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KIMLHORN
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDD1YYYY}3/28/2020
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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Grayling Ins. Brokerage/EPIC
3780 Mansell Road, Suite 370
Alpharetta, GA 30022
NAME C Jerry Noyola
aCN ; Ext : 770-552-4225 ac No): 866-550-4082
E-MAIL er no re Iln
ADDRESS: J rY• Yola @9 Y g•com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: National Union Fire Ins. Co.
19445
INSURED
Kimley-Horn and Associates, Inc.
421 Fayetteville Street, Suite 600
Raleigh, NC 27601
INSURER B : Aspen American Insurance Company
43460
New Ham
INSURER C : shire Ins. Co.
p
23841
INSURER D : Lloyds of London
85202
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 20-21 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 CONTRACTOR 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
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
(MMIDDIYYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
Contractual Liab
5268169
0410112020
04/0112021
EACH OCCURRENCE
S 1,000,900
�REMIG ES Ea occurrence
S
S 500 000
,
X,
GEN'L
MED EXP (Any one personl
525,000 _
$1,000,000
PERSONAL & ADV INJURY
AGGREGATE LIMIT APPLIES PER:
POLICY a JECT FX LOC
OTHER:
GENERAL AGGREGATE
S 2,000,000
PRODUCTS - COMP/OP AGG
S 2,000,000
$
A
AUTOMOBILE
X
X
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
4489663
4101/2020
04/01/2021
EaacccdentSINGLE LIMIT
2,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident)
ccident
$
B
X
UMBRELLA LIAR
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
CXOOSFT20
4/01 /2020
04/01/2021
EACH OCCURRENCE
$5 000 000
AGGREGATE
$S 000 000
DED I X RETENTION $O
$
C
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N
OFFICER/MEMBER EXCLUDED? �
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
015893685 (AOS)
015893686 (CA)
4101 /2020
4101/2020
04/01/2021
04/01/2021
X PE T T OTH-
E.L. EACH ACCIDENT
$1 00O 000
E.L. DISEASE - EA EMPLOYEEI
$1 00O 000
E.L. DISEASE- POLICY LIMIT
$1 000 000
D
Professional Liab
B0146LDUSA2004949
4/01/2020
04/01/2021
Per Claim $2,000,000
Aggregate $2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Re: City of Gilroy On -Call Agreement; Bill Wiseman. The City of Gilroy, its officers, officials & employees
are named as Additional Insureds with respects to General Liability where required by written contract.
CERTIFICATE HOLDER CANCELLATION
City of Gilroy
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7351 Rosanna Street
ACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy, CA 95020-6141
AUTHORIZED REPRESENTATIVE
Aaw/ v
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
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