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HomeMy WebLinkAboutCOI - Frontier California, Inc. - Expires 2024-06-01CERTIFICATE OF LIABILITY INSURANCE D061122U023DnYYY) 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 L-C. 540 W. MADISON CONTACT Marsh I U.S. Operations PHOIAIC.NENo. Eat. (866) 966-4664 P(A—IC No): 212-948-0770 ADDRESS: Chicago.CerlRequest@marsh.com CHICAGO, IL 60661 INSURERM AFFORDING COVERAGE NAICN INSURER A: Steadfast Insurance Company 26387 CN1O2898337--GAW-23-24 FC609 GAIN INSUREDFrontier California Inc. INSURERS: Zurich American Insurance Company 16535 INSURER C: American Zurich Insurance Company 40142 401 Merritt 7 INSURER D: Norwalk, CT 06851 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-010079163-05 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 LSUBR POLICY NUMBER PODCYEFF MMIDD POLICY EXP MM/D LIMITS A X COMMERCIAL GENERAL LIABILITY X GLO 028599206 W0112023 0610112024 EACH $ 1,OIX),000 CLAIMS -MADE Fx ] OCCUR ORENTE TO PREMISES Ea oecumenee $ 500.000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1.000.1)00 GEN'L AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ECT LOC PRODUCTS -COMP/OPAGG $ 210001000 $ OTHER: B AUTOMOBILELIABILITY X X BAP 12111M 01 061012023 06/012024 COMBINED SINGLE LIMIT Ea accident $ 1000000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY PAUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ C B WORKERSCOMPENSATION ANDEMPLOYERS'LUIBILRV Y/N ANYPROPRIETORTARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDEDF F (Mandatory in NH) N/A WC 0285988 06 (ADS) WC 028598906(RETRO) 0 01 0 06101/2023 O6/01/2024 W01/2024 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000.0W Use. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD101, Additional Remarks Schedule, maybe attached It more apace is required) Re: Frontier Project #5273663. Frontier California Inc.'s insurance certificate for permitting purposes with the City of Gilmy, CA. The City of Gilroy, and its officers, employees and agents shall be named as Additional Insureds as respects the Goriest Liability and Auto Liability policies where required by written contract. CERTIFICATE HOLDER I CANCELLATION City of Gilroy 7351 Rosanna Street JUN 20 2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gilroy. GA 95020 ACCORDANCE WITH THE POLICY PROVISIONS. GILROY CITY CLERi' S OFFICE AUTHORIZED REPRESENTATIVE , yak �C.ig —If—ee? ACORD 25 (2016/03) 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD G)wC) �^ 0^ LJ o uJ D N O• .00) C cn POLICY NUMBER: GLO 0285992-06 COMMERCIAL GENERAL LIABILITY CG20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization s Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 13 of 126 0188-01-00-0001259-0002-0003037 A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily Injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 4 Insurance Services Office, Inc., 2018 Page 14 of 126 09 Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) -- E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001259-0003-0003038 CERTIFICATE OF LIABILITY INSURANCE °0066//12023 """"' 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 LLC. 540 W. MADISON CHICAGO, IL 60661 CONTACT Marsh I U.S. Operations IPA NONE (866) 966.4664 FAX No), 212-948-0770 E-MAIL ADDRESS. ADDR9 ESS: China o' mlCerR uesuamarsh.com INSURERSAFFORDING COVERAGE NAICa INSURER A: Steadfast Insurance Company 26387 CN102898337--GAW-23-24 FC608 GAW INSUREDFronter Calpomia Inc. INSURER B: Zurich American Insurance Company 16535 INSURER C : American Zurich Insurance Company 40142 401 Merritt 7 Norwalk, CT 06851 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-010079162-05 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. ILTR TYPE OF INSURANCE DLS BR POUCYNUMBER MM/DDYEFF Mao EXP LIMITS A X COMMERCIAL GENERAL LIABILITY � OCCUR X GLO 028599206 06/01/2023 06/0112024 EACH OCCU $ 11IX10,000 HE IE DAMACLAIMS-MADE PREMISES Ea occurrence $ 500,000 MED EXP (Any one Person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JEC7 LOC OTHER: GENERALAGGREGATE $ 2.000,000 PRODUCTS-COMP/OP AGG $ 2,01X1,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X BAP 028599006 06/0112023 0001/2024 COMBINED SINGLE LIMIT Ea amide t $ 1000000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident) ( ) $ PROPERTY DAMAGE Par accident $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ 4 AGGREGATE $ DELI RETENTION $ C B WORKERS COMPENSATION ANDEMPLOYERS'LIABILfTY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDE07 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC 0285988 06 (ADS) WC 02B598906 (RETRO) 06 1 23 06/0112023 06/0112024 06/01/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1000Opp E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Frontier California Inc.'s insurance certificate for permitting purposes with the City of Gilroy, CA. The City of Gilroy, and Its officers, employees and agents shall be named as Additional Insureds as respects the General Liability and Auto Liability policies where required by written contract. City of Gilroy u11l��l�u v Iw SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7351 