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HomeMy WebLinkAboutCertificate of Insurance (5)AC<>1?bV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) TYPE OF INSURANCE 3/29/2019 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 endorsement(s). PRODUCER Bolton & CompanyNAME: T 3475 E. Foothill Blvd,, Suite 100 Pasadena, CA 91107 PHONN Ext: 626 799-7000 A/C No: 626 583-2117 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # www.boltonco.com 0008309 INSURERA: Twin City Fire Insurance Company 29459 INSURED P. McClanahan Company 1 1 Arastradero Road -INSURER B: Hartford Fire Insurance Company 19682 INSURERC: Hartford CasualtyInsurance Company 29424 INSURER D: Redwood Fire and Casualty Insurance Co 11673 Portola Valley, CA 94028 INSURER E: PRODUCTS -COMP/OP AGG $2,0002000 INSURER F : B (;OVERAGES CERTIFICATE NUMBER: A7891797 RFVIRlr1N NIIMRPR• 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. INSR LTR TYPE OF INSURANCE ADDL SUER WVDPOLICY NUMBER MMDDIYYYY MMIDDNYYY LIMITS A ,/ COMMERCIAL GENERAL LIABILITY ]CLAIMS -MADE 1�1OCCUR ✓ 57UENOK3257 4/1/2019 4/1/2020 EACHOCCURRENCE $1,000,000 DAMAGE IIITID PREMISES Ea occur ence $300000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY✓❑ PRO- JECTF—] LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,0002000 Arborist&Landsca er P *$1 000,000 B AUTOMOBILE v' LIABILITY �.NY AUTO OWNEAUTOS SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 57UUNSR5675 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident 1 000 000 - BODILY INJURY (Par person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE Per accident) ccident $ C ✓ UMBRELLA LIAB,/ EXCESS LIAB OCCUR CLAIMS -MADE 57HHUOK7901 4/1/2019 4/1/2020 EACH OCCURRENCE $5000000 AGGREGATE $5,000,000 DED I ✓ I RETENTION $10,000 D WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N OF ICRP/MEMBEREXCLUDED9ECUTIVE ] (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A SPWC031766 - 4/1/2019 4/1/2020 ,/ STATUTE ETH AND — E.L. EACH ACCIDENT $1 000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: All California Operations of the named insured as required by written contract Certificate holder Is named as additional insured per blanket policy form HG00010916 attached. CERTIFICATE HOLDER CANCELLATION Town Town f of Los Altos Hills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fremont Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Los Altos Hills CA 94022 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE , Mary Ann Sun ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 47821727 1 SPMCCLE-Cl 1 2019 Master SPMcClenahan GL/AU/EX/WC/IM I Mary Ann Sun 1 3/29/2019 11:26:31 AM (PDT) I Page 1 of 3 57UENOK3257 The insurance afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply to injury or damage with respect to which such Insured is also a named insured under another policy or would be a named insured under such policy but for its termination or the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or fonrn, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a, Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" A person or organization is an additional insured under this provision only for that period of time required by the contractor agreement. However, no such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsement Issued by us and made a part of this Coverage Part. a. Vendors Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the '°products -completed operations hazard". (t) The insurance afforded the vendor is subject to the following additional exclusions: or "property damage" that occurred before This insurance does not apply to: you acquired or formed the organization; and (a) "Bodily injury" or "property damage" for c. Coverage B does not apply to "personal and which the vendor is obligated to pay advertising injury" arising out of an offense damages by reason of the assumption committed before you acquired or formed the of liability in a contract or agreement. organization. This exclusion does not apply to . Nonowned Watercraft liability for damages that the vendor With respect to watercraft you do not. own that is would have in the absence of the teC than. 51 feet. long and Is,not..boing-used-to contractor artreerrt ent;— carry persons for a charge, any person is an (b) Any express warranty unauthorized by insured while operating such watercraft with your you; permission. Any other person or organization (c) Any physical or chemical change in the responsible for the conduct of such person is product made intentionally by the also an insured, but only with respect to liability vendor; arising out of the operation of the watercraft, and (d) Repackaging, except when unpacked only if no other insurance of any kind Is available solely for the purpose of inspection, to that person or organization forthis liability, demonstration, testing, or the However, no person or organization is an insured substitution of parts under instructions with respect to: from the manufacturer, and then a. "Bodily injury" to a co -"employee" of the repackaged in the original container; person operating the watercraft; or (e) Any failure to make such inspections, b. "Property damage" to property owned by, adjustments, tests or servicing as the rented to, in the charge of or occupied by you vendor has agreed to make or normally or the employer of any person who is an undertakes to make in the usual insured underthis provision. course of business, in connection with 5. Additional Insureds When Required By the distribution or sale of the products; Written Contract, Written Agreement Or (f) Demonstration, installation, servicing Permit or repair operations, except such The following person(s) or organization(s) are an operations performed at the vendor's additional Insured when you have agreed, in a premises in connection with the sale of written contract, written agreement or because of the product; a permit issued by a state or political subdivision, () Products which, after distribution or that such person or organization be added as an sale by you, have been labeled or additional insured on your policy, provided the relabeled or used as a container, part injury or damage occurs subsequent to the or ingredient of any other thing or execution of the contract or agreement. substance by or for the vendor; or IC91 541011111M. 47821727 1 SPMCCLE-C7. 