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HomeMy WebLinkAboutCertificate of Insurance (7)A� CERTIFICATE OF LIABILITY INSURANCE DATE04/02/ 021 04/02/2021 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 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER o Ext): 888-333-4949 AIc P IOVNNo : 507-446-4664 EMAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 AUTHORIZED REPRESENTATIVES �� / '/`/,y INSURED 175-357-3 INSURER B: SKYLINE LANDSCAPES, INC. 384 4TH AVE INSURER C: INSURER D: REDWOOD CITY, CA 94063-3724 INSURER E: INSURER F: cvvcrwvea GCKI IFIGAIC NUMtltH: 3 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYV LIMITS LOS ALTOS HILLS, CA 94022-2624 X COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVES �� / '/`/,y • A EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED $100,000 PREMISES En occurrence MED EXP (Any one person) EXCLUDED A Y N 9841713 04/01/2021 04/01/2022 PERSONAL& ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: PRO• LOC )ECT GENERAL AGGREGATE $2,000,000 GEN'L XPOLICY PRODUCTS • COMPIOP A00 $2,000,000 OTHER: A AUTOMOBILE LIABILITY X ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS N N 9841713 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT ccident r!! $1,000,000 Ea accident) BODILY INJURY (Per person)) BODILY INJURY (Per accident) HIRED AUTOS ONLY AUTOSNON-OWNEDLPROPERTY AUTOS ONLY DAMAGE Per accident UMURELLA LAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY .� N ANY PROPRIETORIPARTNER/EXECUTIVE OTH• PER STATUTE ER E.L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? ❑ NIA r E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE •POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) ADDITIONAL INSUREDS INCLUDE THE TOWN OF LOS ALTOS HILLS, ITS ELECTIVE AND APPOINTED OFFICERS, EMPLOYEES AND VOLUNTEERS. CERTIFICATE HOLDER CANCELLATION 175-357-3 30 TOWN OF LOS ALTOS HILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 26379 W FREMONT RD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN LOS ALTOS HILLS, CA 94022-2624 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVES �� / '/`/,y • A © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD APR 12 2021 TOWN OF LOS ALTOS HILLS