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HomeMy WebLinkAboutRana Creek Habitat Restoration - Insurance CertificateACC ®® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 7n7>2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Andreini & Company -San Mateo 220 West 20th Ave San Mateo CA 94403 NANMEACT Andreinl & Company PHONE 650 - 573 -1111 FOXY 650-378-4361 E-MARL amatthews @andreinl.com INSURER(S) AFFORDING COVERAGE NAIC # 7129/2017 INSURER A Farmland Mutual Ins Company 13838 $1,000,000 INSURED RANAC -2 INSURER B Fireman's Fund Ins. Co 21873 Rana Creek Habitat Restoration INSURER C State Compensation Ins Fund 35076 27875 Berwick Drive PERSONAL & ADV INJURY Carmel CA 93923 INSURER D GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 INSURER E $ INSURER F AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CnVFRAGFS CFRTIFICATF NUMRFR- 12723584 RFVISInN NUMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY YE D/YY POLICY EXP M/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XI OCCUR CPP118982A 7129/2017 7/29/2018 EACH OCCURRENCE $1,000,000 MAGE TO KEN i PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY ❑ PE0 F7 LOC OTHER GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CPP118982A 7/2912017 7129/2018 Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE FA000058110818 7/29/2017 7/2912018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DIED I X I RETENTION$0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Myyandatory In NH) If DESCRIPTI N OF OPERATIONS below NIA 91008862017 6/1/2017 611/2018 X PER OTH- STATUTE ER E L EACH ACCIDENT $1,000,000 E L DISEASE- EA EMPLOYE $1,000,000 E L DISEASE - POLICY LIMIT 81,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, Its officers, officials and employees are named as an additional insured, per the attached Endorsement. L;tKIII-IUAI t MULUtK (;ANUELLAIIUN City of Gilroy, its officers, officials and employees 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 © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured any person(s) or organization(s) with whom you have agreed in a valid written contract or agreement, executed prior to any 'occurrence ", that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage ", or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III — LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office. Inc., with its permission. (CG2026 0413) CGLB303 0413 Page 1 of 1 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO PLUS ENDORSEMENT This endorsement modes insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following additions and extensions of coverage: A. NEWLY ACQUIRED OR FORMED ENTITIES S. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE C. BLANKET ADDITIONAL INSURED - REQUIRED BY CONTRACT D. EMPLOYEES AS INSUREDS - NONOWNED AUTOS E. EMPLOYEE HIRED AUTOS F. SUPPLEMENTARY PAYMENTS - BAIL BONDS G. SUPPLEMENTARY PAYMENTS - LOSS OF EARNINGS H. FELLOW EMPLOYEE COVERAGE I. PROPERTY OF OTHERS J. PERSONAL EFFECTS COVERAGE K. AUTO MEDICAL PAYMENTS COVERAGE - INCREASED LIMITS L. EXPANDED TOWING COVERAGE M. AUTO LOAN OR LEASE COVERAGE N. RENTAL REIMBURSEMENT COVERAGE O. EXPANDED TRANSPORTATION EXPENSE P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE R. PHYSICAL DAMAGE • TWO OR MORE DEDUCTIBLES S. BLANKET WAIVER OF SUBROGATION T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS A. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority (more than 50 %) interest; if there is no other similar insurance available to that organization. Coverage under this provision is afforded only until the 901" day after you acquire or form the organization, or the end of the policy period, whichever comes first. B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE The following is added to paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION 1- COVERED AUTOS: If Physical Damage Coverage is provided on a covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss ", or destruction, then you have coverage for any "auto" you do not own, while used with the permission of its owner as a temporary substitute for the covered out of service "auto ". The deductible for the temporary substitute "auto" will be the same as the applicable deductible for the covered "auto" it replaces. CCAB191 0813 Includes copyrighted matenal of Insurance Services Office, Inc., with its permission Page 1 of 6 insured copy COMMERCIAL AUTO C. BLANKET ADDITIONAL INSURED — REQUIRED BY CONTRACT The following is added to paragraph A.I. Who Is An Insured of SECTION 11 — LIABILITY COVERAGE: Any person(s) or organization(s) is an additional "insured" with whom you have agreed in a valid written contract or agreement, executed prior to any "accident" or "loss ", that such person(s) or organization(s) be added as an additional "insured" on your policy. Such persons or organizations are additional "insureds ", but only with respect to liability for "bodily injury" or "property damage" caused by an "accident" that is, in whole or in part, caused by your acts or omissions or the acts or omissions of those acting on your behalf and resulting from the ownership, maintenance or use of a covered "auto ". D. