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HomeMy WebLinkAboutCertificate of Insurance (3)il% >' CERTIFICATE OF LIABILITY INSURANCE �,,,,...-' FDATE /2022 /YYYY) 0410512022 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 MARSH USA, INC. 99 HIGH STREET BOSTON, MA 02110 CONTACT Finn Davis NAME: W N o Ext : (617) 999-7893 A/C No ADDRESS: Finn.Davis@marsh.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Insurance Co 19682 CN102891976-TTI-GAWX+-22-23 INSURED Tyler Technologies, Inc. INSURER B : Trumbull Insurance Company 27120 INSURER C : QBE Specialty Insurance Company 11515 5101 Tennyson Parkway Plano, TX 75024 INSURER D : Sentinel Insurance Company 11000 INSURER E : Hartford Casualty Insurance Company 29424 INSURER F : COVERAGES CERTIFICATE NUMBER: NYC -011256555-02 REVISION NUMRFR- 0 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 ADDL SUER POLICY NUMBER MM/DD�YY MM/DD/Y YPOLICY Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1�1 OCCUR 10 UEN DL0437 04/01/2022 04/01/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X ❑ POLICY PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 10 LIEN DI9897 04/01/2022 04/01/2023 MBINED SINGLE LIMIT (CEO, idnt $ 1,000,000 acc e_ X AINY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS Per accident ( ) BODILY INJURY $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR 10 XHU DLO102 04/01/2022 04/01/2023 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N/A 1OWBAK8AGK 04101/2023 X PER OTH- STATUTE ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 C Professional Liability 130001996 12/17/2021 12/1712022 Limit 5,000,000 Cyber Protection DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder its officers officials employees and volunteers are included as additional insureds on a primary and non-contributory basis under the general and automobile liability policies when required by written contract. Waiver of subrogation applied under the workers' compensation policy in favor of the additional insureds where required by written contract. CERTIFICATE HOLDER CANCELLATION Town of Los Altos Hills, CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Nick Pegueros THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26379 Fremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE ..��r� / ,►�r� JS'L.G"d1ZW4 C'G.�1_0 GIC. @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY MARSH USA, INC. POLICY NUMBER CARRIER AGENCY CUSTOMER ID: CN102891976 LOC #: Boston ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED Tyler Technologies, Inc. 5101 Tennyson Parkway Plano, TX 75024 EFFECTIVE DATE: HUUI I IUIVHL KtIVIHKKb THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance The Professional Liability/Cyber policies evidenced contain Self Insured Retentions to various perils covered. If you would like additional information regarding these sublimits or deductibles, please contact the insured. Excess Cyber Protection: $5,000,000 xs $5,000,000 Carrier: Munich Re Syndicate Limited Policy Number: B0509FINPY2150857 Eff/Exp dates: 12117/2021 -1211712022 Per Claim and Aggregate Limit: $5,000,000 Business Interruption: $2,500,000 Ransomware: 2,500,000 ACORD 101 (2008101) 0114.01-00-0002338-0002-0005027 Page 2 of 2 © 2008 ACORD CORPORATION. All rights I The ACORD name and logo are registered marks of ACORD 0