HomeMy WebLinkAboutCOI - Silicon Valley Regional Interoperability Authority - Expires 2024-07-01Issue Date
NON-MEMBER'S CERTIFICATE OF COVERAGE
7/1/2023
Provider Special District Risk Management Authority
'I' hlil
1112 Street, Suite 300
Sacramento, California 95814 /�
SDPMA
800.537.7790 www.sdrma.org
Member Silicon Valley Regional Interoperability Authority Member Number 7595
601 El Camino Real Certificate Number., 3
Santa Clara, California 95050
This is to certify that coverages listed below have been issued to the Member named above for the period indicated. This certificate is not an insurance
policy or an agreement of coverage and does not amend, extend or alter the coverage afforded by the agreements listed herein. 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 coverage
described herein is subject to all the terms, exclusions, and conditions of the specific coverage document. This certificate of coverage evidences the limits
of liability in effect at the inception of the agreements shown; limits shown may have been reduced by paid claims. This certificate is issued as a matter o
information only and confers no rights upon the certificate holder.
Type of Coverage
Policy Number
Effective Date
Expiration Date
Limits
General Liability
LCA-SDRMA-202324
7/1/2023
7/1/2024
Bodily Injury
Per Occurrence $1,000,000
Property Damage
$1,000,000
The City of Gilroy, its officers, agents, employees and volunteers are named as additional covered parties with respect to the MOU
for the "Silicon Valley Regional
Communications system".
^,—,0751D
Intl
JJUN 27 2023
GILROY CITY CLERK'S OFFICE
Cancellation: Should any of the above -described policies be cancelled before the expiration dates thereof, the issuing company will endeavorto mail 30 days
written notice to the above -named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company.
Certificate Dates:
Effective Date
Expiration Date
Certificate Type:
OAdditional Covered Party ❑ Loss Payee
7/1/2023
7/1/2024
Evidence of Coverage
Certificate Holder
City of Gilroy
7351 Rosanna Street
Brian Kelley, MBA, ARM
Gilroy, CA 95020
Chief Executive Officer
SDRMA
SPECIALDISIRICI RISKMANAGEMENTAUTHORIIY
This endorsement changes the Liability Coverage Agreement Please read it Carefully.
COVERAGE PERIOD: 7/1/2023 through 7/1/2024
MEMBERAGENCY
Silicon Valley Regional Interoperability Authority
601 El Camino Real
Santa Clara, California 95050
11121 Street, Suite 300
Sacramento, California 95814-2865
T 916.231.4141 or 800.537.7790 • F 916.231.4111
Maximizing Protection, Minimizing Risk--www.sflrnia.org
ADDITIONAL COVERED PARTY
City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
This endorsement modifies the Liability Coverage Agreement Provided under the following:
General Liability - Bodily Injury - LCA-SDRMA-202324 - Per Occurrence - $1,000,000
General Liability - Property Damage - LCA-SDRMA-202324 - Per Occurrence - $1,000,000
It is hereby agreed that this endorsement is added to the Liability Coverage Agreement issued to Silicon Valley Regional
Interoperability Authority by Special District Risk Management Authority ("SDRMA") adding the following as an Additional Covered
Party:
The City of Gilroy, its officers, agents, employees and volunteers are named as additional covered parties with respect to the MOU for
the "Silicon Valley Regional Communications System".
The coverage afforded by this endorsement is afforded only as limited above and provided further that this coverage does not apply
to the sole negligence of the Additional Covered Party. In addition, Coverage shall not apply to liability for the active negligence of the
Additional Covered Party in any case where an agreement to indemnify the Additional Covered Party would be invalid under
Subdivision (b) of Section 2782 of the Civil Code.
Unless required by the Agreement identified above, coverage afforded by this endorsement shall be excess and non-contributory with
respect to any other valid and collectible insurance or risk financing providing coverage to the Additional Covered Party, including any
self -insured retention the Additional Covered Party may have, and any other insurance or risk financing providing coverage to the
Additional Covered Party shall be considered primary to this coverage. If required by a contract between the SDRMA Member named
above and the Additional Covered Party, the coverage afforded by this endorsement shall be primary with respect to any other valid
and collectible insurance or risk financing providing coverage to the Additional Covered Party, including any self -insured retention the
Additional Covered Party may have, and any other insurance or risk financing providing coverage to the Additional Covered Party shall
be considered excess to this coverage. All other terms and conditions remained unchanged.
Coverage provided by this endorsement, under the terms, conditions and exclusions contained in the Liability Coverage Agreement
issued by SDRMA to the Member named above shall not be reduced or canceled without 30 days written notice given to the Additional
Covered Party via certified mail.
THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGE AGREEMENT. PLEASE READ IT CAREFULLY
The inclusion of more than one Covered Party shall not operate to impair the rights of one Covered Party against another Covered
Party and the coverages afforded shall apply as though separate policies have been issued to each Covered Party except that the
inclusion of more than one covered party shall not increase the limit of liability of SDRMA.
Effective date of this endorsement is: 7/1/2023
Signed by:
Brian Kelley, MBA, ARM
Chief Executive Officer
A proud California Special Districts California Special Districts Association CSDA Finance Corporation
Alliance partner. 1112I Street, Suite 200 11121 Street, Suite 200
Sacramento, California 95814-2855 Sacramento, California 95814-2865
T877.924 CSDA(2732) xF 916,4427889 T877,924. CSDA(2732)+F 916. 4427889
DocuSign Envelope ID: 353CA7E6-E5DF-4609-8B47-218E51A6F51E
County of Santa Clara
Office of the County Executive
Office of Risk Management
Liability/Property Insurance Division
2310 North First Street, Suite 203
San Jose, California 95131
Tel. No. (408) 4414340 FAX (408) 4414341
Ins. Cert. No. FY24-051
CERTIFICATE OF COVERAGE
ISSUED BY
COUNTY OF SANTA CLARA
This is to Certify to: City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
Attn: Jimmy Forbis
That the following described coverages are in force on this date as set forth below:
Assured: County of Santa Clara
70 W. Hedding Street
San Jose, CA 95110
Insurer
1. Self -Funded Retention
2. Self -Funded Retention
Type of Coverage
1. Comprehensive General
& Automobile Liability
2. Workers' Compensation
Expiration
Continuous
Continuous
Limits
$5,000,000 Per Occurrence
Statutory
This certificate of coverage is provided by the County of Santa Clara to the above named certificate holder.
The coverage specified herein will not be cancelled or reduced without thirty (30) days written notice from
County of Santa Clara to the certificate holder This certificate pertains to the agreement between the City
of Gilroy and County of Sant Clara, Probation Department for using San Ysidro Beacon of Hope Family
Resource Center facility. This certificate is valid from July 1, 2023 to June 30, 2024.
DocuSigned by:
Hank Ford
Insurance Contracts & Claims Manager
June 21, 2023
HF:td
FY24-051 FacilyUse@SanYsidroHopeCtr-Probation
Board of Supervisors: Sylvia Arenas, Cindy Chavez, Otto Lee, Susan Ellenberg, S. Joseph Simitian
County Executive: Jeffrey V. smith
Issue Date
NON-MEMBER'S CERTIFICATE OF COVERAGE
7/1/2023
Provider Special District Risk Management Authority /��
Ak
1112 'I' Street, Suite 300
Sacramento, California 95814 11 /�
SDRMA
800.537.7790 www.sdrma.org
Member Silicon Valley Regional lnteroperabilityAuthority Member Number.7595
601 El Camino Real Certificate Number., 39
Santa Clara, California 95050
This is to certify that coverages listed below have been issued to the Member named above for the period indicated. This certificate Is not an insurance
policy or an agreement of coverage and does not amend, extend or alter the coverage afforded by the agreements listed herein. Notwithstanding any
requirement, term, or condition of any contractor other document with respect to which this certificate maybe issued or may pertain, the coverage
described herein is subject to all the terms, exclusions, and conditions of the specific coverage document. This certificate of coverage evidences the limits
of liability in effect at the inception of the agreements shown; limits shown may have been reduced by paid claims. This certificate is issued as a matter o'
information only and confers no rights upon the certificate holder.
Type of Coverage
Policy Number
Effective Date
Expiration Date
Limits
General Liability
LCA-SORMA-202324
7/1/2023
7/1/2024
Bodily Injury
Per Occurrence $1,000,000
Property Damage
$1,000,000
City of Gilroy is named as an additional covered party in respects to Site Access Agreement for Gilroy City Hall Annex Building, Gilroy Target Range, and Gilroy Reservoir D.
Cancellation: Should any of the above -described policies be cancelled before the expiration dates thereof, the issuing companywill endeavor to mail 30 days
written notice to the above -named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company.
Certificate Dates:
Effective Date
Expiration Date
Certificate Type:
[i]Additional Covered Party Loss Payee
7/1/2023
7/1/2024
[]Evidence of Coverage
Certificate Holder
- J
City of Gilroy
Jimmy Forbis, City Administrator
Brian Kelley, MBA, ARM
7351 Roseanna Street
Gilroy, CA 95020
Chief Executive Officer
Alk
SDRMA
SI'LCIAL DIS I'ItICr RISKA%AGLNUN 1- AU I11URI IY
This endorsement changes the bablItly Coverage Agreement. Please read it carefully.
COVERAGE PERIOD: 7/1/2023 through 7/1/2024
MEMBERAGENCY
Silicon Valley Regional Interoperability Authority
601 El Camino Real
Santa Clara, California 95050
1112 1 Street, Suite 300
Sacramento, California 95814-2865
T 916.231.4141 or 800.537.7790 * F 916-231.4111
Maximizing Protection. Minimizing Risk. •www.stlrnta.org
ADDITIONAL COVERED PARTY
City of Gilroy
Jimmy Forbis, City Administrator
7351 Roseanna Street
Gilroy, CA 95020
This endorsement modifies the Liability Coverage Aareement Provided under the following:
General Liability - Bodily Injury - LCA-SDRMA-202324 - Per Occurrence - $1,000,000
General Liability - Property Damage - LCA-SDRMA-202324 - Per Occurrence - $1,000,000
It is hereby agreed that this endorsement is added to the Liability Coverage Agreement issued to Silicon Valley Regional
Interoperability Authority by Special District Risk Management Authority ("SDRMA') adding the following as an Additional Covered
Party:
City of Gilroy is named as an additional covered party in respects to Site Access Agreement for Gilroy Gty Hall Annex Building, Gilroy
Target Range, and Gilroy Reservoir D.
The coverage afforded by this endorsement is afforded only as limited above and provided further that this coverage does not apply
to the sole negligence of the Additional Covered Party. In addition, Coverage shall not apply to liability for the active negligence of the
Additional Covered Party in any case where an agreement to indemnify the Additional Covered Party would be invalid under
Subdivision (b) of Section 2782 of the Civil Code.
Unless required by the Agreement identified above, coverage afforded by this endorsement shall be excess and non-contributory with
respect to any other valid and collectible insurance or risk financing providing coverage to the Additional Covered Party, including any
self -insured retention the Additional Covered Party may have, and any other insurance or risk financing providing coverage to the
Additional Covered Party shall be considered primary to this coverage. If required by a contract between the SDRMA Member named
above and the Additional Covered Party, the coverage afforded by this endorsement shall be primary with respect to any other valid
and collectible insurance or risk financing providing coverage to the Additional Covered Party, including any self -insured retention the
Additional Covered Party may have, and any other insurance or risk financing providing coverage to the Additional Covered Party shall
be considered excess to this coverage. All other terms and conditions remained unchanged.
Coverage provided by this endorsement, under the terms, conditions and exclusions contained in the Liability Coverage Agreement
issued by SDRMA to the Member named above shall not be reduced or canceled without 30 days written notice given to the Additional
Covered Party via certified mail.
THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGE AGREEMENT. PLEASE READ IT CAREFULLY.
The inclusion of more than one Covered Party shall not operate to impair the rights of one Covered Party against another Covered
Party and the coverages afforded shall apply as though separate policies have been issued to each Covered Party except that the
inclusion of more than one covered party shall not increase the limit of liability of SDRMA.
Effective date of this endorsement is: 7/1/2023
Signed by:
Brian Kelley, MBA, ARM
Chief Executive Officer
A proud California Special Districts California Special Districts Association CSDA Finance Corporation
Alliance partner. 1112 1 Street, Suite 200 11121 Street, Suite 200
Sauarrento, California 95814-2865 Sacramento, California 95814-2865
T 877.924.CSDA (2732) • F 916.442 7889 T 877.924 CSDA (2732) • F 916,442.7889.