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Home My WebLink AboutCertificate of Insurance 2018 (3)A`� ®� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) TYPE OF INSURANCE 11/6/2018 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(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 endorsements). PRODUCER Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 MOMTACT PHONE (626) 799-7000 rC Nol; (626 583-2117 E:•MAIL ADDRES ' INSURERS AFFORDING COVERAGE NAIc# www,boltonco,com 0008809 _ INSURER A: Old Republic General Insurance Corp24139 INSURED O'Grady Paving, Inc, DBA: A & D Trucking; Best Equipment Rentals 2513 Wyandotte Street Mountain View CA 94043 I INSURERR:Starrindemnit &LiabilityCGmpan� 38318 .INSURER 0: Underwriters at Lloyd's London INSURER D: INSURER E: y INSURER F: DAMAG O RENT D '",00000 PREMISE, EQ Accu rents $100000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEWISSUED 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, [NSR LTR TYPE OF INSURANCE ADDL 11181) SUER WvO POLICY NUMBER POLICY EFF MMIDg1YYYY LIMITS A �/ GOMMERCIALGENERAL LIABILITY CLAIMS -MADE � OCCUR Al C 18180 7/112018 7/1/2019 EACH OCCURRENCE $1 000 DAMAG O RENT D '",00000 PREMISE, EQ Accu rents $100000 MED EXP An one arson) $5,00 -._. - PERSONAL & ADV INJURY $1,000,)00 AGGREGATE LIMIT APPLIES PER: POLICY [,D,/ PRO- JECT LOC GENERAL AGGREGATE $2,000,000 GEN'L PROD UCTS-COMPJOPAGG $2000000 $ OTHER: A AUTOMOBILE LIABILITY Al CA44181800 7/1/2018 7/1/2019 C'0 M1,31NEDtSINGLE LIMIT . $1 000 000 ANY AUTO BODILY INJURY (Per parson) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Par accident) $ PROPERTY DAMAGE Per accident $ $ H UMBRELLALIAB / OCCUR 1000585182181 7/1/2018 7/1/2019 EACH OCCURRENCE $1.0,000,000 7 EXCESS LIABCLAIMS-MADE AGGREGATE $10 OOQ OOO DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 (Mandatory In NH) If yes, describe under NIA AICW44181800 7/1/2018 7/1/2019 PER ' TH- -/STATUTE ER E.L, EACH ACCIDENT $1 QOO 000 E.L. DISEASE -EA EMPLOYEE $1,000.000 Ek. DISEASE» POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below C Pollution Liability POIARK0873600 7/112018 7/1/2019 Limit: $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO i0i, Additional Remarks schedule, may be attached if mono apace Is required) Re: Job #18174, Install Sharrows at Elena Rd and Moody Road, GL Additional Insured applies per CG20100413 & OG20370413 attached, only if required by written contracUagreement, GL, Auto and WC Notice of Cancellation clauses apply per IL02700912 and WC9903140107 attached, Addlflonal Insured(s): The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers. k'r.mi rrjua nr 11 mra rAni�cr 1 AT Ink[ Job #18174 Town Of Los Altos HIIIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 26379 Fremont Road THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN Los Altos Hills, CA 94022 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE�`- Chau Tran V 1988-2015 ACORD CORPORATION, All rights reserved. ACORD 26 (2016103) The ACORD name and Toga are registered marks of ACORD 45246868 1 OGRAPAV-Cl 1 10-19 WC, Auto, GL, XS, POLL I Bolton Certificate Pr—nosing 1 11/5/2010 3:24:01 PN (PST) I Page 1 of 13