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Home My WebLink AboutComcast (14)® CERTIFI( XTE OF LIABILITY Ill ANCE DATE 11/20//20142014 /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 pol,icy(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). PRODUCERp� 11 MARSH USA INC. NM 1717 Arch Street Philadelphia, PA 19103-2797 Attn: Comcast,Certs@marsh.com Fax: 212-948-0360 CONTACT Mft FAX A ColdA/C No): E-MAIL ADDRESS: of Marsh USA Inc. XSLG27340313 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 22667 05194 -ALL--14-15 COMCA CONCO CA NO NO INSURED COMCAST OF CALIFORNIA/OHIO/PENNSYLVANIA/ UTAHMASHINGTON, INC. INSURER B: Indemnity Ins Cc Of North America 43575 INSURER C: ACE Property And Casualty Ins Co 20699 INSURER D: GENERAL AGGREGATE 12647 ALCOSTA BLVD., SUITE 200 P.O. BOX 5147 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG SAN RAMON, CA 94583 INSURER E: $ INSURER F: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COVERAGES CERTIFICATE NUMBER: CLE -003249295-18 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 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 MM/DDnEYY MM/DD/YYEXP Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX1 OCCUR X SIR: $100,000 of Marsh USA Inc. XSLG27340313 12101/2014 12/01/2015 EACH OCCURRENCE $ 4,900,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 4,900,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 4,900,000 GENERAL AGGREGATE $ 25,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 6,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ISAH08830502 12101/2014 12/01/2015 COMBINED SINGLE LIMIT Ea accident) 5,000,000 X BODILY INJURY (Per person) _ $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ C X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE X00 G27636895 12/01/2014 12/01/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MA (Mandatory in H) EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLRC48140087 (AOS) WLRC48140105 (CA, MA) SCFC48140129 WI ( ) 12101/2014 1210112014 12101/2014 12/01/2015 12/0112015 12/01/2015 X T WC STATU- I OTH- 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 WCUC48140130 (WA) 12/01/2014 12101/2015 Ea Acc/Dis Employee/Dis Policy 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CERTIFICATE HOLDER CANCELLATION TOWN OF LOS ALTOS HILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: CITY MANAGER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26379 FREEMONT ROAD ACCORDANCE WITH THE POLICY PROVISIONS. LOS ALTOS HILLS, CA 94022 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjeesrsck:+G� @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD /y.Cq,,,,I�%\" C E RT I F I` X 1 E OF LIABILITY 11 N V it A N V E DATE 11/20/2014 /2014 YYY Y) 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 ADDITION ALINSURED, 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 2 c.;.20 MARSH USA INC. U 1717 Arch Street Philadelphia, PA 19103-2797 Attn: Comcast,Certs@marsh.com Fax: 212-948-0360 CONTACT NAME' PHONE /C N o t A/C No): E-MAIL ADDRESS: XSLG27340313 12/01/2014 INSURERS AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 22667 05194 -ALL--14-15 COMCA SAN RA CA INSURED COMCAST OF CALIFORNIA/OHIO/PENNSYLVANIA/ UTAHANASHINGTON, INC. INSURER B: Indemnity Ins Co Of North America 43575 INSURER C : ACE Property And Casualty Ins Co 20699 INSURER D; 12647 ALCOSTA BLVD., SUITE 200 P.O. BOX 5147 INSURER E: SAN RAMON, CA 94583 INSURER F: A COVERAGES CERTIFICATE NUMBER: CLE -003246441-16 REVISION NUMHFR- 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. ILTR TYPE OF INSURANCE ADDL SWVD UBR POLICY NUMBER MM% POLID YYYY MY EFF M/DD/YYYCY Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR X SIR: $100,000 XSLG27340313 12/01/2014 12/01/2015 EACH OCCURRENCE $ 4,900,000 DAMAGE TO RENTED 4,900,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 4,900,000 GENERAL AGGREGATE $ 25,000,000 GENT AGGREGATE LIMIT APPLIES PER: [E POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 6,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ISAH08830502 12/01/2014 12101/2015 COMBINED SINGLE LIMIT 5,000,000 Ea accident $ X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ P OPER entDAMAGE $ C X UMBRELLA LIABX EXCESS LIAB OCCUR CLAIMS -MADE X00 G27636895 12/01/2014 12/01/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I I RETENTION $ $ B A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N �OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLRC48140087 (AOS) WLRC48140105 (CA, MA) SCFC48140129 (WI) 12/01/2014 12/01/2014 12/01/2014 12/01/2015 12/01/2015 12/01/2015 X I WC STATU- OTH- DRY LIMI ER 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 CompensationWCUC48140130 (WA) 12/01/2014 12/01/2015 Ea Acc/Dis Employee/Dis Policy 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CERTIFICATE HOLDER CANCFI_I_ATION TOWN OF LOS ALTOS HILLS, CALIFORNIA ATTN: CITY MANAGER 26379 FREEMONT ROAD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. LOS ALTOS HILLS, CA 94022 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjeew,� @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD