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HomeMy WebLinkAboutComcast (2)AGf>Rl7�CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDnYYY) 11/1912021 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 endorsement(s). PRODUCER MARSH USA INC. 1717 Arch Street Philadelphia, PA 19103-2797 Attn: Comcast.Certs@marsh,com Fax: 212-948-0360 CONTACT NAME: PHONEExtim aC No): ADDRESS: INSURERS AFFORDING COVERAGE NAIC # XSL G72480922 INSURER A: ACE American Insurance Company 22667 1210112022 INSURED COMCAST OF CALIFORNIA/OHIO/PENNSYLVANIA/ INSURER B: Indemnity Ins Co Of North America 43575 INSURER C: ACE Property And Casualty Ins Co 20699 UTAHANASHINGTON, INC. 12647 ALCOSTA BLVD., SUITE 200 P.O. BOX 5147 INSURER D: ACE Fire Underwriters Ins. Co. 20702 INSURER E: SAN RAMON, CA 94583 INSURER F : A COVERAGES CERTIFICATE NUMBER: CLE -005483718-27 REVISION Nt]MRFR- THIS IS 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X SIR: $100,000 XSL G72480922 1210112021 1210112022 EACH OCCURRENCE $ 14,900,000 AMA E TO RE TED PREMISES (Ea occurrence) $ 14,900,000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 14,900,000 GENT AGGREGATE LIMIT APPLIES PER: X PRO - POLICY ❑ JECTPRO' ❑ LOC OTHER: GENERAL AGGREGATE $ 60,000,000 PRODUCTS - COMP/OP AGG $ 15,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY r — ISA H25542964 1210112021 12/01/2022 COMBINED SINGLE LIMIT $ 15,000,000 Ea accident BODILY INJURY (Per person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE $ Per accident $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XEU G27924840 007 12/01/2021 12/01/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I I RETENTION $ $ B A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY v / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WLR C68917943 (AOS) WLR 068917980 CA, MA ( ) SCF I �) 12101/2021 12101/2021 210112022 12/0112022 1210112022 X SEATUTE ERH E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 A Excess Workers Compensation WCU 068918029 (WA) 12/01/2021 12/01/2022 Ea ACC/Drs Employee/Dis Polic 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) TOWN OF LOS ALTOS HILLS ATTN: CITY MANAGER 26379 FREEMONT ROAD LOS ALTOS HILLS, CA 94022 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 ""cam W.5711-0 49"e. ©1988-2016 ACORD CORPORATION- All rinhfn rasaruaA ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD