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HomeMy WebLinkAboutCOI - Fiorio Farms, Inc. - Expires 2020-04-01es FIORFAR-01 LISA .Accom� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 4/18/2019 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 License # OK07568 Pacific Diversified Insurance Services 15005 Concord Circle, Suite 110 Morgan Hill, CA 95037 CONTACT NAME: PHONE FAX (Arc, No, Ext): (408) 842-2131 1 (Arc, No):(408) 842-0867 E-MAIL INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Allied Insurance 10127 INSURED Fiorio Farms Inc. Dan Fiorio 6330 Thomas Rd Gilroy, CA 95020 INSURER B : Wesco Insurance Company 25011 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDY EFF ) IMM(DD�1 LIMITS A COMMERCIAL GENERAL LIABILITY FPKFMP7880914858 4/1/2019 4/1/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PAMGEESn&Ra EocNcTDence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE j� jI POLICY I I OTHER: LIMIT APPLIES PER: Plc°T LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ A L AUTOMOBILE X LIABILITY SCHEDULED AUTOSyy� AUTO ONL9, FPKFMP7880914858 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ INJURYp(Per accident) $ pBOODILY (Perr acc dent) AMAGE $ $ A X f UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE FPKFMP7880914858 4/1/2019 4/1/2020 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? mandatory In NH) i yes, describe under if) DESCRIPTION OF OPERATIONS below YIN N N 1 A WWC3414682 4/1/2019 4/1/2020 X I STATUTE I I TH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Rented Equipment FPKFMP7880914858 4/1/2019 4/1/2020 Ded $500 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Monterey & Luchessa Rd, Gilroy, CA. (Gilroy Sports Complex) Certificate holder is named as Additional Insured with respects to the above referenced land. 10 days notice for non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Gilroy 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FPK FMPN 78 8 0914858 INSURED'S COPY FORM 8110 ADDITIONAL INFORMATION SUPPLEMENTAL DECLARATIONS Form DESCRIPTION FL70610 ti FP70526 FP70582 FP70550 FL70634 ADDITIONAL INSURED -DESIGNATED OPERATION, LOCATION OR EQUIP MARIO C & INEZ B FIORIO,TRUSTEES OF THE FIORIO FAMILY TRUST 6300 THOMAS RD,GILROY,CA95020,LOC 001 YVONNE VALENCIA,501 PINECREEK CT,ROSEVILLE,CA 95747, LOC 001 CITY OF GILROY,7531 ROSANNA ST,GILROY,CA 95020 RE LOC 009 JAMES RANCH,BILL & SUE JAMES,7550 KENTWOOD CT,GILROY,CA 95020 RE LOC 003 RICHARD HASONI,7340 CREWS RD,GILROY,CA 95020 RE LOC 013 MITCHELL J HILLA,2175 OAK KNOLL AVE,SAN MARTIN,CA 91108 RE LOC 014 SEE FORM 28B FOR MORE ADDITIONAL INSUREDS EXTENDED FARM OFFICE EQUIPMENT 001/002 LIMITED FUNGI OR BACTERIA COVERAGE ENDORSEMENT - PROPERTY LIMIT: 810,000 RENTED/LEASED FARM MACHINERY & EQUIPMENT- PRIMARY COVERAGE AGGREGATE LIMIT: $500,000 PERIOD OF COV-NUM OF DAYS: 090 PACIFIC AG RENTALS, 1 HARRIS PL IA, SALINAS, CA 93901 PETERSON TRACTOR COMPANY, 13155 SYCAMORE AVE, SAN MARTIN, CA DUMAC LEASING, PO BOX 760, SANTA ROSA, CA, 95402 PENSKE TRUCK LEASING COMPANY, PENSKE TRUCK LEASING CO.,LP ADDITIONAL INSURED -VENDOR OF YOUR PRODUCT 01 ADDITIONAL INSUREDS WM BOLTHOUSE FARMS, INC. ISADA CARROTS 8110 (01.01) 00 Page 14954 47 EFFECTIVE DATE: 12:01 AM Standard Time, FARM (at your principal place of business) FL 70610 (01-01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED OPERATION, LOCATION OR EQUIPMENT COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: FARM LIABILITY COVERAGE FORM This endorsement applies only to the person(s) or organization(s) identified on Form 8110 (Additional Endorsement Information) of this policy. Under Section C. WHO IS AN INSURED, in paragraph 2., each of the following is also an insured: The persons or organizations shown on Form 8110, but only with respect to liability arising out of the designated operation or location or your use of equipment shown on Form 8110, subject to the following additional exclusion: All terms and conditions of this policy apply unless modified by this endorsement. FL 706 10 (01-01) This insurance, including any duty we have to defend "suits", does not apply to "bodily injury", "property damage" or "personal and advertising injury" that arises out of, in whole or in part, or is a result of, in whole or in part, the active or primary negligence of any person or organization designated as an additional insured on Form 8110, AC�RD® kb......----- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 2/6/2020 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 Arthur J. Gallagher & Co. 4250 Congress St., Suite 200 Charlotte NC 28209 CONTACT Lori Staples PHONE FAX INC. No. Extt: 336-217-5767 IA/C. No): 336-275-1776 ADDRESS: Lori_Staples@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Great American Fidelity Insurance Co 41858 INSURED FINACRE-02 Financial Credit Network Inc 1300 West Main St Visalia CA 93291 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1442913298 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 INSD SUBR WYD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) S PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY ^ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) S S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION 5 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Errors & Omissions MPL1751975 2/1/2020 2/1/2021 Each Claim Limit Policy Aggregate Deductible $1,000,000 $1,000,000 $20,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 1 City of Gilroy, its officers officials and employees 7351 Rosanna Street Gilroy CA 95020 USA 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 a" ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORIJ CERTIFICATE OF LIABILITY INSURANCE DA TE (MM/DDlYYW) 1TE(M0I 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 MARSH USA INC 1717 Arch Street Philadelphia, PA 19103 Attn: Philadeiphia.oerts@marsh.com 1 Fax: (212) 948-0360 CN118025105-ALL-STAND-19-21 CONTACT NAME' PHONE FAX (A/C. No. Ext): (A/C. No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A : Lexington Insurance Company 19437 INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 INSURER B : Greenwich Insurance Company 22322 INSURER C : XL Insurance America 24554 INSURER D : Indian Harbor Insurance Company 36940 INSURER E : XL Specialty Insurance Company 37885 INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006525310-07 REVISION NUMBER: 2 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 INSD SUBR VWD POUCY NUMBER POUCY EFF (MM/DD/YYYY) POLICY EXP (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 082695264 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 DAMAGE TO PREMISES (EaENTED occurrence) $ 10,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ X CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ 10,000,000 X SIR $1,750,000 GENERAL AGGREGATE $ 10,000,000 GEN'L X AGGREGATE POLICY OTHER. LIMIT APPLIES PRO- JECT PER. LOC PRODUCTS - COMP/OP AGG $ 10,000,000 $ B AUTOMOBILE X _ _ UABIUTY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY ^ SCHEDULED AUTOS NON -OWNED AUTOS ONLY RAD9437818-03 11/01/2019 01/0112021 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE RES9437994 EXCESS OF GENERAL LIABILITY 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED RETENTION $ C E WORKERS COMPENSATION EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below Y / N N Ni A _ RWD3001203-04(AOS) RWR3001204-04(WI) 11/01/2020 11/01/2020 01/01/2021 01/01/2021 X PER STATUTE OTH- ER ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION City of Gilroy Public Works Department 613 Old Gilroy Road Gilroy, CA 95020 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -14.0. o6,41 -to-a•At -e.- ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACCORD® ADDITIONAL REMARKS SCHEDULE Page 2 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance First Named Insured: Allied Universal Topco, LLC Additional Named Insureds: AlliedBarton (NC) LLC AlliedBarton (NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC AlliedBarton Security Services LLC, dba Allied Universal Security Services AlliedBarton Security Services LP AlliedBarton Security Services LP, dba Allied Universal Security Services Allied Security Holdings LLC Allied Universal Holdco LLC Andrews International Government Services, Inc. Andrews International Government Services, Inc., dba Allied Universal Risk Advisory and Consulting Services Apollo Security International, Inc. C & D Enterprises, Inc. FJC Security Services, Inc. FJC Security Services, Inc., dba Allied Universal Security Services Guardsmark (Puerto Rico), LLC Guardsmark (Puerto Rico), LLC, dba Allied Universal Security Services, LLC Guardsmark (Puerto Rico), LLC, dba Universal Protection Service, LLC Intelligent Access Systems of North Carolina, LLC Intelligent Access Systems of North Carolina, LLC, dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid -Mantic Peoplemark, Inc. Peoplemark, LLC Securadyne Systems Intermediate LLC Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Universal Protection Security Systems Spectaguard Acquisition LLC Staff Pro Inc. Staff Pro Inc., dba Allied Universal Event Services Surveillance Specialties, Ltd. Surveillance Specialties, Ltd., dba Allied Universal Technology Services Surveillance Specialties, Ltd., dba Securadyne Systems Northeast Universal Building Maintenance, LLC Universal Building Maintenance, LLC, dba Allied Universal Janitorial Services Universal Protection Security Systems, LP Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Service of Canada Co. Universal Protection Service of Canada Co., dba Allied Universal Security Services of Canada Co. Universal Protection Service of Canada Corporation ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACORD® ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Universal Protection Service of Canada Corporation., dba Allied Universal Security Services of Canada Universal Protection Service, LLC Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Protection Service of Seattle, LLC Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Services of America, LP Universal Thrive Technologies, LLC Universal Thrive Technologies, LLC, dba Allied Universal Technology Services Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Thrive Intelligence U.S. Security Associates, Inc. U.S. Security Associates, Inc., dba Allied Universal Risk Advisory and Consulting Services U. S. Security Associates Aviation Services, Inc. U. S. Security Associates Holding Corp. U. S. Security Associates Holdings II Corp. U. S. Security Associates Holdings, Inc. U. S. Security Associates Staffing, Inc. U. S. Security Holdings, Inc. Vance Executive Protection, In. Vance International Consulting, Inc. The following acquisitions are included for coverage in the policies evidenced above as follows: Coverage effective dates: General and Umbrella Liability: 12/31/2019 Auto Liability and Workers' Compensation: 01/12/2020 AS Solution North America, Inc. AS Solution North America, Inc., dba AS Solution First Alarm Security & Patrol, Inc. First Alarm Security & Patrol, Inc., dba First Alarm First Alarm Security & Patrol, Inc., dba First Security First Alarm Security & Patrol, Inc., dba First Security Services SOS Security, LLC SOS Security LP SOS Security LP, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Risk Advisory and Consulting Services TSI Security LLC City of Gilroy Public Works Department is additional insured on the above General Liability, and Auto Liability Policies if required by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACORD® ADDITIONAL REMARKS SCHEDULE Page 4 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ARSH October 31, 2020 Subject: Allied Universal Topco, LLC Certificate of Insurance Marsh USA Inc. 11001 Lakeline Blvd., Bldg 1, Suite 200 Austin, TX 78717 Philadelphia.Certs@marsh.com Allied Universal is making a change in the expiration date of its casualty insurance programs. These changes will have no impact on the insurance coverages or limits being provided to your organization as required by your contract with Allied Universal. Due to the change in policy periods, the attached certificate evidences policy terms ending January 1, 2021 for the casualty liability programs. The liability program is expected to follow a January 1 — January 1 cycle going forward. You will receive a separate certificate of insurance for this period. If this certificate is no longer needed, please mark delete and email to Philadelphia.certs©marsh.com or fax to 212-948-0360. We will then deactivate the certificate so you will no longer receive it. If your certificate requires a revision, please contact your representative at Allied Universal directly. Sincerely, Shandala Brown, Operations Manager, AVP Marsh I US Operations & Technology: Centralized Services 11001 Lakeline Blvd., Bldg. 1, Suite 200, Austin TX 78717 www.rnarsh.com j Marsh USA Inc. LEADERSHIP, KNOWLEDGE, 5Oi J11ONS...WORLDWiDE. MARSH & McLENNAN COMPANIES POLICY NUMBER: RAD943781803 XIC 414 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Schedule Additional Insured(s) Work Any person or organization you have agreed to include as an additional insured under written contract, provided such contract was executed prior to the date of loss. All Operations COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in the Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS I- DLICY. All other terms and conditions of this policy remain unchanged. XIC 414 1013 © 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: RAD943781803 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ALLIED UNIVERSAL TOPCO, LLC Endorsement Effective Date: November 1, 2019 SCHEDULE Names) Of Person(s) Or Organization(s): Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 ENDORSEMENT #050 This endorsement, effective 12:01 AM 11/01/2019 Forms part of policy number: 082695264 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided by the following: GUARDSECURE GENERAL AND PROFESSIONAL LIABILITY COVERAGE FORM A. SECTION II - Who Is An Insured is amended to include as an additional insured a person(s) or organization(s) who is required to be added by written contract or written agreement which does not require that a specific form number be used. B. The insurance provided to additional insureds applies only to "bodily injury', "property damage", "professional liability" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured; or "your work" performed for that additional insured and included in the "products -completed operations hazard" 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 for such additional insured. C. 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. D. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim. 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured also has rights an insured or additional insured. E. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1. The additional insured is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this Insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions remain as written. tea. 0 La - Cs Or 16 frf 4k i-- w wa) ta OV z�- � z QNoa a°d- 4-010, 0 co cza Ua C U cX z a' c>CC ECD E <0 a)en w WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SCHEDULE Name of person or Organization: Where required by written contract. L 00.Q: CU C C M- iii C p 0gaaa Z 15 ;lcL 0 0 c a CO a CI 3 .CL > 0 — C E = = N at. C C U 4 0 E a) N O tta cil -gyp F. 3 N C 0 As L p 73 "C 0 o vs ._ tv ) U C.6 II G F.!) IC 0 V3 CA5M s co o W w Co o E co E.EN� 8 w c"Fe0 .. -- 01 p D >co m CO el'. e 4 U) Z th L 0 0 sn o a 0 .c c3 0.a, o. a, Q b E'wza o w at Z, 0 = a y o > p >4 u.a) > uE c8ia 6 o U LE = tii ` > C L e a r' CL a ~ 0.an uut. a tv p, w >, cf to Z ."a CO �o at cozO I-o All other terms and conditions remain as written. 0 U Oa Q ;A. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. 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 11-01-2020 Insured ALLIED UNIVERSAL TOPCO, LLC Insurance Company XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) Policy No. RWD3001203-04 Endorsement No. Countersigned by 1883 National Council on Compensation Insurance. Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support our firm's commitment to sustainability, going forward, we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an email address where we can deliver your COI in the future. Please send your response to: USOperations.email@marsh.com and provide the following information so that we can expedite your COI delivery: • Certificate # (Shown below Insured Name — e.g.: ABC-123456789-01) • E-Mail for future delivery: For undeliverable email addresses, our system is configured to automatically redirect the Certificate for delivery via USPS. Lastly, if you no longer need this COI please respond to USOperatiions.emailpmarsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery. Thank you. US Operations, Marsh USA, Inc. .acoRD® CERTIFICATE OF LIABILITY INSURANCE TE(MMIDD/YYYY) DATE 0/19/2020 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 MARSH USA INC 1717 Arch Street Philadelphia, PA 19103 Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360 CN118025105-ALL-STAND-19-21 CONTACT NAME: ••• PHONE FAX (A/C. No. Ext.): (A/C, No): E- I RESS: INSURER(S)AFFORDING COVERAGE NAIC # INSURER A : Lexington Insurance Company 19437 INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 INSURER B : Greenwich Insurance Company 22322 INSURER C : XL Insurance America 24554 INSURER D : Indian Harbor Insurance Company 36940 INSURER E : XL Specialty Insurance Company 37885 INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006525314-08 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 082695264 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 CLAIMS -MADE X OCCUR PRTORENTED PREMISES ((Ea occurrence) $ 10,000,000 X CONTRACTUAL LIABILITY MED EXP (Any one person) $ X SIR $1,750,000 PERSONAL & ADV INJURY $ 10,000,000 GEN'L X AGGREGATE POLICY L OTHER: LIMIT APPLIES PRO- JECT PER LOC GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 $ B AUTOMOBILE X LIABIUTY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - SCHEDULED AUTOS NON -OWNED AUTOS ONLY RAD9437818-03 11/01/2019 01/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE RES9437994 EXCESS OF GENERAL LIABILITY 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ C E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A RWD3001203-04(AOS) RWR3001204-04(WI) 11/01/2020 11/01/2020 01/01/2021 01/01/2021 x PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) 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 of Marsh USA Inc. Manashi Mukherjee ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance First Named Insured: Allied Universal Topco, LLC Additional Named Insureds: AlliedBarton (NC) LLC AlliedBarton (NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC AlliedBarton Security Services LLC, dba Allied Universal Security Services AlliedBarton Security Services LP AlliedBarton Security Services LP, dba Allied Universal Security Services Allied Security Holdings LLC Allied Universal Holdco LLC Andrews International Government Services, Inc. Andrews International Government Services, Inc., dba Allied Universal Risk Advisory and Consulting Services Apollo Security International, Inc. C & D Enterprises, Inc. FJC Security Services, Inc. FJC Security Services, Inc., dba Allied Universal Security Services Guardsmark (Puerto Rico), LLC Guardsmark (Puerto Rico), LLC, dba Allied Universal Security Services, LLC Guardsmark (Puerto Rico), LLC, dba Universal Protection Service, LLC Intelligent Access Systems of North Carolina, LLC Intelligent Access Systems of North Carolina, LLC, dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid -Atlantic Peoplemark, Inc. Peoplemark, LLC Securadyne Systems Intermediate LLC Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Universal Protection Security Systems Spectaguard Acquisition LLC Staff Pro Inc. Staff Pro Inc., dba Allied Universal Event Services Surveillance Specialties, Ltd. Surveillance Specialties, Ltd., dba Allied Universal Technology Services Surveillance Specialties, Ltd., dba Securadyne Systems Northeast Universal Building Maintenance, LLC Universal Building Maintenance, LLC, dba Allied Universal Janitorial Services Universal Protection Security Systems, LP Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Service of Canada Co. Universal Protection Service of Canada Co., dba Allied Universal Security Services of Canada Co. Universal Protection Service of Canada Corporation ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4 AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia Aco ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER. 25 FORM TITLE: Certificate of Liability Insurance Universal Protection Service of Canada Corporation., dba Allied Universal Security Services of Canada Universal Protection Service, LLC Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Protection Service of Seattle, LLC Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Services of America, LP Universal Thrive Technologies, LLC Universal Thrive Technologies, LLC, dba Allied Universal Technology Services Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Thrive Intelligence U.S. Security Associates, Inc. U.S. Security Associates, Inc., dba Allied Universal Risk Advisory and Consulting Services U. S. Security Associates Aviation Services, Inc. U. S. Security Associates Holding Corp. U. S. Security Associates Holdings II Corp. U. S. Security Associates Holdings, Inc. U. S. Security Associates Staffing, Inc. U. S. Security Holdings, Inc. Vance Executive Protection, In. Vance International Consulting, Inc. The following acquisitions are included for coverage in the policies evidenced above as follows: Coverage effective dates: General and Umbrella Liability: 12/31/2019 Auto Liability and Workers' Compensation: 01/12/2020 AS Solution North America, Inc. AS Solution North America, Inc., dba AS Solution First Alarm Security & Patrol, Inc. First Alarm Security & Patrol, Inc., dba First Alarm First Alarm Security & Patrol. Inc., dba First Security First Alarm Security & Patrol, Inc., dba First Security Services SOS Security, LLC SOS Security LP SOS Security LP, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Risk Advisory and Consulting Services TSI Security LLC ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SH October 31, 2020 Subject: Allied Universal Topco, LLC Certificate of Insurance Marsh USA Inc. 11001 Lakeline Blvd., Bldg 1, Suite 200 Austin. TX 78717 Philadelphia.Certs@marsh.com Allied Universal is making a change in the expiration date of its casualty insurance programs. These changes will have no impact on the insurance coverages or limits being provided to your organization as required by your contract with Allied Universal. Due to the change in policy periods, the attached certificate evidences policy terms ending January 1, 2021 for the casualty liability programs. The liability program is expected to follow a January 1 — January 1 cycle going forward. You will receive a separate certificate of insurance for this period. If this certificate is no longer needed, please mark delete and email to Philadelphia.certs©marsh.com or fax to 212-948-0360. We will then deactivate the certificate so you will no longer receive it. If your certificate requires a revision, please contact your representative at Allied Universal directly. Sincerely, Shandala Brown, Operations Manager, AVP Marsh j US Operations & Technology: Centralized Services 11001 Lakeiine Blvd., Bldg. 1, Suite 200, Austin TX 78717 www.marsh.com j Marsh USA Inc. LEADERSHIP, KNOWLEDGE, SQWTIONS...WORLDWIDE, MARSH &MCLENNAN COMPANIES POLICY NUMBER: RAD943781803 XIC 414 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Schedule Additional Insured(s) Work Any person or organization you have agreed to include as an additional insured under written contract, provided such contract was executed prior to the date of loss. All Operations COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in the Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY. All other terms and conditions of this policy remain unchanged. XIC 414 1013 tc) 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: RAD943781803 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ALLIED UNIVERSAL TOPCO, LLC Endorsement Effective Date: November 1, 2019 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 c Insurance Services Office, Inc., 2011 Page 1 of 1 .a ENDORSEMENT #060 This endorsement, effective 12:01 AM 11101 /2019 Forms part of policy number: 082695264 Issued to: ALLIED UNIVERSAL TOPCO, LI.0 By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided by the following: GUARDSECURE GENERAL AND PROFESSIONAL LIABILITY COVERAGE FORM A. SECTION II - Who Is An Insured is amended to include as an additional insured a person(s) or organization(s) who is required to be added by written contract or written agreement which does not require that a specific form number be used. B. The insurance provided to additional insureds applies only to "bodily injury", "property damage", 'professional liability" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured; or "your work" performed for that additional insured anc included in the "products -completed operations hazard" 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 for such additional insured. C. 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 Insuranc e shown in the Declarations. D. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim. 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured also has rights an insured or additional insured. E. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1. The additional insured is a Named Insured under such other insurance: and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions remain as written. 