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Avaya LLC AC ® DATE(M/DD/Y YY) t 0 CERTIFICATE OF LIABILITY INSURANCE 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 d 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 - CONTACT 'O NAME: Aon Risk Insurance Services West,' Inc. PHONE FAX , ' San Francisco CA Office. (A/C.No.Ext): (866) 283-7122 (A/C.No.): (800) 363-0105 $. 425 Market. Street - E-MAIL o Suite 2800 ' ADDRESS: - _ San Francisco CA 94105 USA INSURER(S)AFFORDING COVERAGE NAIL# 'INSURED ' - INSURER A: ZUrich"American Ins-Co 16535 Avaya LLC INSURER B:, Ameri can zuri ch ins Co 40142 350 Mount Kemble Avenue ' Morristown Ni 07960 USA INSURERC: ` XL Insurance America Inc 24554 INSURER D: INSURER E: INSURER F: , ...5' COVERAGES CERTIFICATE NUMBER: 570102120178 REVISION NUMBER: -i 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. Limits shown are as requested -iNSR - ADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER ( LIMITS LTR INSD WVD iMM/DD/YY.YY f MM/DDlYYY1� A X COMMERCIAL GENERAL LIABILITY GL0015$16507 . '09/30/2023 09/30/2024 EACH OCCURRENCE $2,500,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR - PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,500,000 GENL AGGREGATE LIMIT APPLIES PER:' GENERAL AGGREGATE $5,000,000 N POLICY JERCOT- X. LOC ' ' - PRODUCTS-COMP/OP AGG '$5,000,000 o OTHER: - o' A AUTOMOBILE LIABILITY - BAP 0158167 07 09/30/2023 09/30/2024 COMBINED SINGLE LIMIT(Ea accident) $5,000,000 � - - _ - X ANY AUTO BODILY INJURY(Per person) Z • OWNED SCHEDULED ' . '. BODILY INJURY(Per accident) - CD AUTOS ONLY AUTOS- at HIRED AUTOS NON-OWNED PROPERTY DAMAGE .v- ONLY AUTOS ONLY (Per accident) 4= i - C X UMBRELLA LIAR X 'OCCUR; OS00076703L123A 09/30/2023 09/30/2024 EACH OCCURRENCE - $1,500,000 U EXCESS LIAB CLAIMS-MADE AGGREGATE $1,500,000 DED X RETENTION$10,000 B -WORKERS COMPENSATION AND - - WC015816607 09/30/2023 09/30/2024 X PER STATUTE - OTH- Y EMPLOYERS'LIABILITY Y/N AOS - ' ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 B OFFICER/MEMBER EXCLUDED? N N/A WC015816807 09/30/2023 09/30/2024 -___ _ (Mandatory in NH) _ _ _ __ MA,-WI. --- _. -__.. .._ E.L.DISEASE-EA EMPLOYEE .. -$1,000,000 . If yes describe under - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— M DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Xe .. Certificate Holder is Included As Additional Insured In Accordance with The Policy Provisions of The General Liability Policy. a. CERTIFICATE HOLDER CANCELLATION • iN o SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE• L N EXPIRATION DATE THEREOF, NOTICE WILL.BE DELIVERED IN ACCORDANCE WITH THE m POLICY PROVISIONS. sa.a o ;VC. • City of Campbell AUTHORIZED REPRESENTATIVE Attn: Al oxenian o 70 N Fi rst -Street- 7,�� /� �i �,�� i a- ` o Campbell CA 95008 USA Sept i :ric/nxcta e/al�u Welecf= • o M ©19861015 ACORD GORPORATIO ,�ht$�A9�1'�" ' ACORD 25(2016/03) The ACORD name and logo are registel'ed marks ofACORD ry��'