HomeMy WebLinkAboutCertificate of Insurance (2)'`rte ®wCERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
8/11/2020
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(ies) 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 FAX
A/C. No Ext); 949-242-9240 A/C No:
E-MAIL
ADDRESS: sypqng@risk-strategies.com
INSURERS AFFORDING COVERAGE NAIC #
www.risk-strategies.com CA DOI License No. OF06675
INSURER A: Travelers Property Casualty Cc of America 25674
INSURED
Live Oak Associates, Inc.
P.O. Box 2697
INSURER B: California Automobile Insurance Co. 38342
INSURER C: Continental Casualty Co. 20443
INSURER D:
Oakhurst CA 93644
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 01 -HER 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBR
D
POLICY NUMBER
POLICY EFF
MM%DDNYYY
LIMITS
A
�/ COMMERCIAL GENERAL LIABILITY
✓
68061-1320880
1/11/2020
1/11/2021
EACH OCCURRENCE $$2000000
CLAIMS -MADE 17/ OCCUR
DAMAGENTE
PREMISES (Ea occurrence)
.$$1,000,000
MED EXP (Any one person) $$10,000
PERSONAL & ADV INJURY $ $2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $$4,000,000
PRODUCTS - COMP/OP AGG $ $4,000,000
POLICY ✓� jE � LOC
OTHER:
B
AUTOMOBILE
LIABILITY
BA040000008393
8/7/2020
8/7/2021
COMBINED SINGLE LIMIT
Ea accident $ $1,000,000
✓
ANY AUTO
BODILY INJURY (Per person) $
OWNED SCHEDULED
BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
✓
HIRED NON -OWNED
AUTOS ONLY ✓ AUTOS ONLY
PROPERTY DAMAGE
Per accident $
A
✓
UMBRELLA LIAB ,/
OCCUR
CUP8G472200
1/11/2020
1/11/2021
EACH OCCURRENCE $$1 000000
EXCESS LIAB
CLAIMS -MADE
AGGREGATE $ $1,000,000
DED ✓ RETENTION $0
A
WORKERS COMPENSATION
U138J163720
12/1/201912/1/2020
$
AND EMPLOYERS' LIABILITY Y / N
✓ STATUTE EERH
E.L. EACH ACCIDENT $ $1 000,000
OF IC R MEMBEREXC UDED?ECUTIVE F---1
N / A
E.L. DISEASE - EA EMPLOYEE $$1,000000
(Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT I $ $1,000,000
DESCRIPTION OF OPERATIONS below
J
C
Professional Liability
EEH288344329
2/1/2020
2/1/2021
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 2495-01 La Paloma-Robleda Pathway.
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.
Town of Los Altos Hills
Attn: Steve Padovan
26379 Fremont Rd.
Los Altos Hills CA 94022
ACORD 25 (2016/03)
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
Michael Christian
v'Iauu-ZU90 AUUKU UUKPOKATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
56963222 1 20-21 GL -AL -UL -PL, 19-20 WC I Sherry Young 1 8/11/2020 6:27:22 AM (PDT) I Page 1 of 3
Live Oak Associates, Inc.
6806II3COMMERCIAL GENERAL LIABILITY
1/2020 /2
l/ / 1 11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided Linder' the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. The following is added to SECTION II — 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 riot 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
work" 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 nut 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 81 08 15 0 2015 The Travelers Indemnity Company. All rights reserved.
Includes the copyrighted material of Insurance Services Office, Inc., with its permission
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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 0 2015 The Travelers Indemnity Company, All rights reserved.
Includes the copyrighted material of Insurance Services Office, Inc., with its permission
56963222 1 20-21 GL -AL -DL -PL, 19-20 WC I Sherry Young 1 8/11/2020 6:27:22 AM (PDT) I Page 3 of 3
CG D3 81 08 15
Risk Strategies Company
2040 Main Street, Suite 450
Irvine, CA 92614
Town of Los Altos Hills
Attn: Steve Padovan
26379 Fremont Rd.
Los Altos Hills CA 94022
MAIL DOCUMENT
Certificate of Insurance Delivery by ecertsontincTM
Sender:
Sherry Young
Phone:
949-242-9240
Subject:
Cert No. 56963222 - Live Oak Associates, Inc. -
Renewal Certificate of Insurance
Date::
8/11/2020
No of Pages:
4
URI:
` www.risk-strategies.com
Attached is your renewal certificate of insurance.
If you have any questions, please email Sherry Young at syoung@risk-strategies.com.
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 ecertsonlinoTM Insurance Visions, Inc. All rights reserved.