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Home My WebLink AboutCertificate of InsuranceCERTIFICATE OF LIABILITY INSURANCE DATE (MMIL)DIYYYY) 11/2912021 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 , : It 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 endorsementW. PRODUCER CRNTACT - - Arthur J. Gallagher & Co, N MR: Certificate Department PHONE AX 2121 N. California Blvd., Suite 350 C, No. Fyn! 925-299-1112 (AICyML225-963-6270 E-MAIL Walnut Creek CA 94596 ADDRESS: CertReauests0almcom INSURED ChrisE Company 4365 Osgood Road Fremont, CA 94539 COVERAGES CERTIFICATE NUMBER, 1526127544 : Starr I REVISION NUMBS -R! 38318 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. TYPSOPINSURANCE bV V Y, LTR INS[) WVD POLICYNUMaER (MMID YY Y) (M ID IYYYY "91' L LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE E-1 OCCUR Y Y 1000026834211 12/112021 1211/2022 EACH OCCURRENCE _IJAff&Gff -R $2,000,000 TO -Off MY— L)rronvq).__A100,000 MED EXP2 llqy_... r2IRLO X DED/OCC _Ix.E. PERSONAL & ADV INJURY 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY E] PJE19 1:1 LOC GENERAL AGGREGATE PRODUCTS - COMP/OP AGO- $4,000,000 s4,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 1000198720211 '12/1/2021 12/1/2 022 n . JeMBN D 8 1 �GR LIMIT - on, J 32 000 ANY AUTO BODILY INJURY (Per person)~~ X OWNED SCHEDULED AUTO$ ONLY AVTOO HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY BODILY INJURY (Puracoldont) PROPERTY DAMAGE (PoI WA4091101 A UMBRELLA LIAB X OCCUR 1000587463211 12/1/2021 121,112022 EACH OCCURRENCE $5,000.000 EXCESS LIAR y µ HW CLAIMS -MADE __m1a9 AGqll� GAE$5.000,000 DED X A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY131,10PRlr-TOR/PARTNER/FXCCUTIVL I— I OFFIOER/MrMUERCXCLUDED? L (Mandatory In NH) It Los, dosorlbe under D SORIPTION9FOPERATIONS below NIA Y '1000004442 12/1/2021 12/1/2022 XOIN ER r . DISEASE - EA EMPLOYEE 1,000,000 $1 000,000 —1 C.I..DISEASE - POLICY LIMIT $1000000 =zz1zX4___ [SEE ATTACHED SUPPL. PAGE] DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) ChrO Job #: I OL.20.001 RE: SCHOOL ZONE SIGNAGE, LOS ALTOS HILLS, CA, ADDITIONAL INSURED(S): TOWN OF LOS ALTOS HILLS, ITS ELECTIVE & APPOINTED OFFICERS, EMPLOYEES, & VOLUNTEERS. NOTICE OF CANCELLATION: The Producer will endeavor to mail 30 days written notice to the Certificate Holder named on the certificate If any policy listed on the certificate Is cancelled prior to the expiration date. Failure to do so Shall Impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. CERTIFICATE HOLDER CANCELLATION 01988.2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 11 187 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF LOS ALTOS HILLS ACCORDANCE WITH THE POLICY PROVISIONS. 26379 FREMONT ROAD LOS ALTOS HILLS CA 94022 AUTHORIZED REPRESENTATIVE 01988.2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 11 187 S� Starr Inder"n ty & Liability ompiamy Dallas, TX 1-866-519-2522 M lr is � � i ►` i . W11111101 LIN IN01A i t i' iYAU i Policy Number: 1000026834211 Effective Date: 12/01/2021 Named Insured: Chri.sp Company This endorsement modifies insurance provided under the following SCHEDULE NAME OF ADDITIONAL INSURED PERSON OR ORGANIZATION: AS REQUIRED PER WRITTEN CONTRACT LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: AS REQUIRED PER WRITTEN CONTRACT ADDITIONAL. PREMIUM: (If No entry appears above,, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) SECTION II M WHO IS AN INSURED is amended to include as an Insured; The person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". All other terms and conditions remain unchanged. OG 185 (04/12) Page 1 of 1 Copyright* C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISA Properties, Inc,, used with Its permission. 3" of 11 107 (I Starr Indemnity & Liability Company Dallas, TX 1-866.519-2522 ADDITIO11AL INSURED- OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION Policy Number: 1000026834211 Effective Date: 12/01/2021 Named Insured: Chrlsp Company This endorsement modifies insurance provided tinder the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM NAME OF PERSON OR ORGANIZATION: AS REQUIRED PER WRITTEN CONTRACT (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION 11 -WHO IS AN INSURED is amended to include as an insured; The person or organization shown in the schedule, but only with respect to liability arising out of your ongoing operations performed for that additional insured. B. With respect to the insurance afforded to these additional Insureds, SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. -Exclusions, Is amended to include the following additional exclusion; This insurance does riot apply to "bodily injury" or "property darnage" 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 site of the covered operations has been completed; or, (2) that portion of "your work" out of which the Injury or damage arlses has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain unchanged. OG 180 (04/12) Page 1 of 1 Copyright @ C. V. Starr &c Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with Its permission. 4' of 11 197 Starr Indemnity & Liability Company Dallas, TX 1-866-619-2522 Policy Number: 1000025834211 Effective Date: 12/01/2021 Named Insured: Chrisp Company This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. SECTION IV— CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following is added to paragraph 4.a, of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional Insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED, Signed for STAIR INDEMNITY & LIABILITY COMPANY Steve Blakey, President Wehemlah E. 0 , 1-n-'sburg, General Pounsel OG 107 (04/11) Page I of I Copyright @ C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with Its permission. 5' of 11 197 POLICY NUMBER: 1000025834211 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "Your work" done under a contract with that person or organization and included In the "products -completed operations hazard". 'This waiver applies only to the person or organization shown in the Schedule above, CG 24 04 05 09 0 Insurance Services Office, Inc,, 2008 Page 1 of 1 6* of 11 187 Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 Addonal Insured — Where Required Under Written Contract or Written Agreement Endorsement Policy Number: 1000198720211 Named Insured: Chrisp Company Effective Date: 12/01/2021 at 12:01 A.I. This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the declarations page, Please read the endorsement and respective policy(les) carefully. Business Auto Coverage Form THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. It is hereby agreed that SECTION 11 — COVERED AUTO$ LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, is amended to include the following: d. Any person or organization whom you become obligated to include as an additional insured under this policy, as a result of any written contract or written agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said written contract or written agreement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President and Chief Executive Officer SICA 1016 (04/14) Nehemiah E. Ginsburg, General CoOnsel Copyright (0 Store 111dellililty & Lbilillity Compony, All righti reserved, Incluldo's, Copyrighted 11111terlal of 180 llroptrtles, hoc„ lised with its 1) Celli h4sloll. Page I of I 7* of 11 167 , S•tarr Indemnity & Liability Company Dallas, TX 1-666-510-2522 INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS Policy Number: 1000198720211 Effective Cate: 12/01/2021 at 12:01 AM Named Insured: Chrisp Company This policy is amended as follows: Section IV — Business Aute Conditions, B., General Conditions, 5., Other Insurance, c,, is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, president Chief Executive Officer Nehemiah E. Ginsburg, General Co nsel SICA 1017 (02112) Page 1 of 1 Copyright O C. V. Starr & Company and Starr Indemnity & Liability Company, All rights reserved. Includes copyrighted material of IBC? Properties, Inc., used with Its permission. 8* of 11 197 0306 POLICY NUMBER: 1000198720211 COMMERCIAL AUTO 04-84) CA 04 44 10 13 THIS ENDORSEMENT CAANGES THE POLICY. PLEASE READ IT CAREFULLY, inforce WAIVER OF TRANSFER OF RIGHTS OF RECOVERY nt that AGAINST OTHERS TO US (WAIVER OF SUBROGATION) in the This endorsement modifies insurance provided under the following: arnlurn AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement, This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Chrisp Company Endorsement Effective Date: 12 / 01 /2 02 1 SCHEDULE Name(s) Of Person(s) Or Organization (s): Where required by written contract or written agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization (s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA 04 44 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 1 of 1 9' of 11 197 10* of 11 197 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 2121 North California Boulevard, Suite 350 Walnut Creek, CA 94596 197 3 AB 1.180 III 111 11 111111111111111111111111111111111111111111111111111111111 TOWN OF LOS ALTOS HILLS 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 197 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to got certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyErnail9AJG,com and provide the following information for processing: 1, Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of US. Mail delivery 3. Insured Code found in the Insured section on the enclosed certificate. An example of this code is XXXXXX-01 4. This Certificate Number: 1526127544 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.0-9g.com/us/about-us/how-we-wor�/Cco—re-360. Gallagher does not share your e-mail as detailed in our privacy policy found at htt.ps:flw Q-ig.com/us/privacy-polic,y/. 1* of 11 197