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HomeMy WebLinkAboutCertificate of Insurance 05/2021KIELARB-01 I I la CERTIFICATE OF LIABILITY INSURANCE DAT/1212DIY 5/12/21 021 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 have ADDITIONAL INSURED provisions or 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 confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0757776 HUB International Insurance Services Inc. 40 East Alamar Avenue Santa Barbara, CA 93105 COINEACT Yvonne Esquivel NA Pn"/CO,NIJ ,Ext,; (805 204-3244 FAC ( ) lac, Ne,:(805) 832-6581 a oRIEss: Yvonne.esquivel@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # A INSURER A: ColonyInsurance Compan 39993 Los Altos, CA 94022 INSURED INSURER B: United States Llabillty Insurance 25895 INSURER C : Kielty Arborist Services LLC P.O. Box 6187 San Mateo, CA 94403 INSURER D: MED EXP (Any oneperson) $ 5,000 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NI IMRr-0m 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. INSR LTR TYPE OF INSURANCE ADDL IND SUBR D POLICY NUMBER POLICY EFF fMMIDDIYYYYI POLICY EXP (MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_X] OCCUR Los Altos, CA 94022 101GL006971704 2/14/2021 2/14/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 5,000 PERSONAL &ADV INJURY $ Excluded GEN'L AGGREGATE LIMIT APPLIES PER: POLICY E JECT � LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ Excluded OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accide t $ BODILY INJURY Perperson) $ 1 ANY AUTO OWNED F SCHEDULED AUTOS ONLY AUTOpS BODILY INJURY Per accident $ LP OPc R DAMAGE $ AUR OS ONLY AUOTOS ONLY L $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ?Man ato/,M in NH) EXCLUDED? If yes, describe under N I A PER OTH- STATUTE I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below B Errors & Omissions SPIS58694F 2/14/2021 2/14/2022 Each Claim 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Various arborist services throughout Los Altos Hills. Proof of Insurance. CERTIFICATE HOLDER CANCEI I ATION ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are 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. Public Works Engineering 26379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos, CA 94022 6XdsG,W 4 _.. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD