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Home My WebLink AboutCertificate of Insurancenl AnnnV111 I WHIM nCH 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 AcoRn` CERTIFICATE OF LIABILITY INSURANCE 101DATE'MMO°m vl 27/2018 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 endowed. 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 endomement(s). PRODUCER License If 0757776 CONTACT Jordan Bartleson HUB International Insurance Services Inc. 3390 University Avenue, Suite 300 Riverside, CA 92501 P.0xx , Ea: (877) 825-2681 FARC, xo:(951) 231-2572 NUL AE -DR , Cal.Cpu@hubinternationai.com 1,000,090 I I .=. INSURER A: Sentinel Insurance Company, Ltd. 11000 GENERALAGGREGATE $ 21000,000 INSURED INSURER .:Hartford Accident and Indemnity Company 22357 INSURER c: United States Liability Insurance 25895 Gladwell Governmental Services INSURER D. P.O. Box 62 Lake Arrowhead, CA 92352 INSURER E: INSURER F: 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. 'INSIR I TA TYPE OF INSURANCE ADMSUBR POLICY NUMBER POLICY EFF POLICY ERA UNITS A X COMMERCIAL GENERAL LIABILITY CLAIMSNAOE x-1 OCCUR 1, X725BAIB5623 10132018 10/312019 EACX OCCURRENCE $ 1,000,000 1,000,090 MEDE%PLnyme reap $ 10,000 PERSONAL S ADV INJURY $ 1.000.000 GENERALAGGREGATE $ 21000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2'000'000 �X POLICYE1jECQT El— NEP B AUTOMOBILE LIABILITY COMBINEOSINGLE UMR 1ggg 1100 $ X ANY AUTO 72UECPT0490 10/31/2018 10131/2019 BODILY INJURY RA, ,am $ OWNED SCHEDULED AUNPO�S ONLY ALLFT1O�Sµ�Ep BODILY INJURY (P>accV Y) 5 AUTOB ONLY AJTOS ONLY P OaARdl�DAMAGE UMBRELLA UAB ',OCCUR EACH OCCURRENCE $ EXCESS UAe CLAIMSMADE. 1 AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION ANDEM0.0YERTUANUtt T,IN I 1PENTTATUOp " ANY PROPRIETORNARTNERIE%ECUTIVE ❑NIA OFF6E FIM EACLUOEDi ((AA1,e a EL EACH ACCIDENT $ E_L_DISEASE-EA EMPLOYEE ,% tiv6a des M uMn UFS.m1R.N OT OPERA PONS oebw E L. DISEASE -POLICY LIMIT C Professional Liab. SP 1020955H .10/31/2018 10/31 Y1019 Per Claim 1,000,000 C Prof Llab DED:92,500 SP 1020955H 10/31/2018 10/31/2019 Aggergate 2,000,000 DESCRIPTION OFOPERATKINSILOCATIONSIVEHICLES IACORD101, AdBC mlonal R... NRI.I. may Ee enecMd N mon g- Is ntylndl Town of LOS Altos Hills H Additional Insured with regard to the General Liability policy when required by Mn contract per Me attached endorsement form IH12001185T. GFRTIFIr.ATF Hnl nFR CANCFI I ATION ACORD 25 (2016103) C 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo am registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of LOS Altos Hills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AM: Deborah Padovan, City Clerk 26379 Fremont Road Los Altos Hills, CA 90022 RESEMTATE AUTHORQED��REP%%N 4k(dY.itipL_ ACORD 25 (2016103) C 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo am registered marks of ACORD POLICY NUMBER:72 SSA IBS623 er THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOS ALTOS HILLS, CA 94022 Fom IH12001185TSEO.NO.005 PHntedin U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 08/15/16 Expiration Date: 10/31/19