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DATE (MMIDD/YYYY) <br />A`"J?" CERTIFICATE OF LIABILITY INSURANCE <br />5/15/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER p <br />Bolton & Com an yy <br />3475 E. Footn)II Blvd., Suite 100 <br />Pasadena, CA 91107 <br />CONTACT <br />NAME: <br />PHONE(AM626 798-7000 FARC N 826 583-2117 <br />E MMA"IL <br />AODRE : <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURERA: Old Republic General Insurance Corp24139 <br />www.boltonco.com 0008309 _ <br />INSURER B : Starr Indemnity & Liability Company_38318 <br />INSURED <br />O'Grad Paving Inc. <br />A & D Trucking est Equipment Rentals <br />INSURERC: <br />INSURER D: <br />2513 Wyandotte Street <br />Mountain View CA 94043 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: s44g474 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />/NSR EFF POLICY EXP <br />LTR MM DDNYYY LIMITS <br />TYPE OF INSURANCE POLICY NUMBER MM;DDY YY <br />A <br />COMMERCIAL GENERAL LIABILITY <br />✓ <br />Al CG44181801 <br />7/1/2019 <br />7/1/2020 <br />EACH OCCURRENCE $1.000,000 <br />CLAIMS -MADE M✓ OCCUR <br />P M Es ante $ 100 OOO <br />MED EXP (Any one person) $5,000 <br />PERSONAL & ADV INJURY $1.000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,000 <br />POLICY PRS LOC <br />JEC7 <br />HOTHER: <br />PRODUCTS - COMP/OP AGG $2.000,000 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />✓ <br />Al CA44181801 <br />7/1/2019 <br />7/1/2020 <br />ee oINE.: IT $1,000,000 <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />BODILY INJURY (Per accident) $ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />PROPERTYpAMAGE $ <br />r 'dans <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />B <br />UMBRELLA LIAB <br />�/ OCCUR <br />1000585182191 <br />7/1/2019 <br />7/1/2020 <br />EACH OCCURRENCE $10,000,000 <br />AGGREGATE $ 10,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />PED I I RETENTION $ <br />$ <br />1 <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICER/MEMBEREXCLUDED? <br />NIA <br />AlCW44181801 <br />71112019 <br />7/112020.STRTIIT!_ <br />ER <br />E.L. EACH ACCIDENT $1,000.000 <br />(Mandatory In NH) <br />E.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $1.000,000 <br />i <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: OGP #20039, Project #STPL-5029(036), Redwood City Pavement Preservation. <br />GL Additional Insured applies per CG20100704 & CG20370704 attached, only if required by written contract/agreement. GL Primary&Non-Contributory <br />Wording applies per CGENGN00290906 attached. Auto Additional Insured and Primary&Non-Contributory Wording applies per CAENGN00440212 attached. <br />GL, Auto & WC Notices of Cancellation apply per ILENGN00040911 and WC9903150906 attached. <br />Additional Insured(s): City of Redwood City, its City Council, and their elective and appointed, boards, officers, agents, and employees . <br />CERTIFICATE HOLDER CANCELLATION <br />OGP #20039 <br />City of Redwood City <br />Attn: Engineering Division <br />P.O. Box 391 <br />Redwood City, CA 4064 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Chau Tran 4 <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />55499974 1 OGRAPAV-Cl 1 19-20 WC, Auto, GL, XS I Bolton Certificate Processing 1 5/15/2020 5:47:28 PM (PDT) I Page 1 of 9 <br />