Rosanna Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gilroy, CA 95020 JUN 20 2023 11 ACCORDANCE WITH THE POLICY PROVISIONS. GILROY CITY CLERK'S OFFICE O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IRM POLICY NUMBER: GLO 0285992-06 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 13 of 126 t 0188-01-00-0001258-0002-0003034 A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 O Insurance Services Office, Inc., 2018 Page 14 of 126 i/9 Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate 4 (Shown below Insured Name — e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001258-0003-0003035 A� o® CERTIFICATE OF LIABILITY INSURANCE DATE G611712023nvYYY1 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(fes) 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 LLC. 540 W. MADISON CHICAGO, IL 60661 CONTACT Marsh Un .S.O Operations NAME: I P PHONE Ea (856) 966A664 Nq: 212-94"770 E-MAIL go' ADDRESS: Chira CenR uest4amarsh:cem INSURERS AFFORDING COVERAGE NAIC0 INSURER A: Steadfast Insurance Company 26387 CN102898337--GAW-23-24 FC611 GAW INSURED Frontier California Inc. INSURER B: Zurich American Insurance Company 16535 INSURER c: American Zurich Insurance Company 40142 401 Merritt 7 INSURER D - Norwalk, CT 06851 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: CHI.010079165-05 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. INSfl LTR TypE OFINSURANCE ADDLSUBR POUCYNUMBER POLICY EFF MM D POLICY EXP W MMrDD/Y LIMITS A X COMMERCIALGENERAL LIABILITY CUMM&MADE FXI OCCUR X GLO 028599206 06101/2023 06/01/2024 EACH OCCURRENCE $ 1,000,0W PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL d ADV INJURY $ 1'000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JEO- LOC OTHER: GENERAL AGGREGATE $ 2.000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 $ 8 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X BAP 028599006 06101/2023 06/01/2024 COMBINED SINGLE LIMIT Ea accident $ 1000000 BODILY INJURY (Per person) $ I BODILY INJURY (Per amidenl) $ PROPERTY D AMAGE Per accidentt $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YTN OFFICER/MEMBEREXCLUDED9 (Mandatory in NH) 11 yes, describe under DESCRIPTION OF OPERATIONS below N/A WC 0285988 06 (AOS) WC 028598906 RETRO ( ) 06012023 06101/2023 W01/2024 0 01/2024 X PER OTH- srnrAC ER E.L. EACH ACCIDENT $ 1,IXq.000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISFABE- POLICV LIMIT $ 1 00(1000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Frontier Work Order #5268719. Frontier California Inc.'s Insurance certificate for permilbng purposes with the City of Gilroy, CA. The City or Gilroy, and its officers, employees and agents shall be named as Additional Insureds as respects the General Liability and Auto Liability policies where required by writlen contract. City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7351 Rosanna Street' �'6FS �TI /7F?D THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gilroy, CA 95020 L`� v LS ACCORDANCE WITH THE POLICY PROVISIONS. JUN 2 0 201_; AUTHORIZED REPRESENTATIVE GILROYCITYCLERKS OFFICE © 1988-2016 ACORD CORPORATION. All rights reserved ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD w N' POLICY NUMBER: GLO 0285992-06 COMMERCIAL GENERAL LIABILITY CG20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS Information required to complete this Schedule, if not shown above, will be shown in the Declarations- CG 20 10 12 19 0188-01-00-0001261-0002-0003043 © Insurance Services Office, Inc., 2018 Page 13 of 126 A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 14 of 126 00 Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) -- E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001261-0003-0003044 ACORO® CERTIFICATE OF LIABILITY INSURANCE D0611zi2o023 DryYYY) 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 LLC. 540 W. MADISON CONTACT Marsh I U.S. Operations PHONEeXo, (866) 966-4664 FAX Net: 212-948-0770 CHICAGO, IL 60661 E-MAIL ADDRESS: 9 Chica D CertR uest@marsh.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Steadfast Insurance Company 26387 CN102898337--GAW-23.24 FC610 GAW INSURED Frontier California Inc. INSURER B: Zurich American Insurance Company 16535 INSURER C : American Zurich Insurance Company 40142 401 Merritt 7 Norwalk, CT 06851 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-010079164-05 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- INSfl LTR 7ypE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MWDDNYYY) POLICY EXP (MWDDWM LIMITS A X COMMERCIAL GENERAL LIABILITY X GLO 028599206 06101/2023 06/01/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑ OCCUR IMAGE TO RENT PREMISES Ea occunence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY D PRO- JECT ❑ LOG PRODUCTS-COMP/OP AGO $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY X BAP 028599006 0610112023 06/0112024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlem $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DELI I I RETENTION$ $ C B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANYPROPRIETOWPARTNEH/EXECUTIVE v/N OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N/A WC 0285988 06 (ADS) WC 028598906 (RETRO) 06012023 06/01/2023 0610112024 Ofi10112024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000000 E.L. DISEASE - EA EMPLOYEEI $ 1,000,000 If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached if more space is required) Re: Frontier Work Order #5268859. Frontier California Inc.'s insurance certificate for permitting purposes with the City of Gilroy, CA. The City of Gilroy, and its officers, employees and agents shall be named as Additional Insureds as respects the General Liability and Auto Liability policies where required by written contract. L93lu IRDJd\rR City of Gilroy [C�[M0M�D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7351 Rosanna Street V IS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gilroy, CA 95020 ACCORDANCE WITH THE POLICY PROVISIONS. JUN 2 0 2023 AUTHORIZED REPRESENTATIVE GILROY CITY CLERICS OFFICE 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 0285992-06 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 a Insurance Services Office, Inc., 2018 Page 13 of 126 0188-01-00-0001260-0002-0003040 A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2-That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 O Insurance Services Office, Inc., 2018 Page 14 of 126 6�/9 Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001260-0003-0003041 CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDO/YYYY) 06112/2023 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 LLC. 540 W. MADISON CONTACT Marsh U.S.Operations NEI I tX.NE . (866) 966.4664 FAX No): 212-948-0770 CHICAGO, IL 60661 E-MAIL ADDRESS: 9 Chia a CeRReVC�m ueslarsh.com INSURERS AFFORDING COVERAGE NAICIF INSURER A: Steadfast Insurance Company 26387 CN702898337--GAW-23.24 FC607 GAW INSUREDFrontier California Inc. INSURER B: Zurich American Insurance Company 16535 INSURER C: American Zurich Insurance Company 40142 401 Merrill? Norwalk, CT 06051 INSURER 0: INSURER E INSUREfl F: COVERAGES CERTIFICATE NUMBER: CHI.010079161-05 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 TypE OFINSURANCE ADDLSUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/Y MM/DD/Y LIMITS A X commERCIALGENERALUABIIm X GLO 028599206 06101/2023 06101/2024 EACH OCCURRENCE $ 1,0110,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 560.006 MED EXP (Any one parson) $ 10,000 PERSONAL B ADV INJURY $ 1.000.006 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.WD•000 GEN'L X POLICY D JECT LOC PRODUCTS-COMP/OP AGG $ 2,000.000 $ OTHER: B AUTOMOBILELIABILITY X BAP 028599006 06101/2023 06101/2024 COMBINED SINGLE LIMIT Ea accident It 1000000 X1ANY BODILY INJURY (Per Person) $ AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE Pet accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CLAIMS -MADE DELI I I RETENTIONS $ C B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y - OFFICERWEMSEREXCLUDED4 F (Mandatory in NH) N/A WC 0285988 06 (ADS) WC 0285989 06 (RETRO) 0 012023 0610112023 06101/2024 0610112024 X PER OTH' STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 Use. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, AddBlonal Remarks Schedule, may W attached if more apace Is required) Re: FronBer Project FWO896889. Frontier California Inc.'s insurance certificate for permitting purposes with the City of Gilroy. CA. The City of Gilroy, and its officers, employees and agents shall be named as Addi ional Insureds as respects the General Liability and Auto Liability policies where required by wrtitten contract. City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 JUN 2 0 2023 GILROY CITY CLERK'S OFFICE la�aelnarl �_v I•J.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 yx�� 2rsrr rL�G IBY.Y.SIITiF1_[K.7:IaIaTe7:11s7:k\ 0fo72Ws1IR MS1171 rrxrr'Tr .1 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 0285992-06 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 0188-01-00-0001257-0002-0003031 © Insurance Services Office, Inc., 2018 Page 13 of 126 A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 14 of 126 00 Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001257-0003-0003032 La =UN¢1 0 21 y Z WOO 0. E ^o �ov ❑ JW❑ m m O S Q .O 0 m O r O a W Y N V W 2 4 E i �¢y o�2 WOz ago ULLO W a wai ¢ = LOU7 r y � m y E ou zy z m $ q W J m V 7O= r Z: O c U U Z F' U W C m ° Q o u m u m Q > > Z¢ W a•� _ tied U Cl)¢ wm L z Z Q U c C m U Emu in ti dF' Z 0¢ t¢- O❑ 0 y^ T a 0' U o w ii 00 U Q. 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PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations Locations Of Covered Operations THE CITY OF GILROY, AND ITS THE CITY OF GILROY, CA OFFICERS, EMPLOYEES AND AGENTS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 0188-01-00-0001256-0002-0003028 © Insurance Services Office, Inc., 2018 Page 13 of 126 KOM A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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(s) at the location(s) designated above. 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. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 O Insurance Services Office, Inc., 2018 Page 14 of 126 ft Marsh Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: -- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, LLC A business of Marsh McLennan 0188-01-00-0001256-0003-0003029