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SOURCEW-01
CERTIFICATE OF LIABILITY INSURANCE
PIHPATRA2
DATE(MMIDDP
1119/2D'e }�
ATE HOLDER.'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOFV
N THE CERTIFIC
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POI
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORt---
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 policles may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsements .
PRODUCER
CO CT House - SRS Suhr Risk
ProCo Insurance Services
910 E Hamilton Ave
9410
Campbell, CA 95008
PHONE FAX
AID, No, Pat): ac, No
E-MDDRE.. None@none.com
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A: Alliance of Nonprofits for Insurance, Risk Retention Group
10023
INSURED
INSURER B
INSURER C :
SOurcewlse
3100 De La Cruz Blvd, #310
Santa Clara, CA 95054
INSURER D:
INSURER E
INSURER F :
SCR.
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.
ILTRNT.SR
rypE OF INSURANCE
AODL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS-MADEFV] OCCUR
X
202314829
1/1/2023
11112024
DAMAGETO RENTED
500,000
Owner's & Contractor
X
¢cDce
MED EXP (Anyone person)$
20,000
X
See "Other Covg"
PERSONAL S ADV INJURY
§ 1,000,000
GEN'L AGGREGATE LIMIT APPLIESPER:
POLICY PRO- ❑X LOC
GENERAL AGGREGATE
$ 3,000,000
PRODUCTS - COMP/OP AGG
$ 3.000,000
OTHER:
A
AUTOMOBILE LIABILITY
EOaMBIINED SINGLE LIMIT
1,000,000
$
X
BODILY INJURY Per erson
$
ANY AUTO
202314829
1/1/2023
1/1/2024
OWNED SCHEDULED
AUTOS ONLY AUTOOSyy
BODILY INJURY Per accident
$
D
AUT %ONLY AUTOS ONLY
Pe�eccident AMAGE
$
EACH OCCURRENCE
$ 2,000,000
A
X UMBRELLA LIAR X OCCUR
EXCESS UAB CLAIMS -MADE
202314829UMBNPO
1/1/2023
1/112024
AGGREGATE
$
DELI X RETENTION$ 10,000
Agg&SSSPL
S 2,000,000
WORKERS COMPENSATION
PER OTH-
ANDEMPLOYERS'LIABILITV YIN
E.L. EACH ACCIDENT
$
ANY PROPREIIETgO�RRfPARTNER/EXECUTIVE
(M,, NH) EXCLUDED? El
NIA
E.L. OISE4SE-EA EMPLOYE
S
lOEmMl/In
describe under
It yus,DESCRIPTION
E.L. DISEASE - POLICY LIMIT
3
i
OESCRIPTON OF OPERATIONS below
A
General Liability
202314829
1/1/2023
1/1/2024
Aggregate Limit
3,000,000
A
General Liability
202314829
1/1/2023
1/112024
Occurrence
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, ma be attached if more space is required)
The City of Gilroy, its officers and employees are amed as an additional insured on general Liability policy per the attached endorsement.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy I,1 q 2�Z3 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Rosanna Street JAN ` ACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy, CA 95020
GILROY CITY CLERICS OFFICE AUTHORIZED REPRESENTATIVE
vT9atl-2UT b ACORU CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD