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HomeMy WebLinkAboutCertificate of Insurance (5)ACOR& CERTIFICATE OF LIABILITY INSURANCE73/31/2020 �� E(MM/DD/YYYY) 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 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 NAME: Moira Crosby Hays Companies Inc. PHONE FAX AIC No Ext : A/C No): 133 Federal Street, 4th Floor E-MAIL ADDRESS: mcrosby@hayscompanies.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Insurance Company 19682 Boston MA 02110 INSURED INSURER B: Hartford Casualty Insurance Company 29424 INSURERC:Llo ds of London Syndicates 048337 & Tyler Technologies, Inc. INSURER D: 048945 5101 Tennyson Parkway INSURER E : OBUENAYB572 Plano TX 75024 INSURER F: UL)VERAGE5 CERTIFICATE NUMBER:20-21 GL Auto WC REVISION NUMBER: 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 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. ITR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MM/DD/YYYY POLICY Y MMIDD/YYYPOLICY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEXOCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 OBUENAYB572 4/1/2020 4/1/2021 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIESPER: X POLICY ❑ PROJECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 BODILY INJURY (Per person) $ A X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS OBUENAY8572 4/1/2020 4/1/2021 BODILY INJURY (Per accident) $ X HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25 000,000 AGGREGATE $ 25, 000, 000 B EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ 08XHUAZ8392 4/1/2020 4/1/2021 WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N X STATUTE OERH AND E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, doscribo under NIA OBWEELS271 4/1/2020 4/1/2021 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below C Cyber Privacy Prof Liab B0621PTYLE000219 12/17/2019 12/17/2020 Limit $20,000,000 C Cyber Privacy Prof Liab B0621PTYLE000319 12/17/2019 12/17/2020 Excess Limit $10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD