Loading...
HomeMy WebLinkAboutCertificate of Insurance (4)I QV ACOR" CERTIFICATE OF LIABILITY INSURANCE 6. F DATE(MMIDDIYYYY) 3/26/2021 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 policy(les) must 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 CONTACT NAME: Moira Crosby Hays Companies Inc. PHONEFAX AIC No Ext): AIC No): 133 Federal Street, 4th Floor E-MAIL ADDRESS: mcrosby@hayscompanies.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Hartford Fire Insurance Company 19682 Boston MA 02110 INSURED INSURER B: Hartford Casualty Insurance Company 29424 INSURERC:Llo ds of London Syndicates 4000 & Tyler Technologies, Inc. INSURER D: 9667 & 5101 Tennyson Parkway INSURER E : 1686 08UENAY8572 INSURER F: Plano TX 75024 COVERAGES CERTIFICATE NUMBER:21-22 GL Auto UMB WC REVISION NUMBER: THISIS 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY NUMBER POLICY EFF MMID.1YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGES(EaocTO ED 1,000,000 PREMISES PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 08UENAY8572 4/1/2021 4/1/2022 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: X POLICY PRO- JECT [7 LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ A X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS OBUENAY8572 4/1/2021 4/1/2022 BODILY INJURY (Per $ er accident) X HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,0 0, 000 B EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ 08XHUAZ8392 4/1/2021 4/1/2022 WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under N /A 08WBAK8AGK 4/1/2021 4/1/2022 E.L. DISEASE - EA EMPLOYEE $ 1, 00,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below C Cyber/Privacy Prof Liab B0621PTYLE000220 12/17/2020 12/17/2021 Primary Limit $10,000,000 C Cyber/Privacy Prof Liab B0621PTYLE000320 12/17/2020 12/17/2021 Excess Limit $10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Hills, CA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Nick Pegueros ACCORDANCE WITH THE POLICY PROVISIONS. 26379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos Hills, CA 94022 James Hays/MCROSB ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Cyber/Privacy Professional Liability Policy 4B0621PTYLE001220 Effective 12/17/2020-12/17/2021 Lloyds of London Syndicates Excess Limit $10,000,000 (Excess of Primary Cyber Policy Limit of $10,000,000 and Excess Cyber Policy Limit of $10,000,000) OFREMARK COPYRIGHT 2000, AMS SERVICES INC. 1