0 o g p ••cr c) w X WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US C Eh ▪ W 0 CD • � try -- it '0 • Z :: a.. o 0 = 0. - r.4 �y/ u ( 0 o Q o LL d] 2 .... a. c 0 c Ili. o c a 0 3 (5 E S 4` ..cO E N m c.5 W N C v71, C O U o C • os 0 CD • p �N0 g - • • i� •` ? N C. O C Cr. 0 c -aO] .? ccoo J ,c en a o m o D asco Q CD 0 sz, o© c osc- o u Z w Etn co }- NJ c 0 S o W c��0 C3 I aioo- N 0 3di yL' O ....I o W = a`y • N. c >, o W co 0 ear 6 ,C N 0 n. a. c 8 d ,c •. ""'• 0. m as t z o �- E•Q c� N t) *� C.t € cry cruj>^ 11,E .� co-c o30 (0W C t7 Q+3 > ice. iII N Z c ai0u o o c co o 0 q .v_ [Y. c �., o .s: E C 3 q u. 'o o ci v I- taC o 5. a s�. 0 ;c cx. m e <t c a; +� 01 0 o3 N O - a cry W c fly -p di E • C9 a cs AI u_ an c 0)�j di 4 .0 I—C 73 di • 0c6 a) a' oQ-LCD tom- sUn Z �© Pm s o 3 rt All other terms and conditions remain as written. att r. U WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. 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 11-01-2020 Insured ALLIED UNIVERSAL TOPCO, LLC Insurance Company XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) Policy No. RWD3001203-04 Endorsement No. Countersigned by 1983 National Council on Compensation insurance. ACCORD® CERTIFICATE OF LIABILITY INSURANCE 0/192020D�Y ' 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 MARSH USA INC 1717 Arch Street Philadelphia, PA 19103 Attn: Philadelphia.oerts@marsh.com / Fax: (212) 948-0360 CN118025105-ALL-STAND-19-21 CONTACT NAME: ••' OE FAX (A/C. No. Ext): (A/C, No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Lexington Insurance Company 19437 INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 INSURER B : Greenwich Insurance Company 22322 INSURER C : XL Insurance America 24554 INSURER D : Indian Harbor Insurance Company 36940 INSURER E : XL Specially Insurance Company 37885 INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006525313-07 REVISION NUMBER: 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 TYPE OF INSURANCE ADDL INSD SUBR WVD POUCY NUMBER POUCY EFF (MM/DDIYYYY) POUCY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABIUTY 082695264 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 CLAIMS -MADE X OCCUR DAMAGETO RENTED PREMISES (Ea occurrence) $ 10,000,000 X CONTRACTUAL LIABILITY MED EXP (Any one person) $ X SIR $1,750,000 PERSONAL & ADV INJURY $ 10,000,000 GEN'L X AGGREGATE LIMIT APPLIES PRO- PER: GENERAL AGGREGATE $ 10,000,000 10,000,000 $ B AUTOMOB1LEUABIUTY X - ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY + ^ SCHEDULED AUTOS NON -OWNED AUTOS ONLY RAD9437818-03 11/01/2019 01/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE RES9437994 EXCESS OF GENERAL LIABILITY 11/0112019 01/01/2021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ C E WORKERS COMPENSATION EMPLOYERS' UABIUTY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N /A RWD3001203-04(AOS) RWR3001204-04(WI) 11/01/2020 11/01/2020 01/01/2021 01/01/2021 X MUTE STATUTE ER 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 If more space Is required) 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 of Marsh USA Inc. Manashi Mukherjee �LANAJAR b•• • -u ACORD 25 (2016103) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACQ D® ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE• Certificate of Liability Insurance First Named Insured: Allied Universal Topco, LLC Additional Named Insureds: AlliedBarton (NC) LLC AlliedBarton (NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC AlliedBarton Security Services LLC, dba Allied Universal Security Services AlliedBarton Security Services LP AlliedBarton Security Services LP, dba Allied Universal Security Services Allied Security Holdings LLC Allied Universal Holdco LLC Andrews International Government Services, Inc. Andrews International Government Services, Inc., dba Allied Universal Risk Advisory and Consulting Services Apollo Security International, Inc. C & D Enterprises, Inc. FJC Security Services, Inc. FJC Security Services, Inc., dba Allied Universal Security Services Guardsmark (Puerto Rico), LLC Guardsmark (Puerto Rico), LLC, dba Allied Universal Security Services, LLC Guardsmark (Puerto Rico), LLC, dba Universal Protection Service, LLC Intelligent Access Systems of North Carolina, LLC Intelligent Access Systems of North Carolina, LLC, dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid -Atlantic Peoplemark, Inc. Peoplemark, LLC Securadyne Systems Intermediate LLC Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Universal Protection Security Systems Spectaguard Acquisition LLC Staff Pro Inc. Staff Pro Inc., dba Allied Universal Event Services Surveillance Specialties, Ltd. Surveillance Specialties, Ltd., dba Allied Universal Technology Services Surveillance Specialties, Ltd., dba Securadyne Systems Northeast Universal Building Maintenance, LLC Universal Building Maintenance, LLC, dba Allied Universal Janitorial Services Universal Protection Security Systems, LP Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Service of Canada Co. Universal Protection Service of Canada Co., dba Allied Universal Security Services of Canada Co. Universal Protection Service of Canada Corporation ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 118025105 LOC #: Philadelphia ACa EP ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Universal Protection Service of Canada Corporation., dba Allied Universal Security Services of Canada Universal Protection Service, LLC Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Protection Service of Seattle, LLC Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Services of America, LP Universal Thrive Technologies, LLC Universal Thrive Technologies, LLC, dba Allied Universal Technology Services Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Thrive Intelligence U.S. Security Associates, Inc. U.S. Security Associates, Inc., dba Allied Universal Risk Advisory and Consulting Services U. S. Security Associates Aviation Services, Inc. U. S. Security Associates Holding Corp. U. S. Security Associates Holdings II Corp. U. S. Security Associates Holdings, Inc. U. S. Security Associates Staffing, Inc. U. S. Security Holdings, Inc. Vance Executive Protection, In. Vance International Consulting, Inc. The following acquisitions are included for coverage in the policies evidenced above as follows: Coverage effective dates: General and Umbrella Liability: 12/31/2019 Auto Liability and Workers' Compensation: 01/12/2020 AS Solution North America, Inc. AS Solution North America, Inc., dba AS Solution First Alarm Security & Patrol, Inc. First Alarm Security & Patrol, Inc., dba First Alarm First Alarm Security & Patrol, Inc., dba First Security First Alarm Security & Patrol, Inc., dba First Security Services SOS Security, LLC SOS Security LP SOS Security LP, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Risk Advisory and Consulting Services TSI Security LLC ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MARSH October 31, 2020 Subject: Allied Universal Topco, LLC Certificate of Insurance Marsh USA Inc. 11001 Lakeline Blvd., Bldg 1, Suite 200 Austin. TX 78717 Philadelphia.Certs@marsh.com Allied Universal is making a change in the expiration date of its casualty insurance programs. These changes will have no impact on the insurance coverages or limits being provided to your organization as required by your contract with Allied Universal. Due to the change in policy periods, the attached certificate evidences policy terms ending January 1, 2021 for the casualty liability programs. The liability program is expected to follow a January 1 — January 1 cycle going forward. You will receive a separate certificate of insurance for this period. If this certificate is no longer needed, please mark delete and email to Philadelphia.certs@marsh.com or fax to 212-948-0360. We will then deactivate the certificate so you will no longer receive it. If your certificate requires a revision, please contact your representative at Allied Universal directly. Sincerely, Shandala Brown, Operations Manager, AVP Marsh I US Operations & Technology: Centralized Services 11001 Lakeline Blvd., Bldg. 1, Suite 200, Austin TX 78717 www.marsh.com I Marsh USA Inc. LEADERSHIP, KNOWLEDGE, SOLUTIONS -WORLDWIDE. MARSH &McLENNAN COMPANIES POLICY NUMBER: RAD943781803 XIC 414 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Schedule Additional Insured(s) Work Any person or organization you have agreed to include as an additional insured under written contract, provided such contract was executed prior to the date of loss. All Operations COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in the Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY. All other terms and conditions of this policy remain unchanged. XIC 414 1013 © 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: RAD943781803 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ALLIED UNIVERSAL TOPCO, LLC Endorsement Effective Date: November 1, 2019 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 Insurance Services Office, Inc., 2011 Page 1 of 1 ENDORSEMENT #060 This endorsement, effective 12:01 AM 11 /01 /2019 Forms part of policy number: 082695264 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided by the following: GUARDSECURE GENERAL AND PROFESSIONAL LIABILITY COVERAGE FORM A. SECTION II - Who Is An Insured is amended to include as an additional insured a person(s) or organization(s) who is required to be added by written contract or written agreement which does not require that a specific form number be used. B. The insurance provided to additional insureds applies only to "bodily injury", "property damage", "professional liability" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured; or "your work" performed for that additional insured and included in the "products -completed operations hazard" 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 for such additional insured, C. 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 Insuranc e shown in the Declarations. D. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim. 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured also has rights an insured or additional insured. E. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1. The additional insured is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions remain as written. WAIVER OF TRANSFER OF RIGHTS► OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the folio SECURITY GUARD GENERAL AND PROFESSIONAL LIABILITY COVERAGE PART SCHEDULE s 02 CU • 3 ZO ca s C�"' - ccn5- 14Q E ' • w- 0 a) o 0 = fl. � CO • ti • 0) r .0 > p .; 0 C N _ C :: E u ?©Ea • t to w zs c a c ©.a Q o ::, 2) 3 J 13 N • p O Q) to in 0 c •C 73 E7 Cl)i 'c N a 0 v al c o E I- 0 0 N 0, E co � 'c u o � c °' a 4- N �o Coo sflA-a -- 03 ^0 • _ > C o RI '— (4 to 0 0 ,,,,,c.= RI a,. a)_ .6, .ca 'lZ : E r a O « €vs >-`6 ECcu �� W3, c a .N oQ O€>CU — II u.tv p c .... Ou. II m(ja riTri: o 13 auu) ws •'0-0 2 Q. � L. ,, 7ti m c id 43 •5 al en IA >.. c . o ,C �„ aa)i ..... .o z ..� PH E m ° 5 • H e > Se 15. z © I- it . All other terms and conditions remain as written, U 0 a wx WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. 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 11-01-2020 Insured ALLIED UNIVERSAL TOPCO, LLC Insurance Company XL Insurance America, Inc. WC000313 (Ed. 4-84) Policy No. RWD3001203-04 Endorsement No. Countersigned by e. 1983 National Council on Compensation Insurance. ACCURO® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDIYYYY) 10/19/2020 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 MARSH USA INC 1717 Arch Street Philadelphia, PA 19103 Attn: Philadelphia.certs@marsh.com I Fax: (212) 948-0360 CN118025105-ALL-STAND-19-21 CONTACT NAME: PHONE FAX (NC. No. Ext): (A/C. No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC 11 INSURER A : Lexington Insurance Company 19437 INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 INSURER B : Greenwich Insurance Company 22322 INSURER C : XL Insurance America 24554 INSURER 0 : Indian Harbor Insurance Company 36940 INSURER E : XL Specialty Insurance Company 37885 INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006525312-07 REVISION NUMBER: 2 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 INSD SUBR WVD POLICY NUMBER POUCY EFF (MMIDD/YYYY) POUCY EXP (MMIDOIYYYY) LIMITS A X COMMERCIAL GENERAL LIABIUTY 082695264 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ 10,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ X CONTRACTUAL LIABILITY PERSONAL F. ADV INJURY $ 10,000,000 X SIR $1,750,000 GENERAL AGGREGATE $ 10,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 10,000,000 $ B AUTOMOBILE X - UABIUTY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ .- SCHEDULED AUTOS NON -OWNED AUTOS ONLY RAD9437818-03 11/01/2019 01/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE RES9437994 EXCESS OF GENERAL LIABILITY 11/01/2019 01/01/2021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED RETENTION $ C E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXC UDED? ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N I A RWD3001203-04(AOS) RWR3001204-04(WI) 11/01/2020 11/0112020 01/01/2021 01/01/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 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 of Marsh USA Inc. Manashi Mukherjee _.Vilav4.ia.es*►i 401.rc.te.-> -e.s. ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACORD® ADDITIONAL REMARKS SCHEDULE Page 2 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER- 25 FORM TITLE: Certificate of Liability Insurance First Named Insured: Allied Universal Topco, LLC Additional Named Insureds: AlliedBarton (NC) LLC AlliedBarton (NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC Allied8arton Security Services LLC, dba Allied Universal Security Services AlliedBarton Security Services LP AlliedBarton Security Services LP, dba Allied Universal Security Services Allied Security Holdings LLC Allied Universal Holdco LLC Andrews International Government Services, Inc. Andrews International Government Services, Inc., dba Allied Universal Risk Advisory and Consulting Services Apollo Security International, Inc. C & 0 Enterprises, Inc. FJC Security Services, Inc. FJC Security Services, Inc., dba Allied Universal Security Services Guardsmark (Puerto Rico). LLC Guardsmark (Puerto Rico), LLC, dba Allied Universal Security Services, LLC Guardsmark (Puerto Rico), LLC, dba Universal Protection Service, LLC Intelligent Access Systems of North Carolina, LLC Intelligent Access Systems of North Carolina, LLC. dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid -Atlantic Peoplemark, Inc. Peoplemark, LLC Securadyne Systems Intermediate LLC Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Universal Protection Security Systems Spectaguard Acquisition LLC Staff Pro Inc. Staff Pro Inc., dba Allied Universal Event Services Surveillance Specialties, Ltd. Surveillance Specialties, Ltd., dba Allied Universal Technology Services Surveillance Specialties, Ltd., dba Securadyne Systems Northeast Universal Building Maintenance, LLC Universal Building Maintenance, LLC, dba Allied Universal Janitorial Services Universal Protection Security Systems, LP Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Service of Canada Co. Universal Protection Service of Canada Co., dba Allied Universal Security Services of Canada Co. Universal Protection Service of Canada Corporation ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia Aco ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER- 25 FORM TITLE: Certificate of Liability Insurance Universal Protection Service of Canada Corporation., dba Allied Universal Security Services of Canada Universal Protection Service, LLC Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Protection Service of Seattle, LLC Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Services of America, LP Universal Thrive Technologies, LLC Universal Thrive Technologies, LLC, dba Allied Universal Technology Services Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Thrive Intelligence U.S. Security Associates, Inc. U.S. Security Associates, Inc., dba Allied Universal Risk Advisory and Consulting Services U. S. Security Associates Aviation Services, Inc. U. S. Security Associates Holding Corp. U. S. Security Associates Holdings II Corp. U. S. Security Associates Holdings, Inc. U. S. Security Associates Staffing, Inc. U. S. Security Holdings, Inc. Vance Executive Protection, In. Vance International Consulting, Inc. The following acquisitions are included for coverage in the policies evidenced above as follows: Coverage effective dates: General and Umbrella Liability: 12/31/2019 Auto Liability and Workers' Compensation: 01/12/2020 AS Solution North America, Inc. AS Solution North America, Inc., dba AS Solution First Alarm Security & Patrol, Inc. First Alarm Security & Patrol, Inc., dba First Alarm First Alarm Security & Patrol, Inc., dba First Security First Alarm Security & Patrol, Inc., dba First Security Services SOS Security, LLC SOS Security LP SOS Security LP, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Security Services SOS Security LLC, dba Allied Universal Risk Advisory and Consulting Services TS! Security LLC Re: All Security Operations performed by the Named Insured For the Certificate Holder. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN118025105 LOC #: Philadelphia ACORD® ADDITIONAL REMARKS SCHEDULE Page 4 of 4 AGENCY MARSH USA INC NAMED INSURED Allied Universal Topco, LLC (See Attached for Additional Named Insureds) 161 Washington Street, Suite 600 Conshohocken, PA 19428 POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER- 25 FORM TITLE: Certificate of Liability Insurance City of Gilroy, its officers, officials and employees are additional insured on the above General Liability and Auto Liability Policies where required by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MARSH October 31, 2020 Subject: Allied Universal Topco, LLC Certificate of Insurance Marsh USA Inc. 11001 Lakeline Blvd.. Bldg 1, Suite 200 Austin, TX 78717 Phiiadelphia.Certs@marsh.com Allied Universal is making a change in the expiration date of its casualty insurance programs. These changes will have no impact on the insurance coverages or limits being provided to your organization as required by your contract with Allied Universal. Due to the change in policy periods, the attached certificate evidences policy terms ending January 1, 2021 for the casualty liability programs. The liability program is expected to follow a January 1 — January 1 cycle going forward. You will receive a separate certificate of insurance for this period. If this certificate is no longer needed, please mark delete and email to Philadelphia.certs@marsh.com or fax to 212-948-0360. We will then deactivate the certificate so you will no longer receive it. If your certificate requires a revision, please contact your representative at Allied Universal directly. Sincerely, Shandala Brown, Operations Manager, AVP Marsh I US Operations & Technology. Centralized Services 11001 Lakeline Blvd., Bldg. 1, Suite 200, Austin TX 78717 www.marsh.com I Marsh USA Inc. LEADERSHIP, KNOWLEDGE, SOW11ONSS...WORLDWlDE. MARSH &MCLENNAN COMPANIES POLICY NUMBER: RAD943781803 XIC 414 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Schedule Additional Insured(s) Work Any person or organization you have agreed to include as an additional insured under written contract, provided such contract was executed prior to the date of loss. All Operations COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in the Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY. All other terms and conditions of this policy remain unchanged. XIC 414 1013 © 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: RAD943781803 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ALLIED UNIVERSAL TOPCO, LLC Endorsement Effective Date: November 1, 2019 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 ENDORSEMENT #050 This endorsement, effective 12:01 AM 11 /01 /2019 Forms part of policy number: 082695264 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided by the following: GUARDSECURE GENERAL AND PROFESSIONAL LIABILITY COVERAGE FORM A. SECTION II - Who Is An Insured is amended to include as an additional insured a person(s) or organization(s) who is required to be added by written contract or written agreement which does not require that a specific form number be used. B. The insurance provided to additional insureds applies only to "bodily injury", "property damage", "professional liability" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured; or your work" performed for that additional insured and included in the 'products -completed operations hazard" 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 for such additional insured. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill — 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 Insuranc e shown in the Declarations. D. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim. 2. We receive written notice of a claim or "suit° as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured also has rights an insured or additional insured. E. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1. The additional insured is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions remain as written. ENDORSEMENT #24 This endorsement, effective 12:01 AM 11/0112019 Forms part of policy number: 082696264 Issued to: ALLIED UNIVERSAL TOPCO, LLC By: LEXINGTON INSURANCE COMPANY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: SECURITY GUARD GENERAL AND PROFESSIONAL LIABILITY COVERAGE PART SCHEDULE Name of person or Organization: Where required by written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Dec arations as applicable to this endorsement) The TRANSFER OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — 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 waived applies only to the person or organization shown in the Schedule above. All other terms and conditions remain as written. LEXDOCO21 LX0404 %PkAl Amthofbe4 fteprusoutaiwa of WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss. 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 11-01-2020 Insured ALLIED UNIVERSAL TOPCO, LLC Insurance Company XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) Policy No. RWD3001203-04 Endorsement No. Countersigned by a.? 1983 National Council on Compensation Insurance. P FOOTHEA-01 GMUN ACORO" CERTIFICATE OF LIABILITY INSURANCE �--� DATE(MWDDIYYYY) 3110/2020 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 Suhr Risk Services of California Insurance Brokers, LLC 910E Hamilton Suite 410 Campbell, CA 95008 CONTACT House NAME: - SRS Suhr Risk (ac No, Ext): (800) 788-1170 I FAX 408 510-5490 (arc, No}:( ) ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Continental Casualty Company 20443 INSURED Foothill Health Center, Inc. 2670 S. White Road, Suite 200 San Jose, CA 95148 INSURER B :American Casualty Company of Reading, Pennsylvania 20427 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. NOTWTHSTANDING 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 INSD SUBR WVD POLICY NUMBER POLICY EFF IMMIDD/YYYYI POLICY EXP IMM!DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X B6016603036 3/1 /2020 3/1 /2021 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 300,000 $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X - _ LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY _ _ SCHEDULED AUTOS NON-OWNED ONLYY 6021561187 3/1/2020 3/1/2021 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILYOINJURYp(Per accident) $ PROPERTY accident) DAMAGE $ $ A _ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE B6016603084 3/1/2020 3/1/2021 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/ME1MBgER EXCLUDED? ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE. $ E.L. DISEASE • POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Certificate Holder is named Additional Insured in respects to General Liability per endorsement SB-300120-C. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna St Gilroy, CA 95020 I 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 gisi gr-15- ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4 10020003660166030361286 CNA SB-300120-C (Ed. 06/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - WITH PRODUCTS COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM SCHEDULE* Name Of Person Or Organization: * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. A. The following is added to Paragraph C. Who Is An Insured: 4. Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury," caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insured(s); at the location(s) designated above; or c. "Your work" that is included in the "products - completed operations hazard" and performed for the additional insured, but only if this Policy provides such coverage, and only if the written contract or written agreement requires you to provide the additional insured such coverage. B. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of: 1. The rendering of, or the failure to render any professional architectural, engineering, or surveying services, including: (a) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. 2. "Bodily Injury," "property damage," or "personal and advertising injury" arising out of any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Policy. C. The following is added to Paragraph H. of the Businessowners Common Policy Conditions: H. Other Insurance This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing. SB-300120-C (Ed. 06/11) Page 1 of 1 A�ORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODlYYYY) 04/01/2021 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 Marsh Risk & Insurance Services 17901 Von Karman Avenue, Suite 1100 (949) 399-5800; License #0437153 Irvine, CA 92614 Attn: NewportBeach.CertRequest@marsh.com/F: 212-948-4323 CN102166416-STND-GAWUP-21- CONTACT NAME: X (A/C No Ext): (ONE NC, No): E-MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC # INSURER A : Hartford Fire Insurance Company 19682 INSURED Griswold Industries, Cla-Val Company 1701 Placentia Avenue Costa Mesa, CA 92627-4475 INSURER B : Continental Insurance Company 35289 INSURER C : Twin City Fire Insurance Company 29459 INSURER D :NIA N/A INSURER E : N/A N/A INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002486493-02 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 72ECS0A1987 04/01/2021 04/01/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I I OCCUR DAMAGE TORENTED PREMISES(Ea occurrence) { $ 300,000 X $1,000,000 SIR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES JECT PRO- PER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000LOC $ $ A AUTOMOBILE X X LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS NON -OWNED AUTOS ONLY 72UENUM3154 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT (Ea accident) $ 1,000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 6011983924 04/01/2021 04/01/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ,r / N N N/A 72WNC93100(CA) 72WEH03564 AZ KS,MI,MD,KY,IL,OH,NC,NY,NJ,VA,U 04/01/2021 04/01/2021 04/01/2022 04/01/2022 X PER STATUTE OTH- ER E L EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 E L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Gilroy, its officers, officials and employees are included as additional insured (except workers' compensation) where required by written contract. 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 of Marsh Risk & Insurance Services Jairnie Borgonia ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 6Z0E400-100019S9000-00-10-5510 ur Ti+.,. 1 I-995S0d-100- Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support our firm's commitment to sustainability, going forward, we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an email address where we can deliver your COI in the future. Please send your response to: USOperations.email@marsh.com and provide the following information so that we can expedite your COI delivery: • Certificate # (Shown below Insured Name -- e.g.: ABC-123456789-01) • E-Mail for future delivery: For undeliverable email addresses, our system is configured to automatically redirect the Certificate for deliveryvia USPS. Lastly, if you no longer need this COI please respond to USOperations.emailRmarsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery, Thank you. US Operations, Marsh USA, Inc. 0135-01-00-0005564-0002-0013030 a GOLDGAT-17 LGLYNN ACORCr CERTIFICATE OF LIABILITY INSURANCE ki.......----- DATE(MM/DD/YYYY) 3/26/2021 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 License # 0757776 HUB International Insurance Services Inc. 548 W Cromwell Avenue Suite 101 Fresno, CA 93711 CONTACT Cindy Sanders NA E: PHONE FAX (NC, No, Ext): (NC, No): /pDRESS: cindy.sanders@hubinternational.com INSURER(S) AFFORDING COVERAGE ! NAIC # INSURER A : Valley Forge Insurance Company 20508 INSURED Golden Gate Sign Company 2500 Bisso Lane Ste 200 Concord, CA 94520 INSURER B: Continental Insurance Company of New Jersey 42625 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE 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. INSRLT TYPE OF INSURANCE ADM_ SUBR POUCY NUMBER POLICY EFF POLICY EXP j LIMITS (JI+IM/DD/YYYY) {MMJDDIYYYYI A X COMMERCIAL GENERAL LIABILITY PMT7014788957 4/1/2021 4/1/2022 EACH OCCURRENCE $ 1,000,000 1 CLAIMS -MADE 1X1 OCCUR X DAMAGE TO RENTED PREMISES (Ea occur'enoel 300,000 $ MED EXP (Any one person) $ 15,000 - PERSONAL & ADV INJURY 1,000,000 $ GEN'L AGGREGATE X LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED I I SCHEDULED AUTOS WN p X BUA701478860 4/1/2021 4/1/2022 COMBINED SINGLE LIMIT BEe I 1,000,000 $ BODILYL I INJURY (Per person) $ BODILY INJURY (Per accident) $ DAMAGE PROPERTY accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUE7014788988 4/1/2021 4/1/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Yf f OFFICER/MEMBER(MandtHEXCLUDED? �_ If yes, describe under DESCRIPTION OF OPERATIONS below N 1 A WC7014788974 4/1/2021 4/1/2022 X I STATUTE ERH 1 1,000,000 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE' $ 1,000,000 E.L. DISEASE - POLICY LIMIT I 1,000,000 $ A Leased/Rented Equip PMT7014788957 4/1/2021 4/1/2022 $2500 ded/Limit 125,000 DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City, its officers, elected or appointed officials, employees, agents and volunteers Endorsements Attached: CA20481013, CNA75079XX016 CERTIFICATE HOLDER CANCELLATION City of Gilroy 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 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I POLICY NUMBER: BUA701478860 COMMERCIAL AUTO CA20481013 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: Golden Gate Sign Company Endorsement Effective Date: 4/1 /2021 SCHEDULE Name Of Person(s) Or Organization(s): See Endorsement 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 1 — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER BUA701478860 POLICY CHANGES CA2048 - DESIGNATED INSURED INSURED NAME AND ADDRESS Golden Gate Sign Company 2500 Bisso Lane, Ste 200 Concord, CA 94520 This Change Endorsement changes the Policy. Please read it carefully. This Change Endorsement is a part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED BLANKET ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED IS OBLIGATED TO PROVIDE INSURANCE WHERE REQUIRED BY A WRITTEN CONTRACT OR AGREEMENT IS AN INSURED, BUT ONLY WITH RESPECT TO LEGAL RESPONSIBILITY FOR ACTS OR OMISSIONS OF A PERSON OR ORGANIZATION FOR WHOM LIABILITY COVERAGE IS AFFORDED UNDER THIS POLICY. gt. r c C. 11 Secretary Chairman of the Board G-56015-B (ED. 11/91) Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but 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: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10-01 edition of CG2037; or B. additional insured coverage with "arising out of' language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Page 1 of 3 Policy No: PMT7014788957 Endorsement No: Effective Dat 4/1/2021 Insured Name: Golden Gate Sign Company Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. CNA75079XX (10-16) Page 2 of 3 Policy No: PMT7014788957 Endorsement No: Effective Date: 4/1/2021 Insured Name: Golden Gate Sign Company Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) Page 3 of 3 Insured Name: Golden Gate Sign Company Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy No: PMT7014788957 Endorsement No: Effective Date: 4/1/2021 ARD® `� CERTIFICATE OF LIABILITY INSURANCE E (D MM/MMID/Y/Y DATE YYY) E( 3/27/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh & McLennan Agency, LLC 2000 Brookstone Centre Pkwy Suite 118 Columbus GA 31904 CONTACT PHONE FAX (Arc. No. Ext): 706-324-6671 (A/C, No): 706-576-5607 ADDRESS: Connie.Whitmer@MarshMMA.com INSURER(S) AFFORDING COVERAGE NAIC it INSURER A: Federal Insurance Company 20281 INSURED 30GLOBALPAYM Global Payments Inc. & It's Subsidiaries 3550 Lenox Rd NE Suite 3000 Atlanta GA 30326 INSURER B : Great Northern Insurance Company 20303 INSURER C : ACE American Insurance Company 22667 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1315389407 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDfYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 36048071 4/1/2021 4/1/2022 EACH OCCURRENCE $ 1,000.000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 1,000.000 GEN'L AGGREGATE LIMIT APPLIES PRO JECT X PER: LOC GENERAL AGGREGATE $ 2,000.000 PRODUCTS - COMP/OP AGG $ 2,000,000 Gen Agg Cap $ 100,000,000 B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Hired Comp X _ X SCHEDULED AUTOS NON -OWNED AUTOS Hired Coll 73614277 4/1/2021 4/1/2022 COMBINED SINGLE LIMIT (Ea accident) S 1.000 000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Hired Phy Dmg - ACV $ 1,000 Deds A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79894591 4/1/2021 4/1/2022 EACH OCCURRENCE $25.000.000 AGGREGATE $25,000,000 DED X RETENT ON $ 30 Deduct $ C A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DFSCRIPTION OF OPERATIONS below Y / N N N / A 71750292 71750293 4/1/2021 4/1/2021 4/1/2022 4/1/2022 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000.000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 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 requi ed) City of Gilroy, its officers, officials and employees (AU) Additional Insured per form: 16-02-0292 Commercial Automobile Broad Form Endorsement (GL) Additional Insured per form: 80-02-2367 Additional Insured Scheduled Person or Organization (UMC) Follows Form per form: 07-02-0815 Commercial Excess & Umbrella Insurance Contract CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials and employees 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 1/Sc 7 a.R ` kTjj t•4k--t ' Ij! ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACO �® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD!YYYY) 01/29/2021 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 James G Parker Insurance Associates License #0554959 P O Box 3947 Fresno INSURED Graham Prewett Inc 2773 N Business Park Ave # 102 Fresno O o CA 93727 CONTACT Came Stubblefield CISR NAME: PHONE (559) 222-7722 (A/C. No. Ex0: I FAX No): (559) 222-1724 E-MAIL ADDRESS: CarrieStubblefield@jgparker.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Redwood Fire & Casualty Ins Co 11673 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 21-22 WC 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL UABIUTY N EACH OCCURRENCE $ CLAIMS -MADE OCCUR PRMMGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (My one person) $ PERSONAL 8 ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO ❑ LOC OTHER: JECT GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE - - LIABILITY ANY AUTO OWNED _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ - UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YNN N / A Y GRWC220156 02/01/2021 02/01/2022 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 If more space Is required) Job: City Hall - City of Gilroy, 7351 Rosanna Street, Gilroy CA 95020 Blanket waiver of subrogation in favor of The City of Gilroy, its officers, officials and employees are included as per form WC990410B attached. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna Street Gilroy I 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 Xfo) si e`eii-Nv- ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description All CA Operations Waiver Premium 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 2/1/2021 Policy No. GRWC220156 Insured Insurance Company Redwood Fire and Casualty Ins Co Endorsement No. Premium $ Countersigned by WC 99 04 10B (Ed. 9-14) (1) u) O J 0) z c 0) °' Y co> •c c f `° �``��+,.3 �'a `�a o c -- o a) c 0)• E Q w 4 ca 0 0)'a = `--7 z G) O 0 J =c.) o 0 m O 3 W c `) t 1.0 et o^' CO ai c O c H c. o a ▪ � ILa ca w o z , o w m W 0 c E v Ce s .c > 0, 0) z 'ccui O.c cc �� Z 'E 31 co a? Z U c inc c 0CU .0 W •Q C A a CO CV LC) R• 2 = CD O J O) E .o cwc0 WC } �w coc z Z c o 8 c Q n¢ a) 0) 0 2 v v 0 < U a t • >,O w U) CDco 0 • Z z • o H w a- � 0 CO VI _ -a , O 0)z z 0 0z < ¢ U c 3 0 c ¢ W Co Y c , Q c c, lir >- w >- o. ( > O CC in i d > ) c }•• NCn¢ 5 c., C7 N � C a, t 'CII O O w o N • z • 0 0 a.cOD CZN§} ZCnIII �U Z O Z Cr)= Z O a) W 0. W W C/) w m 0 Z O Z J ca O T Z < 0 0 0 Z <0 Ha I AUTHORIZED REPRESENTATIVE LIENHOLDER'S COPY U Z E w Ea oci c cp,- o cca CD N y (i) O 0 0 ▪ = o 03 UI` N CD • 7 LL `1 CIQ w W Z(I]� o el LLJ OZ =cc Mi ¢Ow S?N z¢_ �p ACURD® LI. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 01/04/2021 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 Marsh USA Inc. 1560 Sawgrass Corporate Pkwy, Suite 300 Sunrise, FL 33323 CN102986923—GAWU-21-22 CONTACT NAME: • PHONE No, Ext): FAX No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Liberty Mutual Fire Insurance Company 23035 INSURED Golden State Utility Co. 8766 Fruitridge Road Sacramento, CA 95826 INSURER B : LM Insurance Corporation 33600 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-004679490-14 REVISION NUMBER: 2 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABIUTY TB2-631-004260-011 01131/2021 01/31/2022 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE X OCCUR DAMAGETO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE X LIMIT APPLIES cT PER. LOC GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 $ A AUTOMOBILE X — X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY AS2-631-004260-021 01/31/2021 01/31/2022 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A WA5-63D-004260-031 (AOS) WC5-631-004260-041 (MN, WI) 01/31/2021 01/31/2021 01/31/2022 01/31/2022 x PER STATUTE OTH- ER 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 If more space Is required) City of Gilroy, its Agents, Officers, Officials, Employees & Volunteers is/are included as additional insured where required by written contract with respect to general liability and auto liability. CERTIFICATE HOLDER CANCELLATION City of Gilroy its Agents, Officers, Officials, Employees & Volunteers 7351 Rosanna Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Manashi Mukherjee ACORD 26 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORt7® kr.5 CERTIFICATE OF LIABILITY INSURANCE DATE DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh & McLennan Agency, LLC 2000 Brookstone Centre Pkwy Suite 118 Columbus GA 31904 CONTACT NAME: Connie VVhitmer PHONE Ac (NC. No. �)= 706-324-6671 FAX No): 706-576-5607 E-MAIL SS: cwhitmer@jsmithlaneir.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Federal Insurance A++ XV 20281 INSURED 30GLOBALPAYM Active Payments Inc. & It's Subsidiaries Network LLC GlobalINSURER 3550 Lenox Road NE, Suite 3000 Atlanta GA 30326 _ INSURER B : Great Northern Insurance A++ XV 20303 _ C : ACE American Insurance Co A++ XV 22667 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 407096440 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 36048071 4/1/2020 4/1/2021 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO X LOC JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Gen AQ9 Cap $100,000,000 B AUTOMOBILE X - X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Hired Comp X _ X SCHEDULED AUTOS NON -OWNED AUTOS Hired Cot 73614277 4/1/2020 4/1/2021 COMBINED SINGLE LIMIT (Ea accident) $ 1.000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Hired Phy Dmg -ACV $1,000 Deds A X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE 79894591 4/1/2020 4/1/2021 EACH OCCURRENCE $25,000,000 AGGREGATE $ 25,000,000 DED X 1 RETENTIONS So Deduct $ C A WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 71750292 71750293 4/1/2020 4/1/2020 4/1/2021 4/1/2021 X STATUTE OTH- ER 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 / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) (GL) Additional Insured per form: 80-02-2367 Additional Insured Scheduled Person or Organization CERTIFICATE HOLDER CANCELLATION City of Gilroy 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 ii7itg-tra - 1,44-4-gs ACORD 25 (2014/01) @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� c f CERTIFICATE OF LIABILITY INSURANCE DATE/26/2020rn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh & McLennan Agency, LLC 2000 Brookstone Centre Pkwy Suite 118 Columbus GA 31904 CONTACT NAME: Connie whitmer FAX (NC. No. Ext1: 706-324-6671 I (A/C No): 706-576-5607 ADDRESS: cwhitmer@jsmithlaneir.com INSURER(S) AFFORDING COVERAGE NAIC p INSURER A : Federal Insurance A++ XV 20281 INSURED 30GLOBALPAYM Global Payments Inc. Attn: Devery Gauthier 3550 Lenox Rd NE Suite 3000 Atlanta GA 30326 INSURER B : Great Northern Insurance A++ XV 20303 INSURER C : ACE American Insurance Co A++ XV 22667 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1601340561 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADM INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POUCY EXP (MM/DDIYYYY) UMITS A X COMMERCIAL GENERAL LIABILITY 36048071 4/1/2020 4/12021 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 - MED EXP (My one person) $10,000 - PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- X LOC OTHER: JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Gen Agg Cap $ 100,000,000 B AUTOMOBILE X X - X UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Hired Comp X X SCHEDULED AUTOS NON -OWNED AUTOS Hired Coll 73614277 4/1/2020 4/12021 COMBINED SINGLE LIMIT (Ea accident) $ 1,000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Hired Phy Dmg - ACV $1,000 Deds A X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE 79894591 4/1/2020 4/12021 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 DED I X RETENTION $ g0 Deduct $ c A WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N N I A 71750292 71750293 4/1/2020 4/1/2020 4/12021 4/12021 X I STATUTEPER I 2RTH. 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 / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Gilroy, its officers, officials and employees (AU) Additional Insured per form: 16-02-0292 Commercial Automobile Broad Form Endorsement (GL) Additional Insured per form: 80-02-2367 Additional Insured Scheduled Person or Organization (UMC) Follows Form per form: 07-02-0815 Commercial Excess & Umbrella Insurance Contract CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials and employees 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 POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE p7A-r- a R a - le,A ....v.....ds lc ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD