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HomeMy WebLinkAboutFoothills De Anza CCDAICaC Rbr CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 4/6/2020 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: it 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 endorsement($). PRODUCER CONTAUT NAME: Arthur J. Gallagher & Co. PHONEAX Insurance Brokers of CA, Inc. LIC 40726293 _E_ ra. Extlh 1255 Battery Street, Suite 450 E MAIL ADDRESsc_ San Francisco CA 94111 —� INSURER(S)AFFORDING COVERAGE MAIC# INSURER A: Argonaut Insurance Company 19601 INSURED Foothill -De Anza CCD INSURER 13, — INSURER C : -- 12345 EI Monte Road INSURER D: Los Altos Hills CA 94022 X INSURER E; INSURER F: aaw111104:r_1MIa. harraIIIDIM*uakit ui IN2zazruxrer`u>;u !7 "JifLYrr l�ra;�nrrr=��a 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. IN9i_...-________._.._.,_,__..,,_.____.__.,pb 3C1� _ __.. .._..__.,,____ _._ _.. w. __.___._v_.,_.__._._,._____, ....___. __________ _.._ ^MMlDIDVYYY LTR TYPEOPINSURANCE IND WV POLICY NUMBER MM1tlpYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 4628242.08 4/1/2.020 4/1/2021 EsACHOCCURRENCE $1,000,000 X CLAIMS -MADE OCCUR DA R AGE © E G)RE ISG,9$100,000 X 51R $*, gC oo0� MED EXP (Any ane parson) -- ...._ __._._._._-__...__,. $ Mod Mal rap ct Cov___ PERSONAL & ADV INJURY _ $1,000,000 X AGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE $3,000,000 GEN'L X PNOLICY PRO EJ LOG L_1 PRODUCTS - COMP/OP AGG $1,000,000 AUTOMOBILE LIABILITY Ct9MBINEDSINGLELIMIT $ ANY AUTO _.$__._..___..._..____.._.__...__ BODILYl INJURY (Per person) OWNED SCHEDULED AUTOS ONLY AUTO5 _ BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY _ AUTOS ONLY PROPERTY DAMAGE (Pr accid;r7i)__.__..._.._n._. $ UMBRELLA LIASOCCUR EACHOCCUIIRENCE $ EXCESS LIAS CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION r AND EMPLOYERS' LIABILITY YIN f" 5TATUTE ER C LwCACH AC CIC7EN7' $ ANYPROPRIETon/13ARTNER/EXECU'I`IVENIA �j OFFICER/MEMBEREXCLUDED7 �f (Mandatory In NH) If yes; doscribe under DES RIPTION OF OPERATIONS belowC:.L. E.L. DISEASE EA EMPLOYEE — DISEASE - POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: 2019 summer youth technology program through Los Altos Hills Parks and Rec. 2020 ;LH Los Altos Hills Town Hall Parks & Rec 26379 Fremont Rd. Los Altos Hills CA 94022 ACORD 25 (2016/03) 1 Vuvry Vr LVO HL I UO f IIL.L.,,� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUFIORIZED REPRESENTATIVE � �1�, .e. JIT 01985-2015 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD 2" of 2 6461 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 1255 Battery Street #450 San Francisco, CA 94111 6461 1 AB 0.416 6461 LOS ALTOS HILLS TOWN HALL PARKS & REC 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 1"oft 6461