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Home My WebLink AboutCertificate of InsurancePolicy Number: Date Entered: AA " CERTIFICATE F LIABILITY INSURANCE �,r,...-"' DATE(MMIDDIMY) x3/14/2020 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder i5 an ADDITIONAL INSURED, the policy(ies) 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 Benedetti Insurance Agency 199 California Dr. #202 Millbrae, CA 94030 CONTACT Mi I Watters NAME: chae PHONE�yNotl, (650) 597-7229 i/vc,N(650)697 4506 E-MAIL ADDRESS: _ 94030 INSUReR(S) AFFORDING COVERAGE NAIC'tl_ INSURERA;Associat:ed Industries Ins. Co. X3140 INSURED _ C2R Engineering Inc. PO Box 1017 INSURERB:Liberty" Mutual Insurance Co. 23.035 Campensat. nTs Inca rind_. _ S' ay INSURER O : .__ 35076 INSURER D; 6co `s a e Insuraztae Cnmparry — +' X INSURER E: Navigators Insur'anceJ-Company 6/25/2010 Mountain View, CA 94042 INSURER F: West Chester .Fire insurance Co. 2.1121 MED EXP (AnY one. pergpn .r. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER106 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 TIME TERMS; EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT TYPE OF INSURANCE ADDLSUaR �-- POLICY NUMBER POLTCYEFF MIDDIYYYY POLICY EXP MIDOlYYYY LIMITS .�„ COMMERCIALGENERALLIABILITY -EACH :OCCURRENCE '$1,000,000 _ CLAIMS -MADE OCCUR ``��// X +' X ANaS1048445-02 6/25/2010 /25/2020 PREMISES (DAMAGE TO Ea encs) $100,000 MED EXP (AnY one. pergpn .r. $p5 , 000.._._.....,..____... PERSONAL & ADV INJURY $ 1 , 000 , 000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY j( ( .....J LOC PRODUCTS • COMPIOP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S1,000,000 B ANY AUTO X ,X BAO (20) 57765090 1/29/2020 /20/2021 ODILYINJU. BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per ZzkP nl) $ �� RO ERTY A�MA—.� HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per icCldenl rj UMBRELLAtIAB OCCUR EACH OCCURRENCE $9,000,000 EXCESS LIAR CL:AIMSMADE EBU014628545 1/30/2020 /30/2021 AGGREGATE $9,000,000 DED RETENTION $ $ WORKERS COMPENSATION STATUTE _pRH C AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE2./'5/2020 NIA 9129591.-'20 ./5/2021 E.LEACH ACCIDENT _ $1,000,000 E.L. DISEASE - EA EMPLOYEE _ $ 1,000,000 OFFICERIMEMBEREXCLUDED? (Mandatory in NH) I yyes, describe under D RIPTION.OF OPERATIONS below EL, DISEASE - POLICY LIMIT $1,000,000 E Inland Marine 05--IM012531 6151/2626 �.f21/2021 Rented/Leased $185,000 Equipment, F Pollution Liability 74874 x1 05/30/2020 5/30/2021 Liability Limit I $1mm./$2mm DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more. space Is. required) Certificate of General Liability, Automobile Liability, and Workers Camp. for C2R Engineering Inc insurance is primary and non-contributory. 30 day notice of Banc. to cert holder, 10 days for non-payment The Regents of the University of California, The University of California, University, and each of their The Town, its elected or appointed officials, employees, and volunteer's are included as additional insured per attached blanket endorsements ----------------------- CERTIFICATE HOLDER GANCELLA'riON Town of Los Altos Hills 26379 Fremont Rd. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Los Altos Hills, CA 94022 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 1N ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIve ACORD CORPORATION. All riahts rn-rsrvnrl. ACORD 25 (2016/03) The ACORD name and logo are registered marks Of ACORD