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to the SECTION II — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. EMPLOYEE HIRED AUTOS 1. Changes In Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM is replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: a. Any covered "auto" you lease, hire, rent or borrow; and b. Any covered "auto" hired or rented by your "employee" under a contract in that "employee's" name, with your permission, while performing 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 ". F. SUPPLEMENTARY PAYMENTS — BAIL BONDS The following replaces paragraph A.2.a. (2) of SECTION If — LIABILITY COVERAGE: (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to fumish these bonds. G. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS The following replaces paragraph A.2.a. (4) of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. CCAS191 0813 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 6 Imwwd copy COMMERCIAL AUTO H. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion contained under the LIABILITY COVERAGE does not apply. 1. PROPERTY OF OTHERS The Care, Custody Or Control Exclusion in SECTION II — LIABILITY COVERAGE does not apply to "property damage" to property, other than your property, up to an amount not exceeding $3,000 in any one "accident'. This coverage applies as a result of a covered "loss ", without applying a deductible. Coverage is excess over any other valid and collectible insurance. J. PERSONAL EFFECTS COVERAGE The following is added to paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $1,000 for the "loss" to personal effects which are: (1) Owned by an "insured "; and (2) In or on your covered "auto ". This coverage applies as a result of a covered 'loss ", without applying a deductible. Coverage is excess over any other valid and collectible insurance. K. AUTO MEDICAL PAYMENTS COVERAGE — INCREASED LIMITS In the event of a covered 'loss" where Auto Medical Payments Coverage applies, we will double the Limit Of Insurance for Medical Payments shown in the Declarations for each "insured" who was wearing a seat belt at the time of the "accident". This limit is the most we will pay for all covered medical expenses regardless of the number of covered "autos ", "insureds ", premiums paid, claims made or vehicles involved in the "accident ". L. EXPANDED TOWING COVERAGE The following replaces paragraph A.2. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to: 1. $100 for a covered "auto" you own of the private passenger type; or 2. $500 for a covered "auto" you own that is not of the private passenger type; for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. M. AUTO LOAN OR LEASE COVERAGE Physical Damage Coverage is amended by the addition of the following 1. In the event of a total "loss" to a covered "auto ", we will pay any unpaid amount due on the lease or loan, including up to a maximum of $500 for early termination fees or penalties, for a covered "auto" less: a. The amount paid under the policy's Physical Damage Coverage; and b. Any: CCAB191 0613 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 6 Insured copy COMMERCIAL AUTO 1) Overdue lease /loan payments at the time of the "loss "; 2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; 3) Security deposits not returned by the lessor; 4) Costs of extended warranties, Credit Life insurance, Health, Accident, or Disability insurance purchased with the loan or lease; and 5) Carry-over balances from previous loans or leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Comprehensive, Specified Causes Of Loss, or Collision coverage. 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. 4. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. N. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto ". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto ". No deductibles apply to this coverage. 2. This coverage applies only to a covered "auto" for which Physical Damage Coverage is provided on this policy. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policys expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto ". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. $75 for any one day or for a maximum of 30 days. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Expanded Transportation Expense Coverage Extension in this form. 7. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. O. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE is replaced by the following: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you cant' either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 CCAB191 0813 Includes copyrighted material of Insurance Sennces Office, Inc., with its permission Page 4 Of 6 ms "red copy COMMERCIAL AUTO hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss ". P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO The following is added to paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $5,000 for the expense of recovering a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE The following is added to paragraph B.3.a. of SECTION III — PHYSICAL DAMAGE COVERAGE: Mechanical breakdown does not include the accidental discharge of an airbag. R. PHYSICAL DAMAGE - TWO OR MORE DEDUCTIBLES The following is added to paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE: When two or more covered "autos" sustain "loss" in the same collision, the "loss" will be reduced by the largest single deductible that applies. For purposes of this coverage, an "auto" and its attached trailer are two separate "autos ". S. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply, but only when the Named Insured agrees that subrogation is waived prior to the "accident" or the "loss" under the terms of a written contract entered into between the Named Insured and an entity that is part of that contract. T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following replaces Paragraph A.2.a. Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS: We have no duty to provide coverage under this policy unless there has been full compliance with the following duties: a. In the event of "accident ", claim, "suit", or "loss ", your insurance manager or any other person you designate as responsible for insurance- related matters must notify us promptly of an "accident" or a "loss ", regardless of the amount, which may result in a claim. Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. Paragraph A.2.b.(2) Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: b. Additionally, you and any other involved "insured" must: (2) Notify us and send us copies of any request, demand, order, notice, summons or legal papers received concerning the claim or "suit" as soon as practicable. CCAB191 0813 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 5 of 6 Insured Copy COMMERCIAL AUTO For the purposes of this coverage provided, you are presumed to have knowledge of the accident" or "loss" when it has been reported to the insurance manager or any other person you designate as responsible for insurance - related matters. U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV — BUSINESS AUTO CONDITIONS: Unintentional Failure To Disclose Hazards Failure by you to disclose to us all hazards existing as of the inception date of this policy shall not prejudice us with respect to the coverage afforded by this policy, provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CCAB191 0813 Includes copyrighted material of Insurance Services Office, Inc, with its permission. Page 6 of 6 Inmed cWy A � o® CERTIFICATE OF LIABILITY INSURANCE 7126/2016oAYYY) 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 endorsemen s . PRODUCER Andremi & Company -Sam Mateo 220 West 20th Ave San Mateo CA 94403 CONTACT NAME Jill Strenskl PHONE 6503784307 FAX 650- 378 -4361 650-378-4307 e 0 f ADDAESS,jstrenski @andreini.com INSURER(S) AFFORDING COVERAGE NAIC N 7/2912016 INSURER A .Farmland Mutual Ins. Company 13838 $1,000,000 INSURED RANAC -2 INSURER B: Fireman's Fund Ins. Co. 21873 Rana Creek Habitat Restoration Inc Rana Creek Design Rana Creek Nursery 27B75 Berwick Drive INSURER C State Compensation Ins Fund 35076 INSURER o Hlscox Insurance Company Inc. — 10200 INSURER E $1,000,000 Carmel CA 93923 1 INSURER F GENERAL AGGREGATE COVERAGES CERTIFICATE NUMBER: 523084544 REVISION NUMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDIVY YY POLICY EXP (MMIfDDNYYYl LIMITS A X I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 111 OCCUR Y CPPI18982A 7/2912016 7/29/2017 EACH OCCURRENCE $1,000,000 A PREMISES Ea occurrence) $100,000 MED EXP(Aoycne Pasco) $5,000 PERSONAL &ADV INJURY $1,000,000 GENE _ AGGREGATE LIMIT APPLIES PER PRO. n LOC POLICY CI OTHER: GENERAL AGGREGATE 52,000,000 PRODUCTS- COMPIOP AGG $2,000,000 E A AUTOMOBILE LIABILITY ANY AUTO AbLLT05 NED SCHEDULED HIRED AUTOS NON -OWNED AUTOS CPP118982A 7/29/2016 7/29/2017 COMB1itlem) $1,000,000 X BODILY INIURY(Per pawn) $ BODILY INJURY IPeraccaiem) $ PER AGE (Per accitlenl Ir E $ B X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE FA000058052168 7/29/2016 7/29/2017 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED IX IRETENT ION EO $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNEWEXECUTIVE F-1 /M OFFICEREMBER EXCEL DEOP (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA 91 00886 201 6 611/2016 61112017 PER X STATUTE ORH E.L EACH ACCIDENT $1,000,000 E L DISEASE - EA EMPLOYEE $1,000,000 E L DISEASE - POLICY LIMIT 51,000,000 A D Transit Professional Liability Claims Made COP1189B2A ANE160767516 7129/2016 7/2912016 7/29/2017 7/29/2017 Limit $50,000 Limit $1,000 DOD Deductible 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached If more space Is required) Service Agreement: Fire Department Personnel Testing City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached Endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cl tV of Gilroy, its officers, officials and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy CA 95020 ACORD 25 (2014101) REPRESENTATIVE_ w fl f:I'i:bz4[! The ACORD name and logo are registered marks of ACORD All riahtc reserved. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. SECTION II - WHO IS AN INSURED Is amended to include as an additional insured any person(s) or organization(s) with whom you have agreed in a valid written contract or agreement, executed prior to any "occurrence ", that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage ", or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III — LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc., with its permission. (CG20260413) CGL8303 0413 Page 1 of 1 Insunid Copy