HomeMy WebLinkAboutCertificate of Insurance 2015,�►co>za►`� CERTIFICATE OF LIABILITY INSURANCE
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29120/DDIYYYY)
1 /29/2015
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 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).
PRODUCERNTCT
NAME; Hilda Shields
The Hauser Group
8260 Northcreek Drive, Suite 200
Cincinnati OH 45236
P"CO"E o. t - - 2 AC No
EMAIL
ADDREss: m
INSURERS AFFORDING COVERAGE NAIC #
INSURER Aflartford Fire Insurance
/1/2015
INSURED MANAG-2
INSURER B:LI S of London
INSURER C:
Management Partners, Inc.
1730 Madison Road
Cincinnati OH 45206
INSURER D:
INSURER E:
INSURER F:
MED EXP (Any one person) $10,000
COVERAGES CERTIFICATE NUMBER: 1290400639 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.
ILTR
TYPE OF INSURANCE
ADDLSUSR
NSR
WVD
POLICY NUMBER
MM/DDS
POLICY EXP
LIMITS
A
GENERAL LIABILITY
33SBAUG1832
/1/2015
/1/2016
EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 15F] OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence $1,000,000
MED EXP (Any one person) $10,000
PERSONAL &ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMP/OP AGG $2;000,000
$
POLICY PRO LOC
A
AUTOMOBILE
LIABILITY
33UECVG5096
/1/2015
/1/2016
UOMBIN
Ea accident $1,000,000
BODILY INJURY (Per person) $
ANY AUTO
ALL OWNEDX SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) $
X
NON -OWNED
HIRED AUTOS X AUTOS
PROPERTY DAMAGE
Per accident)$
$
A
X
UMBRELLA LIAB
X
OCCUR
33SBAUG1832
/1/2015
/1/2016
EACH OCCURRENCE $3,000,000
AGGREGATE $3,000,000
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTION $10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
33WECBU6135
/1/2015
/1/2016X
TNCYLATU- OTH-
E.L. EACH ACCIDENT $1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYEE $1,000,000
(Mandatory In NH)
If yyes, describe under
DESCRIPTION.OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $1,000,000
B
Professional Liab
Occurrence
MPL1008388
/20/2014
/20/2015
Ea. Claim $1,000,000
Agg $1,000,000
Deductible $10,000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers are shown as an additional insured(s) solely with
respect to geheral liability and auto liability coverages as evidenced herein as required by written contract with respect to work performed by
the named Insured(s).
L;tK I n -I :A I t MULUCK k;ANr.;tLLA I IUN 3U oays
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills CA 94022
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
6), At. b)o,�V
U 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD