coverage, including limits, of this policy and in no event shall the insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and /or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 andlor CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non - contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective: 9/30/2015 Policy No.: GL15A00056 Endorsement No.: Policy Effective: 9130/2015 Premium $ Insured: Granite Rock Company Insurance Company: American Contractors Insurance Company Risk Retention Group Countersigned By _ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.00000.% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery against. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 09/30/2015 Policy No WCA000019015 Endorsement No. Insured: Granite Rock Company Insurance Company: ACIG Insurance Company Countersigned by WC 04 03 06 (Ed. 04 -84) Premium $ POLICY NUMBER: BAP347266914 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: GraniteRock Company Endorsement Effective Date: 09/30/2015 SCHEDULE Name Of Person(s) Or Organization(s): RE: BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT - PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insured as respects automobile liability. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 303844 ACCPR"® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDIYYYY) 9/24/2015 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: N the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. M 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 Wells Fargo Insurance Services USA, Inc - CA Lic #: OD08408 CONTACT NAME: PHONE FAX 66- 358 -1487 WC. NN ...E�: __�1ac No)_ 8 _-- E-MAIL o.com f t ere ness wesar tR ll ADDRESS: C 9 @ 9 INSURER(S) AFFORDING COVERAGE NAIL p 959 Skyway Rd., 2nd FI _ INSURERA: American Contractors Ins Co RRG 12300 San Carlos, CA 94070 INSURED INSURER 0: Zurich American Insurance Co 16535 Granite Rock Company INSURER C Allied World National Assurance Co. 10690 PO Box 50001 INSURER 0: ACIG Insurance Company 19984 INSURER E: INSURER F: Watsonville, CA 95077 COVERAGES CERTIFICATE NUMBER: 9577073 REVISION NUMBER: 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 A MSUBR POLICY NUMBER POLICY MMIDDI -M LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE u OCCUR X X X X GL15A00056 GL15B00056(GL XS) 09/30/2015 09/30/2015 09/30/2016 09/30/2016 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence)_. $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 - 17 POLICY Fx_1 JECT LOC PRODUCTS - COMP /OP AGG $ 4,000,000 $ OTHER: B AUTOMOBILE _ LIABILITY X BAP347266914 09/30/2015 09/30/2016 COMBINED SINGLE LIMIT Ea accident _ $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) E X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS C X UMBRELLA LIAR X OCCUR 03086260 09/30/2015 09/30/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED I RETENTION $ $ p WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICERMEMBER EXCLUDED? ❑N (Mandatory In NH) NIA X WCA000019015 09/30/2015 09/30/2016 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E:L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CA20480299,Additional Insured - Automatic Status,WC040306 (Ed. 04-84) RE: BIDDING PURPOSES ONLY FOR EIGLEBERRY STREET RESURFACING PROJECT - PROJECT NO. 14 -PW -213. The City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insured as respects general liability and automobile liability per endorsement attached. THE CITY OF GILROY, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS. EMPLOYEES. AGENTS AND VOLUNTEERS ATTN: RISK MANAGER GANGELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION . DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 ROSANNA STREET AUTHORIZED REPRESENTATIVE GILROY, CA 95020 ge -4 ''J01/— The ACORD name and loao are reaistered marks of ACORD ©1988 -2014 ACORD CORI TION. All riahts reserved AC OR - D 25 (2014101) 1 IN III III IN 11111111111111111111111111111111111111111111111111111 -CY801 A24/0034161021051010/010' POLICY NUMBER: BAP347266914 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by th.is endorsement. This endorsement identifies person(s) or organization(s) who are'Insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement, changes the policy effective on the inception date of the policy unless another date is Indicated below. Endorsement Effective: 09/30/2015 Countersigned By: 9e_ — Authorized Representative) Named Insured: Granite Rock Company SCHEDULE Name of Person(s) or OrganizaWn(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A PRIMARY, NON - CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT. IS PROHIBITED BY LAW. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an 'insured "for Liability Coverage, but only to the extent that person or organization qual Pies as an 'Insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 E3 11111111111111111 IN 11111111111111 IN I 111110 11111 IN IIII IIIIII -CYB01A24/0D3416/03/05f0f0/0/0' 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability In a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages In the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or, b) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing In the supervision, hiring, employment, training or monitoring of others by that insured. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically'applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. C. This Insurance shall not exceed the scope of coverage, including limits, of this policy and in no event shall the insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates or the ISO CG2010 aridior CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and /or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non - contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional Insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary. after, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 9/30/2015 Policy No.: GL15A00056 Endorsement No.: Policy Effective: 9/30/2015 Premium $ Insured: Granite Rock Company Insurance Company: American Contractors Insurance Company Risk Retention Group Countersigned By u_2410034.41051010. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be O.OQQOO % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Whomever the named insured is required by written contract executed prior to loss to waive rights of recovery against. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective:' 09/30/2015 Policy No WCA000019015 Endorsement No. Insured: Granite Rods Company Insurance Company: ACIG Insurance Company WC 04 03 06 (Ed. 04 -84) Premium $ Countersigned by Idl01dfl11111lIIIIYUI _..�_�. 303844 AC CPR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 9/24/2015 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(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 Construction & Real Estate Practice Wells Fargo Insurance Services USA, Inc - CA Lic#: OD08408 CONTACT NAME: PHONE FAX 866- 358 -1487 (ac, Nor. E MAIL ADDRESS: CertRequests @wellsfargo.com 959 Skyway Rd., 2nd FI INSURER(S) AFFORDING COVERAGE NAIC S San Carlos, CA 94070 INSURER A: American Contractors Ins Co RRG 12300 INSURED INSURER B: Zurich American Insurance CO 16535 Granite Rock Company INSURER C: ACIG Insurance Company 19984 PO Box 50001 INSURER D PERSONAL & ADV INJURY INSURER E: GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JECT ❑ LOC OTHER: GENERAL AGGREGATE Watsonville, CA 95077 INSURER F: $ 4,000,000 COVERAGES CERTIFICATE NUMBER: 9577034 REVISION NUMBER: 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 WIM POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR ❑ X X GL15A00056 GL]5600056(GL XS) 09/30/2015 09/30!2015 09130/2016 09/30/2016 EACH OCCURRENCE $ 2;000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ .2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP /OP AGG $ 4,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BAP347266914 09/30/2015 09/30/2016 COMBINED SINGLE LIMIT Ea axidaMZ_ $ 2,000,000 X BODILY INJURY (Per person) _ $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED _ _. RETENTION$ $ C WORKERS COMPENSATION Y/ N AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) II S descrThe under DESCRIPTION OF OPERATIONS below MIA WCA000019015 09/3012015 09/30/2016 X STATUTE ERH 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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Additional Insured - Automatic Status RE: Project No. 14 -PW -213, STPL -5034 -025. City of Gilroy is named as additional insured as respects general liability per endorsement attached. 1.crcurn.rtrr_ nVI-ucR GANGCLLAIIC7N City of Gilroy Public Works Department 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 ACORD name and Innn are renictered markc of ARl1Rn LCD 19RR_ ?Md ACARn CARDr1RAT1A1M All rinhfa ros­4 ACORD 25 (201,11101) 1111 IN 1111111111111111111111111111111111111111 IN 111 801A2410033MOV03/0/010/0' 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured), but only with reaped to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional insured has been completed or afterthat portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or, b) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing In the supervision, hiring, employment, training or monitoring of others by that insured. 5. This endorsement shall not apply to a person or organization if any other additional Insured endorsement attached to this policy specifically applies to that person or organization. 8. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. C. This insurance shall not exceed the scope of coverage, including limits, of this policy and in no event shall the insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and /or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and /or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this Insurance be primary or primary and non - contributing. However. this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary, after, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 9/30/2015 Policy No.: GL15A00056 Endorsement No.: Policy Effective: 9130/2015 Premium $ Insured: Granite Rock Company Insurance Company: American Contractors Insurance Company Risk Retention Group Countersigned By 303844 A� o® CERTIFICATE OF LIABILITY INSURANCE DA 9/24/2015 5 ) 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 pollcy(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 Construction & Real Estate Practice Wells Fargo Insurance Services USA, Inc - CA Lic #: OD08408 CONTACT NAME: PHONE FAX No. AIC, No): 866- 358 - 148_7__ ADDRESS: CertRequests @wellsfargo.com INSURE S AFFORDING COVERAGE NAIL tl 959 Skyway Rd., 2nd Fl INSURER A: American Contractors Ins Co RRG 12300 San Carlos, CA 94070 INSURED INSURER 13: Zurich American Insurance Co 16535 Granite Rock Company INSURER C : ACIG Insurance Company 19984 PO Box 50001 INSURER D: $ 5,000 INSURER E: INSURER F: Watsonville, CA 95077 COVERAGES CERTIFICATE NUMBER: 9576903 REVISION NUMBER: 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 JAM SUER POLICY NUMBER POLICY POLICY DDIYYYY LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X X GL15A00056 GL15800056(GL XS) 09/30/2015 09/30/2015 09/30/2016 09/30/2016 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY II JEC 1-1 LOC PRODUCTS - COMP /OP AGG $ 4,000,000 $ OTHER: B AUTOMOBILE LIABILITY X BAP347266914 09/30/2015 09/30/2016 CEa arxOMBINED SINGLE LIMIT ideM $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NN) NIA WCA000019015 09/30/2015 09/30/2016 PER OTH- X STATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may he akachad If more space Is required) CA20480299,Additional Insured - Automatic Status City of Gilroy is named as additional insured as respects general liability and automobile liability per endorsements attached. GL:K 1 Ir'1UA 1 C MUL.L11i City of Gilroy Attn: Marilyn 7351 Rosanna Street Gilroy, CA 95020 -6141 The ACORD name and loan ana renistered marks of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988 -2014 ACORD CORPORATION_ All riahts reserved ACORD 25 (201,4101) 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 loll N 111111 POLICY NUMBER: BAP347266914 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are'9nsureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 09/30/2015 Countersigned By: /r��°`' Authorized Representative)_ Named Insured: Granite Rock Company SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A PRIMARY, NON- CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured "for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in SeCtlon 11 of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 p YY80 /00326710310410000* 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown In the above SCHEDULE (called additional insured), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your premises or your operations for the additional insured. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" occurring after "your work" for the additional Insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury' arising out of the rendering or failure to render any professional services by any insured, including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys. change orders, designs or specifications; or, b) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing In the supervision, hiring, employment, training or monitoring of others by that insured. 5. This endorsement shall not apply to a person or organization if any other additional Insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction industry. C. This Insurance shall not exceed the scope of coverage, including limits, of this policy and in no event shall the insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and /or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and /or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non - contributing. However, this insurance is always excess to other Insurance, whether primary, excess, contingent or on any other basis, when the additional Insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 9/3012015 Policy No.: GL15A00056 Endorsement No.: Policy Effective: 9/30/2015 Premium $ Insured: Granite Rock Company Insurance Company: American Contractors Insurance Company Risk Retention Group Countersigned By ■ __326710410400..