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6.C. - Page 47 of 57 ®® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) DATE 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(les) 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 center rights to the certificate holder In lieu of such endorsement(s). PRODUCER Liberty Mutual Insurance PO BOX 188065 Fairfield, OH 45018 CONTACT NAME: PHONE Exti: 800-962-7132 PAX, C No: 800 845-3666 E-MAIL ADDRESS: BusinessService Liber( Mutual.com INSURERS AFFORDING COVERAGE NAIL # INSURER A: West American Insurance Company 44393 INSURED Zakskorn Construction Company its officers, directors, and employees DBA ICON Builders 780 W Grand Ave INSURER B: INSURERC: INSURER D: INSURER E : Oakland CA 94612 INSURER F; COVERAGES CERTIFICATE NUMBER: 9A7aann.5 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. (LTR TYPE OF INSURANCE AODL iuBRWVO POLICY NUMBER POLICY EFF MMIDP! EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE D OCCUR DAMAGE TO RENTED PREMISES Ea occurcence MED EXP (Any one person) s PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ RO- POLICY ❑ SECT ❑ LOC $ OTHER: A AUTOMOBILE LIABILITY BAW56142156 9/24/2014 9/24/2015 COMBINED SINGLE LIMIT $ Ea accident 11000 000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) 3 ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS I PROPERTY DAMAGE $ Uninsured Motorist $ 1,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVE YN PER OTH- SFATUTE ER E -L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFiCEPiMEMBER EXCLUDED? (Mandatory In NHi ! A E.L. DISEASE - POLICY LIMIT $ Ryes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS IVENICLES (ACORD 501, Additional Remarks Schedule, may be attached It more space is required) The City of Redwood City, its Council Members, Officers, Boards, Commissions, Employees and Agents are named as Additional Insured if required by written contract or written agreement subject to Auto Liability Additional Insured Provision. Waiver of Subrogation is included Project: Jefferson and Franklin Apartments 103 Wilson St. Redwood City, CA 94063 (Zoon #3042) City of Redwood City Enggineering and Construction P. O. Box 391 Redwood City CA 94064 I N]CI 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 Vicky Green / O 1988-2014 ACURV cpRFL)RATIUIV. An rignis reservea. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 25749995 1 56142156 1 14 i5 Master certificate I Vicky Green 1 7/26/2015 12:19e15 PM UIDT) I Page 1 of 9 73