1 2019 Master SPMcClenahan GL/AU/EX/WC/IM I Mary Ann Sun 1 3/29/2019 11:26;31 AM (PDT) I Page 2 of 3 (h) "Bodily injury" or "property damage" omissions of those acting on your behalf: arising out of the sole negligence of the (1) In connection with your premises; or vendor for its own acts or omissions or those of its employees or anyone else (2) In the performance of your ongoing acting on its behalf, However, this operations performed by you or on your exclusion does not apply to: behalf. (i) The exceptions contained in Sub- With respect to the insurance afforded these paragraphs (d) or (f); or additional insureds, the following additional exclusion applies: (ii) Such inspections, adjustments, tests or servicing as the vendor has This insurance does not apply to "bodily ""property agreed to make or normally injury"' damage" or "personal and undertakes to make in the usual advertising injury" arising out of the rendering course of business, in connection of or the failure to render any professional with the distribution or sale of the services by or far you, including: products. 1. The preparing, approving, or failing to (2) This insurance does not apply to any prepare or approve, maps, shop drawings, Insured person or organization, from opinions, reports, surveys, field orders, change orders or drawings and whom you have acquired such products, specifications; or or any ingredient, part or container, entering into, accompanying or containing 2. Supervisory, inspection, architectural or such products, engineering activities. b. lessors Of Equipment This exclusion applies even if the claims (1) Any person(s) or organization(s) from against any insured allege negligence or whom you lease equipment; but only with other wrongdoing in the supervision, hiring, respect to their liability for "bodily injury", employment, training or monitoring of others "property damage" or "personal and by that insured, if the occurrence which "bodily advertising injury" caused, in whale or in caused the injury" or "property pari, by your maintenance, operation or damage", or the offense which caused the „ use of equipment leased to you by such meetorgan t. personal and advertising injury", involved the person(s) or zated rendering of or the failure to render any professional services by or for (2) With respect to the insurance afforded to youu.._ e. permits Issued By State Or political these additional insureds this insurance Subdivisions does not apply to any occurrence" which takes place after the equipment lease An state or political subdivision, but only with Y p Y expires. respect to operations performed by you or on c. lessors Of land Or Premises your behalf for which the state or political subdivision has issued a permit. Any person or organization from whorrr you lease land or premises, but only with respect With respect to the insurance afforded these to liability arising out of the ownership, additional insureds, this insurance does not maintenance or use of that part of the land or apply to: premises leased to you. (1) "Bodily injury" "property damage" or With respect to the insurance afforded these "personal and advertising injury" arising additional insureds the following additional out of operations perforrned for the state exclusions apply: or municipality; or This insurance does not apply to: (2) "Bodily injury" or "property damage'" included within the products -completed 1. Any "occurrence" which takes place after operations hazard". you cease to lease that land; or f. Any Other Party 2. Structural alterations, new construction or Any other person or organization who is not demolition operations performed by or on an additional insured under Paragraphs a. behalf of such person or organization. through e. above, but only with respect to d. Architects, Engineers Or Surveyors liability for "bodily injury" "property damage," Any architect, engineer, or surveyor, but only or "personal and advertising injury" caused, in with respect to liability for "bodily injury", whole or in part, by your acts or omissions or "property damage" or "personal and the acts or omissions of those acting on your advertising injury" caused, in whole or in part, behalf: by your acts or omissions or the acts or (1) In the performance of your ongoing operations; HG 00 0109 16 Page 13 of 21 97821727 1 SPMCCLE-Cl 1 2019 Master SPMcClenahan GL/AU/EX/WC/IM I Mary Ann Sun 1 3/29/2019 11;26;31 AM (PDT) I Page 3 of 3 Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 Town of Los Altos Hills 26379 W. Fremont Road Los Altos Hills CA 94022 MAIL DOCUMENT Certificate of Insurance Delivery by ecertsonlineTM Attached is the requested certificate of insurance for the insured in the subject above. The certificate was created in eCertsOnline and is in PDF format. You need to have Adobe Acrobat Reader installed on your system to view the certificate. To download the Adobe Reader for free, please visit www,Adobe.com. If you have any questions on the certificate, please contact Bolton & Company at 626-799-7000. THIS MESSAGE Is INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBYNOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPHONE, AND RETURN THE __ ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions, Inc. All rights reserved.