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Home My WebLink AboutCertificate of InsurancePage 1 of 2 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDO/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 08/17/2021 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 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 Willie mowers Watson Midwest, Inc. COpNTACT Willis Towers Watson Certificate Center DAME: tANa/o 'ANL 1-877-945-7375 78 (AIC Nolr 26 Century Blvd E ADDRESS; oert�f9c:atee@wil1Js.irom P.O. Box 305191 Nashville, TN .372305191 USA _ INSURERS AFI�ORDINGCOVERAGE_NAICIt INSURERA: Greenwich Insurance Company 22322 _ _... ... _... ..._.__ INSURED MP Nexlevel of California, Ino. INSURER.B: XL Insurance America Inc 24654 INSURERC; XL Specialty Insura<noe Company 37`885 $00 County Road 37 East Maple Lake, MN 55358 INSURER,.17 RSUI Indemnity Company _ ._,-- , ....._ __ -------- 22314 ------- ---- ..._._...__.. INSURER E Zurich American insurance Company 16535 "_rt AAtlP..M1 Al�fx!n wuY.Yr�.w.w.w :.w.. ... ...�..r..� W... ,..:......... ... 1N UR F; 119EScirrenca)_ IkarvYMYNYV 1\VYVY�Ffl. 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 I POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, --___._._ ._,_. _, _,...__ ..._. libtil £+178.8. _.._...._,,._.-".,.,_.._._.....____-__..._p_I, 6V.. P---gy XP _.... _ _,.. _......... WSp LTR TYPE OF INSURANCE FO IiCYNUMSER M IDDIYYYY Mr�O/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS EACH OCCURRENCE $ 2,400,000 _ -MADE. OCCUR 119EScirrenca)_ 500,000 Y _ MCD EXP Anoris erson) _$ 25, 000 .PERSONAL .&ADV INJURY $ 2,000,000 CGD740933707 08l31/2021 06/31/2022 MIT APPLIES PER: ACIpREGATC LIM.1 PR POLICY LOC G5NCRAL AGGREGATE m „. _..__. $ 4, 000 000 LEN'L I H J PRODUCTS-COMP/pPAGO 4,000,000 pTHCR; AUTOMOBILE LIABILITY pMBINEDBIG LIMIT 000,000 x_ ANY AUTO BODILY INJURY (Per person) $ _.. A OWNED SCHEDULED AUTOS ONLY AUTOS I CAD740926908 08/31/2021 08/31/2022 .BODILYINJURY (Por accident) S. HIRED NON -OWNED AUTOS ONLY AUI.08 ONLY RRpPER'fYDA A E _Ltyer J610. T "" $ H UMBRELLA LIAR X OCCUR EACHpCCURRENCE $ 5,000,000 X EXCESSLIAa _ CL--- MADE ____....... U500035056LI21A 08/31/2021 08/31/2022 AGGREGATE 5,000,000 DED I ^I RETENTION$ 0 _. . __...._ WORKERS COMPENSATION X STA $ AND EMPLOYERS LIABILITY Y / N TUTE ER - L EACH ACCIDENT $' 1,000,000 _ C ANYPRGISRIETOR/PARTNER/EXECUI'IVEE Oizrlcm/MEMBEREXCLUDEb7 No NIAI CWR740927108 08/31/2021 05/31/2022 (Mandatory in NH) 11 es, describe under D E.L. DISEASE EA CMPLOYEE 1,000,000 E.L. DISEASE • POLICY LIMIT $ 1, 6005 004 SORIPTION OF OPERATIONS below C Workers Compensation/ CWD740926708 08/31/2021 08/31/2022 Z,L. Mach Accident $1,000,000 Employers Liability E.L. Disease -Ma Empl $1,000,000 Per Statute B.L. Disease—pol Lmt $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 901, Additional Remarks Schedule, maybe attuohsd If more space Is required) SLE A`.CTACHVD w W'YW✓MYMYIYAw.Yw YY✓w. rYr uw Town of Los Altos Hills 26379 Fremont Road Los Altos _.Tills, CA 940 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DE=LIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE zrr��=�� .�s••r�„� 01988-2016 ACORD CORPORATION. All r.Ights reserved. M%j%Jrru `U tcv 101 VO) I ne AUvKu name ana logo are registered marks of ACORD OR sn: 21469680 anTcH; 2204899 202 3279 CAIRN AGENCY Willis Towers Watson Midwest, Inc. POLICY NUMBER See Page I CARRIER See Page I AGENCY CUSTOMER ID: LOC NAMED INSURED _Impmexlev ;Iof C:Iifornia, Ina. 500 Count Road 7 East INaple Lake, MN 65358 NAIC CODR See Page lj:E�F�FECTIVEDATC: See Page I if Page 2 Of 2 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE' Certificate of Liability Insurance - The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers are included an Additional insureds as respects to General Liability and Auto Liability so required by written contract. INSURER AFFORDING COVERAGE: RSUI Indemnity Company NAIC#: 22314 POLICY NUMBER: NHAO95086 EFF DATE: 08/31/2021 EXP DATE: 08/31/2022 ADDITIONAL INSURED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Auto Liability Each Oco or Accident $2,000,000 Aggregate $2,000,000 IINSURZR AWFORDING COVERAGE: Zurich American Insurance Company POLICY XUMSER: OPPOO84169-06 VrV DATE; 05/01/2021 EXP DATE: 05/01/2022 TYpt OV INSURANCE: Leased/Rented Equipment 101 LIMIT DESCRIPTION.' LIMIT AMOUNT: Any One item/Per 000 $1,000,000 @ 2008 ACORD The ACORD name and logo are registerea marKS OT AL;UNLJ SR ID: 21469680 BATCH. 2204899 CERT: W21825742 NAIC#: 16535 RATION. All rights reserved.