The URL can be used to link to this page

Home My WebLink AboutMP Nexlevel of California, Inc.Page l of 2 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) IMr.Y..o+ 1 08/17/2021 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 poilcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terins 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 Willis Towers Watson Midwest, Ina, o/0 26 Century Blvd P.O. Box 305191 Nashville, TN .372305191 USA CANTCT Willis Towers Watson Certificate Center NSE' PHONE 1-877-545-7378 FAX 1-888-467-2378 (A/C No B'xt1 I (A/C Not EMAIL aertificatesewillis.com DD _ESS• �IN$UFIER(S)AFFORDINGCOVERAgE NAICk iNSURERA: Greenwich Insurance Company 22322 INSURED MP Nexlavel of California, Tna. 500 County Road 37 East INSURERB: 2L Insurance America Inc 24594 INSURERC: XL Specialty Insurance Company 87'888 Maple Lake, NN 55358 INSUREFit7_ RSVI Indemnity Company 22314 INSURERS: Zurich American Insurance Company 16535 I $URERF: 500,000 TH11§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 14EREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _,_..___.. _.....___, _.__.-_... ...�_•..._,_...._ A"blai'CRtTI#,f� .._, _ __._._.. ry µry INSFi �� TYPE OF LTR INSURANCE PC ICY NUMBER DD YYYY 11M DU YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 N I DANIAGE PIiEM15E1�L%LLiagnca 500,000 CLAIMS -MADE mX OCCUR I A MED EXP An ane arson) 25,000 .PERSONAL .& ADV INJURY $ 2,000,000 Y CGD740933707 08/31/2021 08/31/2022 AGGREGATE LIMIT APPLIES' PER: GENERAL AGGREGATE $ 4,000 000 GEN'L POLICY " LOC v5 H JEGGr I I PRODUCTS • COMP/OP AGO 4, 000 000 $ OTHER: AUTOMOBILE LIABILITY COMBINEDSI G EWMIT _LCcwic {lent)w._ 3, 000, 0tl0 x ANY AUTO _ _ BODILY INJURY (Par _ __•_..._ A OWNED SCHEDULED AUTOS ONLY AUTOS X CAD740926908 08/31/2021 08/31/2022 BODILYINJURY(Peraccidont) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAOE _d!��r g44�5t�?I?I):_ $ $ H -- UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 X EXCESS LIAO C------ MADE ( US00035056LI21A 08/31/2021 08/31/2022 AGGREGATE —� 5,000,000 DED X RETENTION$ 0 WORKERS COMPENSATION X PE T STEATUTE AND EMPLOYERS' LIABILITY Y / N I I � ER E.l. EACH ACCIIILNT _.._... $ 1,000,000 C ANYPROPRIETOfI/PARTNER/EXECUI'IVE OFFICCWMEMBEREXCLUDED? No NIAi CM740927108 08/31/2021 08/31/2022 (Mandatary In NF1) ii es, describe under E.4. DISEASE. PA EMPLOYEE — 000 $ 1,000,000 _ DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1, 000, 000 C Workers Compensation/ CWD740926708 08/31/2021 08/31/2022 81.L. ash Accident $1,000,000 Employers Liability E.L. Disease—Ma Smpl $1,000,000 Per Statute E.L. Disease -pal Lmt $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLE$ (ACORD 101, Additional Remarks Schedule, may be attached if more speco is required) SEE ATTACHED 'town of Loa Altos Hills 26379 Fremont Road Los Alton Hills, CA 94022 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 11111041141'`" 01988.2016 ACORD CORPORATION, All rights reserved. Auvrsu zo (zU101UJ) me A(;UHL) name and logo are registered marks of ACORD Ott ZD: 21469680 HATCH, 2204899 2 of 2 3279 AGENCY Willis Towers Watson Midwest, Inc. POLICY NUMBER See Page I CARRIER See Page I AGENCY CUSTOMER ID: LOC #. ADDITIONAL REMARKS SCHEDULE NAMED INSURED Mr Nexlevel or California, Inc. 500 County Road 37 Eaot Maple Lake, MN 55358 NAIL CODE See Page I IlFiCTIVEDATE: See Page I Page 2 Of 2 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER' 25 FORM TITLE: Seqj.fjoate of Liability Insurance__ The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers are included as Additional Insureds as respects to General Liability and Auto Liability as required by written contract. INSURER AFFORDING COVERAGE: RSUI Indemnity Company NAIC#: 22314 POLICY NUMBER: NUA095086 EPP DATE: 08/31/2021 EXP DATE; 08/31/2022 ADDITIONAL INSURED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Auto Liability Each Oco or Accident $2,000,000 Aggregate $2,000,000 �INSURER "FORDING COVERAGE: Zurich American Insurance Company POLICY NUMBER: CPP0084169-06 EFL" DATE: 05/01/2021 gXp DATE: 05/01/2022 TYPE OF INSURANCE: Leased/Rented Equipment LIMIT DESCRIPTION: LIMIT AMOUNT: Any One Item/For 000 $1,000,000 nc 9nnR ACORD The ACORD name and logo are registered marks of ACORD SR ID: 21469680 BATCH- 2204899 CERT: W21825742 NAIC#: 16535 ,TION. All rights reserved.