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HomeMy WebLinkAboutCertificate of InsuranceACOR®® CERTIFICATE OF LIABILITY INSURANCE `,... DATE (MM/DD/YYYY) ►� 3/18/2022 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 Risk Strategies Company CONTACT NAME: Risk Strategies Com an 2040 Main Street, Suite 450 Irvine, CA 92614 PHONE Ex : 949-242-9240 a No E-MAIL ADDRESS: syounq@risk-strategies.com INSURERS AFFORDING COVERAGE NAIC# DAMAGE TO RENTED PREMISES Ea occurrence)$$1,000,000 INSURER A: Travelers Indemnity Cc of Connecticut 25682 www.risk-strategies.com CA DOI License No.OF06675 INSURED Live Oak Associates, Inc. P.O. Box 2697 INSURER B: California Automobile Insurance Co. 38342 INSURERC: Travelers Property Casualty Cc of America 25674 INSURER D: Continental Casualty Company 20443 Oakhurst CA 93644 INSURER E: AUTOMOBILE ✓ ✓ INSURER F: COVERAGES CERTIFICATE NUMBER: 67272725 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER MM/DD/YYYY MMDD/YYYY LIMITS A �/ COMMERCIALGENERALLIABILITY CLAIMS -MADE OCCUR ✓ ✓ 68061-1320880 1/11/2022 1/11/2023 EACH OCCURRENCE $$2000000 DAMAGE TO RENTED PREMISES Ea occurrence)$$1,000,000 MED EXP (Any one person) $$10,000 PERSONAL & ADV INJURY $$2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓Z JEST D LOC OTHER: GENERALAGGREGATE $$4,000,000 PRODUCTS - COMP/OP AGO $$4,000,000 $ B AUTOMOBILE ✓ ✓ LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS -OWNED AUTOS NLY HIRED NON AUTOS ONLY IV BA040000008393 8/7/2021 8/7/2022 Ea BINEDaccIdentSINGLE LIMIT 41,000,000 BODILY INJURY (Per person) $ BODILY INJURYPer accident $ ( ) Perr accidenDAMAGE $ C ✓ UMBRELLA LIAB EXCESS LIAR �/ OCCUR CLAIMS -MADE CUP8G472200 1/11/2022 1/11/2023 EACH OCCURRENCE $$1 000000 AGGREGATE $$1,000,000 DED 1 ✓ 1 RETENTION 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A UB8J163720 12/1/2021 12/1/2022 STATUTE ERH E.L. EACH ACCIDENT $$1,000,000 E.L. DISEASE - EA EMPLOYEE $ j 000,000 E.L. DISEASE - POLICY LIMIT $$1.000,000 D Professional Liability EEH288344329 2/1/2022 2/1/2023 Per Claim: $1,000,000 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Projects as on file with the insured including but not limited to 2495-02 La Paloma-Robleda Path. The Town of Los Altos Hills, its elective and appointed officers, employees and volunteers are named as additional insureds on the general liability policy -see attached endorsement. CERTIFICATE HOLDER CANCELLATION Town of Los Altos Hills Attn: Steve Padovan 26379 Fremont Rd. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills CA 94022 AUTHORIZED REPRESENTATIVE RSC Insurance Brokera e. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 67272725 1 22-23 GL -UL -PL, 21-22 AL -WC I Sherry Young 1 3/18/2022 4:07:49 PM (PDT) I Page 1 of 3 Insured: Live Oak Associates, Inc. Policy No. : 68061-1320880 Effective Date:1/11/2022 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION 11 — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury" "property damage" or "personal injury'; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization; or d. For "bodily injury""property damage" or "personal injury" for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your wont" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 8109 1$ 0 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material or Insurance Services Office, Inc., with its permission 67272725 1 22-23 GL -UL -PL, 21-22 AL -WC I Sherry Young 1 3/18/2022 9:07:99 PM (PDT) I Page 2 of 3 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury' offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission 67272725 1 22-23 GL -UL -PL, 21-22 AL -WC I Sherry Young 1 3/18/2022 4:07:49 PM (PDT) I Page 3 of 3 CG D3 81 0815