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HomeMy WebLinkAboutCertificate of Insurance (7).ACV'r`" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 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 & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 www.boltonco.com 0008309 CONTACT PHONE FAX Ext 626 799-7000 (A/C NoI: (626) 583-2117 E -MA Lo ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURERA: Twin City Fire Insurance Company 29459 INSURED S. r trader aRo Company 1 Arastradero Road Portola Valley, CA 94028 INSURER B: Hartford Fire Insurance Company 19682 INSURERC: Hartford CasualtyInsurance Company 29424 INSURER D: Redwood Fire and Casualty Insurance Co 11673 INSURER E: INSURER F: 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. T INS§ LTR TYPE OF INSURANCE ADDL INSD SUER WVD I POLICYNUMBER POLICY EFF MM/DD/YYYYI POLICY EXP (MM/DDIYYYYI LIMITS A / GEN'L COMMERCIAL GENERAL LIABILITY ] CLAIMS -MADE ❑✓ OCCUR ✓ 57UENOK3257 4/1/2019 4/1/2020 EACH OCCURRENCE $ 1 000 000 D ET R ED PREMISES (Ea occurrence) $ 300 000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY Z PE F—] LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2000000 Arborist&Landsca er P "$1,000,000 B AUTOMOBILE ✓ LIABILITY ANY A] iT0 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 57UUNSR5675 4/1/2019 4/1/2020 Ee aBINEDtSINGLE LIMIT $1 000 000 BODILY INJURY -'Pei i Pcrsoii) $ RY BODILY INJU (Par accident) $ PROPERTY DAMAGE Per accident $ $ C ✓ UMBRELLALIAB 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 AND EMPLOYERS' LIABILITY Y/ N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? RN/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below SPWC031766 4/1/2019 4/1/2020 ✓ STATUTE EERH E.L. EACH ACCIDENT $1 ,000,QQQ E.L, DISEASE - EA EMPLOYEE $1 rinn OQ E.L. DISEASE- POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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 H000010916 attached. Town of Los Altos Hills 26379 W. Fremont Road Los Altos Hills CA 94022 ACORD 25 (2016/03) ter..1. 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE r w, Mary Ann Sun d' v'IUt5u-LU10AGVKUcUKPVKA[ION. All rights reserved. The ACORD name and logo are registered marks of ACORD 47821727 1 SPMCCLE-C1 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 A person or organization is an additional insured subsidiary not named in this Coverage Part under this provision only for that period of time as a named insured does not apply to injury required by the contract or agreement, or damage with respect to which such Insured However, no such person or organization is an is also a named insured under another policy insured under this provision if such person or or would be a named insured ander such organization is included as an insured by an policy but for its termination or the exhaustion endorsement issued by us and made a part of of its limits of insurance. this Coverage Part. 3. Newly Acquired Or Formed Organization a. Venders Any organization you newly acquire or forrn, Any person(s) or organization(s) (referred to other than a partnership, joint venture or limited below as vendor), but only with respect to liabilityandover whichyou yai "bodily injury" or ""property damage" arising Interest of of thenoain votingfinanci out of your products which are distributed or stock, will qualify as a Named Insured if there is sold in the regular course of the vendor's no other similar insurance available to that business and only if this Coverage Part organization. However, provides coverage for "bodily injury" or a. Coverage under this provision is afforded only "property damage" included within the until the 180th day after you acquire or form "products -completed operations hazard". the organization or the end of the policy (1) The insurance afforded the vendor is period, whichever is earlier; subject to the following additional b, Coverage A does not apply to "bodily injury" 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 e. Coverage does rat apply " pp y 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 4. 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 IrC than 51 feet long and is, not being used to contract or agreement; 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 to that person or organization forthis liability, solely for the purpose of inspection, 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 . 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, (g) 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 Page 12 of 21 HG 00 01 05 16 97621727 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 2 of 3 (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub- paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessers Of Equipment (1) Any person(s) or organization(s) from whom you lease equipment; but only with respect to their liability for "bodily injury" "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) With respect to the insurance afforded to these additional insureds this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. c. Lessors Of Land Or premises Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. With respect to the insurance afforded these additional Insureds the following additional exclusions apply: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to lease that land; or 2. Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury" "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or c3� omissions of those acting on your behalf: (1) In connection with your premises; or (2) in the performance of your ongoing operations performed by you or on your behalf. With respect to the insurance afforded these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury" "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury" involved the rendering of or the failure to render any professional services by or for you, e. permits Issued By State Or political Subdivisions Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. With respect to the insurance afforded these additional insureds, this insurance does not apply to: (1) "Bodily injury" "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard", Any Other party Any other person or organization who is not an additional insured under Paragraphs a. through e, above, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations; 97821727 1 SPMCCLE-C1 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 ecertsonlinerm 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 HEREBY NOTIFIED 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 ecertsonllneTM Insurance Visions, Inc. All rights reserved.