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HomeMy WebLinkAboutCertificate of InsuranceAte'®RL> CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 4/4/2019 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 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 CONTACT NAME: Vicki Dixon HAUSERPHONE 5905 E. Galbraith Rd Suite 9000 513-745-9200 Alc Nol: 513-745-9129 E-MAIL ADDRESS: vdixon@thehausergroup.com Cincinnati OH 45236 INSURERS AFFORDING COVERAGE NAIC # 3/1/2020 INSURER A: Ohio Security Insurance Company 24082 INSURED MANAG-2 INSURER B: American Fire and Casualty 24066 Management Partners, Inc. 1730 Madison Road INSURER C: The Ohio Casualty Insurance Company 24074 -INSURER D: Continental Casualty Company 20443 Cincinnati OH 45206 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 436553063 REVISION NUMBER: 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. INSRCY LTR TYPE OF INSURANCE ADDL &UR SUER 28a POLICY NUMBER MM/DID/YYW EXP MFF MIDDIIYYYY LIMITS A GENERAL LIABILITY BKS67826057 3/1/2019 3/1/2020 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rx-1 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 _ MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 OHIO STOP GAP $1,000,000 X POLICY PRO LOC B AUTOMOBILE LIABILITY BAA57826057 3/1/2019 3/1/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X AUTO-SWNED ROPERTY (Per accident) DAMAGE $ $ C X UMBRELLA LAB X OCCUR US057826057 3/1/2019 3/1/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 0 Retention $ 0 A WORKERS COMPENSATION XWS57826057 3/1/2019 3/1/2020 X WC STATUITORYLI- JOTH, MIT I ER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $1,000,000 ANY OFFICER/MEMBER EXCLUDED'XECUTIVE � N / A E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 D Mgmt. Prof. Liability 596801719 3/1/2019 3/1/2020 Mgment Liab Profess. See Below Deductible Deductible $10,000 Property Liability Special Form/all Risk DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Umbrella Policy follows form to the General Liability and Auto Liability Policies Professional Liability (E&O): policy limit is $2M per claim/ $2M aggregate The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers are shown as an additional insured(s) solely with respect to general liability and auto liability coverages as evidenced herein as required by written contract with respect to work performed by the named insured(s). CERTIFICATE HOLDER CANCELLATION 3n rinvs axcant 10 days nnn nnvmant ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Los Altos Hills 26379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos Hills CA 94022} ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD