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Home My WebLink AboutCertificate of Insurance 2015® DATE(MM/DD/YYW) coRca► I L 2/12/2015 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). ONTACT PRODUCER NAME: Kell M. Kin or Aileen Hill KELLY KING INSURANCE SERVICES PHONEFAX PO Box 599 (A/C. Ext): (888) 540-5464 A N.):(209)599-7517 ADDREss: aileen@ kellykinginsurance . com Ripon, CA 95366 INSURER(S) AFFORDING COVERAGE NAIC# 0813268 INSURER A: Colony Insurance 39993 INSURED Kielty Arborist Services LLC INSURERB:United States Liability Iris CO 25895 Kevin Kielty INSURER C: P.O. BOX 6187 INSURER D: San Mateo, CA 94403 INSURER E : COVERAGES CFRTIFICATF Nt1MRFR- RFVISInNI NIIAARFR• 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. `NSIR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE CI OCCUR EACH OCCURRENCE $ 1 000,000 PREMISES Ea occurrence $ 00,000 MED EXP (Any one person) $ 5,000 X PESTICIDE/HERB PERSONAL &ADV INJURY $ 1,000,000 A Y GL4067760 2/14/152/14/16 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY CIJECT PRO I I LOC PRODUCTS - COMP/OP AGG $ INCLUDED $ OTHER: AUTOMOBILE LIABILITY$ Ea accident BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE �) OFFICER/MEMBER EXCLUDE D N/A STATUTE I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below EACH OCC $1,000,000 B PROF LIABILITY SP1558694 2/14/152/14/16AGG $2,000,000 DEDUCTIBLE $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ALL TREE WORK. 10 DAYS NOTICE OF CANCELLATION FOR NON—PAYMENT OF PREMIUM. THE TOWN OF LOS ALTOS _HILLS, IT'S ELECTIVE AND APPOINTED OFFICERS, EMPLOYEES, AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSURED PER ATTACHED FORM U156. CERTIFICATE HOLDER CANCELLATION TOWN OF LOS ALTOS HILLS CONTRACTS 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 U 1988-2013 AUORD CORPORATION. All rights reserved. ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) (Additional Insured): Location(s) of Covered Operations: ALL PERSONS OR ORGANIZATIONS AS REQUIRED THIS INSURANCE SHALL BE PRIMARY BY WRITTEN CONTACT WITH THE INSURED & NONCONTRIBUTORY, BUT ONLY IN THE EVENT OFA NAMED INSURED'S SOLE NEGLIGENCE A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" casued, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work "Bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization. Negligence of Additional Insured "Bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional insured(s). ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, U156-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. Insured