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HomeMy WebLinkAboutGranite Rock - Insurance Certificate (2019)AcoRO® CERTIFICATE O F LIABILITY INSURANCE DATE 5 /24/2 D/YYYY) 5/24/2018 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 Woodruff - Sawyer & Co. 50 California Street, Floor 12 San Francisco CA 94111 CONTACT NAME: PHONE FAX A C lino. EXt): 415- 391 -21_41 A/c No): 415 -9989 -9923 ADD_RIESS: _ INSURER(S AFFORDING COVERAGE I NAIC # OR OTHER — INSURER A; American Contractors Insurance Co RRG _ 12300 INSURED GRANCOM -01 Granite Rock Company P.O. Box 50001 Watsonville CA 95077 INSURER B: ACIG Insurance AgeenCy, Inc. - __— — _I — -- — — INSURER C _______ 19984 -- INSURER D: THE POLICIES DESCRIBED INSURER E: ALL THE TERMS, EXCLUSIONS INSR LTR A A A INSURER F: POLICIES. ADDL IN SD COVERAGES CERTIFICATE NUMBER: 1412918364 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS INSR LTR A A A AND CONDITIONS OF SUCH I TYPE OF INSURANCE X I COMMERCIAL GENERAL LIABILITY — r� I— ] CLAIMS -MADE I I OCCUR POLICIES. ADDL IN SD SUBR I WVD I LIMITS SHOWN MAY HAVE BEEN REDUCED POLICY NUMBER GL18A00056 Gl_18B00056 (GL. EXCESS) GL18C00056 (GL EXCESS) BY POLICY EFF (MM /DD/YYYY) 6!112018 6/1/2018 6/1/2018 PAID CLAIMS. POLICY EXP I (MM /DD/YYYY) I 61112019 6/1/2019 6/1/2019 LIMITS EACH OCCURRENCE $ 10,0_00,00_0____ _ DAMAGE TO RENTED PREMISES (Ea occurren9p $ 100,000___ —__ MED EXP (Any one person) PERSONAL & ADV INJURY $ 5,000 _ $10,000,000 - -- GE_N'L AGGREGATE LIMIT APPLIES PER: I G_E_NE_RAL A_GG_REGKI'E $10,000,000 POLICY JEOCT- E J LOC I PRODUCT'S - COMP /OP AGG $ 10,000,000 -- i — - - - - - -- $ A OTHER: AUTOMOBILE LIABILITY _ I _ I I �AL18000019 _ — � 6/1/2018 6/1/2019 -� COMBINED SINGLE LIMIT 1Ea accideni $ 5,000,000 X ANY AUTO OWNED SCHEDULED _ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per � - -_ acciden! $ $ $ UMBRELLA LIAB OCCUR OCCURRENCE $ EXCESS LIAB CLAIMS -MADE I $ _EACH AGGREGATE DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR /PARTNER/EXECUTIVE ❑ OFFICER /MEMBEREXCI_UDED? (Mandatory in NH) If yes, describe under D DESCRIPTION OF OPERATIONS below N / A I WCA0000190 18 -- I 6/1/2078 J I I 611/20 19 I I I X I PER. ^' ' —OTH- STATUTE �R E.L. EACH ACCIDENT I E.L. DISEASE - EA EMPLOYEE $1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) _ City of Gilroy, its officers, officials, and employees is named as additional insured as respects general liability per endorsement attached. CERTIFICATE HOLDER CANCELLATION 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 205 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person(s) or Organization(s): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV -- COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. 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: Same as policy effective date unless otherwise indicated above. Policy Effective Date: 6/1/2018 Policy No.: GL18A00056 Endorsement No.: Insured: Graniterock Company Insurance Company: American Contractors Insurance Co RRG Premium $ 933 ADDITIONAL INSURED - AUTOMATIC STATUS AS REQUIRED BY CONTRACT - BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written 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, and only to the extent and for the minimum limits required in the written contract. 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, whichever occurs first. 2. Unless specifically 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 or on any insured's behalf, including: a) The preparing, approving or failing to prepare or approve rnaps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; and b) Supervisory, inspection, architectural 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, if the "occurrence" which caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 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. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the scope of coverage, including minimum 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. 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: Same as policy effective date unless otherwise indicated above. Policy Effective: 6/1 /2018 Policy No.: GL18A00056 Endorsement No.: Insured: Graniterock Company Premium $ Insurance Company: American Contractors Insurance Co. RRG A� Rv® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDYYY) /Y 5/24/2018 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 Woodruff-Sawyer & CO. 50 California Street, Floor 12 San Francisco CA 94111 CONTACT NAME: _ PHONE FAX A/C. No. EXn: 415 -391 -2141 ac, Nor 415 - 989 -9923 _ ADDRESS: INSURER(S) AFFORDING COVERAGE I NAIC # INSURER A : American Contractors Insurance CO RRG 12300 6/1/2019 6/1/2019 6/1/2019 —_ INSURED GRANCOM -01 Granite Rock Company P.O. Box 50001 — INSURER B: ACIG Insurance Agency, Inc. I 19984 - — INSURER C : MED_EXP (Any one person) INSURER D: Watsonville CA 95077 INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER: 367371221 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL IN SD SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP I MM /DD/YYYY LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GI-18A00056 GL18B00056 (GL EXCESS) GLISC00056 (GL EXCESS) 6/1/2018 6/1/ ?_018 6/1/2018 6/1/2019 6/1/2019 6/1/2019 EACH OCCURRENCE $ 10,000,000 DAMAGE TO RENTED PREMISES Ea occurrence -- $ 100,000 MED_EXP (Any one person) _ $ 5,000 _ -- — PERSONAL & ADV INJURY $ 10.000,000 —_ _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 PRO- I LOC POLICY PRODUCTS _COMP /OP AGG - -- - - -- - -- $10,000,000 $ - OTHER: 1 A AUTOMOBILE LIABILITY AL18000019 6/1/2018 6/1/2019 COMBINED SINGLE LIMIT Ea accidence $ 5,000,000 _ X ANY AUTO I BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I PROPERTY DAMAGE Per accident $ -� UMBRELLA LIAB OCCUR I EACH OCCURRENCE _ I $ EXCESS LIAR CLAIMS -MADE I I I AGGREGATE -�— i T$ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE n OFFICER/MEMBEREXCLUDED? L J N/A WCA000019018 6/1/2018 6/1/2019 X PER OTH- STATUTE ER - —I- E.L. EACH ACCIDENT -- - - - - -- - -- $ 1,000,000 -'— (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $' 1.000,000_ If yes, describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 E.L. DISEASE - POLICY LIMIT — DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Granite Job #6274; West Branch Llagas Creek Trail Project No. 15 -PW -228, STPI_- 5034(023). City of Gilroy, its officers, officials and employees is named as additional insured as respects general liability per endorsement attached. CERTIFICATE HOLDER CANCELLATION ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department AUTHORIZED REPRESENTATIVE ' &A 7351 Rosanna Street Gilroy CA 95020 ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 933 ADDITIONAL INSURED - AUTOMATIC STATUS AS REQUIRED BY CONTRACT - BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written 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, and only to the extent and for the minimum limits required in the written contract. 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, whichever occurs first. 2. Unless specifically 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 or on any insured's behalf, including: a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; and b) Supervisory, inspection, architectural 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, if the "occurrence" which caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 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. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the scope of coverage, including minimum 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: Same as policy effective date unless otherwise indicated above. Policy Effective: 6/1/2018 Policy No.: GL18A00056 Endorsement No.: Insured: Graniterock Company Premium $ Insurance Company: American Contractors Insurance Co. RRG ACC>Ra CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ 0 8YY) 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 Woodruff - Sawyer & Co. 50 California Street, Floor 12 San Francisco CA 94111 CONTACT PHONE FAX A/C No. Ext): 415- 391 -2141 _ A/C No ; 415 - 989 -9923 _ ADDRIESS: INSURERj�LAFFORDING COVERAGE I NAIC # Y INSURER A: American Contractors Insurance Co RRG 12300 6/1/2018 6 /1/2018 6/1/2018 INSURED GRANCOM -01 Granite Rock Company INSURER B: ACIG Insurance Agency, Inc. _ 19984 P.O. Box 50001 INSURER C : I INSURER D: —_ Watsonville CA 95077 INSURER E : $ 5,000 INSURER F: PERSONAL & ADV INJURY $ 10,000.000 COVERAGES CERTIFICATE NUMBER: 870440013 RFV1SI0N 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 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 IN SD I SUBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP I MM /DD/YYYY LIMITS A A A X I COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR Y Y I GL18A00056 GL18B00056 (GL EXCESS) GL18C00056 (GL EXCESS) 6/1/2018 6 /1/2018 6/1/2018 6/1/2019 6/1/2019 6/1/2019 EACH OCCURRENCE _ DAMAGE TO RENTED PREMISES Ea occurrence $ 10,000,000 - - -- $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 10,000.000 AGGREGATE LIMIT APPLIES PER: POLICY I J JECOT- F LOC GENERAL AGGREGATE $ 10,000,000 GEN'L PRODUCTS - COMP /OP AGG $ 10,000,000 $ OTHER: I A I AUTOMOBILE X J LIABILITY ANY AUTO Y Y" 1 AL18000019 611/2018 I 6/1/2019 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS _ BODILY INJURY Per accident ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ _ UMBRELLA LIAB H OCCUR I EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I RETENTION $ _ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE n OFFICER/MEMBEREXCLUDED? N/A WCA000019018 6i 1/2018 6/1/2019 ER X I STATUTE LERH E.L. EACH ACCIDENT - - $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) L�J If yes, describe under I E.L. DISEASE - POLICY LIMIT — -- $ 1,000,000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy is named as additional insured as respects general liability and automobile liability per endorsements attached. CERTIFICATE HOLDER CANCELLATION City of Gilroy Attn: Marilyn 7351 Rosanna Street Gilroy CA 95020 -6141 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 - IM41, �* - ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 596 This endorsement modifies insurance provided under the following: BUSINESS AUTO LIABILITY COVERAGE PART Any person or organization you are required by contract to include as an additional insured on this policy is an "insured" but only with respect to liability arising out of the ownership, maintenance or use of an "auto" in the operations incidental to the contract and to the extent set forth below: (1) The limit of insurance will not be greater than that required by such contract. (2) The coverage provided to the additional insured will not be greater than that customarily provided by the policy forms specified in and required by the contract. (3) All insuring agreements, exclusions and conditions of this policy will apply. (4) In no event shall the coverage or limit of insurance in this coverage form be increased by such contract. 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: same as policy eff. date unless otherwise indicated above. Policy Effective: 6/1/2018 Policy No.: AL18000019 Endorsement No.: Insured: Graniterock Company Premium $ Insurance Company: American Contractors Insurance Co RRG 441 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO LIABILITY COVERAGE PART The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section III - BUSINESS AUTO CONDITIONS) is amended by the addition of the following: All rights of recovery against others are waived hereunder to the extent required by contract executed prior to "accident" or "loss" and with respect to such insurance provided by this policy. 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: same as policy eff. date unless otherwise indicated above. Policy Effective: 6/1/2018 Policy No.: AL 18000019 Endorsement No.: Insured: Graniterock Company Premium $ Insurance Company: American Contractors Insurance Co RRG 205 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: COMMERCIAL_ GENERAL LIABILITY COVERAGE PART C•��101:41119140 Name of Person(s) or Organization(s): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV -- COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. 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: Same as policy effective date unless otherwise indicated above. Policy Effective Date: 6/1/2018 Policy No.: GL18A00056 Endorsement No.: Insured: Graniterock Company Insurance Company: American Contractors Insurance Co RRG Premium $ 933 ADDITIONAL INSURED - AUTOMATIC STATUS AS REQUIRED BY CONTRACT - BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written contract to include as an additional insured on this policy if the contract is executed I prior to the loss. I 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, and only to the extent and for the minimum limits required in the written contract. 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, whichever occurs first. 2. Unless specifically 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 or on any insured's behalf, including: a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, drawings or specifications; and b) Supervisory, inspection, architectural 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, if the "occurrence" which caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 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. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. In no event shall the insurance provided to the additional insured exceed the scope of coverage, including minimum 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. 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: Same as policy effective date unless otherwise indicated above. Policy Effective: 6/1/2018 Policy No.: GL18A00056 Endorsement No.: Insured: Graniterock Company Premium $ Insurance Company: American Contractors Insurance Co. RRG