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HomeMy WebLinkAboutCertificate of Insurance (4)® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) TYPE OF INSURANCE 4/1/2021 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 Bolton & Company CONTACT NAME: 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 AHONN0. Ext): 626 799 7000 FAX No : 626 583 2117 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC # DA GET RENTED PREMISES Ea occurrence $ 300,000 INSURERA: Hartford Fire Insurance Company 19682 www.boltonco.com 0008309 INSURED S. P. McClenahan Company 1 Arastradero Road INSURER B: Hartford Casualty Insurance Company 29424 INSURERC: Redwood Fire and Casualty Insurance Co 11673 INSURER D: Portola Valley, CA 94028 INSURER E: AUTOMOBILE INSURER F: COVERAGES CERTIFICATE NUMBER: 61007914 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. INSR LTR TYPE OF INSURANCE ADDL I S SUBR W D POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �✓ OCCUR ✓ 57UENOK3257 4/1/2021 4/1/2022 EACH OCCURRENCE $1,000,000 DA GET RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY ✓❑ ECT [:] LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Arborist&Landsca er P *$1,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 57UUNSR5675 4/1/2021 4/1/2022O(EaMBINEDtSINGLELIMIT $1,000,000 ✓ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident B UMBRELLA LIAB EXCESS LIAB �/ OCCUR CLAIMS -MADE 57HHUOK7901 4/1/2021 4/1/2022 EACH OCCURRENCE $5000000 V/ AGGREGATE $5,000,000 DED I ✓ I RETENTION $10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A SPWC245995 4/1/2021 4/1/2022�/ STATUTE OT" E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: All California Operations of the named insured as required by written contract Certificate holder is named as additional insured per blanket policy form HG00010916 attached. CERTIFICATE HOLDER CANCELLATION r Town of Los Altos Hills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 26379 W. Fremont Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Los Altos Hills CA 94022 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE G Mary Ann Sun ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 61007914 1 SPMCCLE-Cl 1 2021 Master SPMaClenahan 61L/AU/EX/WC/IM I Mary Ann Sun 1 4/1/2021 11:37:56 AM (PDT) I Page 1 of 3 57UENOK3257 Page 12 of 21 HG 00 0109 16 61007914 1 SPMCCLE-Cl 1 2021 Master SPMcClenahan GL/AU/BX/WC/IM I Mary Ann Sun 1 4/1/2021 11:37:56 AM (PDT) I Page 2 of 3 a I am 1 timp Nall Page 12 of 21 HG 00 0109 16 61007914 1 SPMCCLE-Cl 1 2021 Master SPMcClenahan GL/AU/BX/WC/IM I Mary Ann Sun 1 4/1/2021 11:37:56 AM (PDT) I Page 2 of 3