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Home My WebLink AboutMark Thomas & Company, Inc (2)AC®R®® CERTIFICATE OF LIABILITY INSURANCE 1° DATE(MMIDD/YYYY) 1 TYPE OF INSURANCE 9/14/2022 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 Asero Insurance Services 200 N. Almaden Blvd. 3rd Floor San Jose, CA 95110 NAME: Asero Insurance Services PHONEFAX /C No): 408-271-1802 /AIL Ext): 866-966-8928 AIC, E ADDRESS: Certs aseroins.com INSURERS AFFORDING COVERAGE NAIC # www.aseroins.com License No. OA91339 INSURERA: Valley Fore Insurance Company 20508 INSURED Mark Thomas & Company, Inc. INSURER B: Continental Casualty Company 20443 -INSURER C: Continental Insurance Company 35289 2833 Junction Avenue, Ste 110 San Jose CA 95134 INSURER D: National Fire Insurance Co of Hartford 20478 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 70234549 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 INSD SUER POLICY NUMBER MM/DDYY MMIDD/ YYPY LIMITS A �/ COMMERCIALGENERALLIABILITY CLAIMS -MADE ✓ OCCUR �/ �/ 6078951385 9/15/2022 9/15/2023 EACH OCCURREN NCE $1000000 DAMAGE TO RET ED PREMISES Ea occurrence $1 000 000 MED EXP (Any one person) $15,000 Deductible - None PERSONAL & ADV INJURY $1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓� JEST LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY✓ ✓ 6078951371 9/15/2022 9/15/2023 Ea accidentSINGLE LIMIT $1,000,000 ✓ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ ( ) ✓ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE Per accident $ Comp/Coll Ded: $1,000 $ C o/ UMBRELLA LAB ,/ OCCUR 6078951399 9/15/2022 9/15/2023 EACH OCCURRENCE $9,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $9.000.000 DED I I RETENTION$O Deductible - None $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? F—] NIA ✓ 6078951418 9/15/2022 9/15/2023�/ STATUTE IRH EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 A A Leased,Borrowed Or Rented Equipment Restoration of Media Coverage Valuable Papers) 6078951385 6078951385 9/15/2022 9/15/2022 7/15/2023Per Item Limit: $200,000 Per Occurrence Limit: $200,000 Limit/ Deductible: $1,000,000/$5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: CU -20107 - Town of Los Altos Hills - Sewer Inspection Town of Los Altos Hills, its officers, officials, employees and volunteers are named as additional insureds. The Workers Compensation / Employers Liability Deductible is none. %,erc i irra.m i c nvLur=r% UANI+CLLA t IUN CU -20107 Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVEn Joe Longwello y V 98t$t3-2U15 ACUKU CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 70234549 1 MARKT-1 1 22-23 Master COI I Pxabhjot Kaux 1 9/14/2022 3:19:49 PM (PDT) I Page 1 of AGENCY CUSTOMER ID: MARKT-1 LOC #: ACO A®Dll�l®NAL REMARKS SCHEDULE Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Company, Inc, 2833 Junction Avenue, Ste 110 San Jose CA 95134 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: Town of Los Altos Hills ADDRESS: 26379 Fremont Road Los Altos Hills, CA 94022 Commercial General Liability Blanket Additional Insured - Owners, Lessees Or Contractors With Products -Completed Operations Coverage Endorsement and Primary and Noncontributory Insurance as required by written contract per attached form CNA75079XX (10-16). Commercial General Liability Waiver Of Transfer Of Rights Of Recovery Against Others To The Insurer Endorsement as required by written contract per attached form CNA75008XX (10-16). Commercial Auto Liability Additional Insured - Primary And Non -Contributory as required by written contract per attached form CNA71527XX (Ed. 10/12). Commercial Auto Liability Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) as required by written contract per attached form CA 04 44 10 13. Workers' Compensation Blanket Waiver Of Our Right To Recover From Others as required by written contract per attached form G -19160-B (Ed. 11/97). *Subject To Policies Terms, Conditions,, and Exclusions ACORD 101 (2008/01) V ZUUU AGUKU GUKF'UKA I IUIV. Ali rignis reserves. The ACORD name and logo are registered marks of ACORD ATTACHMENT 70234549 1 MARKT-1 1 22-23 Master COI I Prabhjot Kaux 1 9/14/2022 3:19:49 PM (PDT) I Page 2 of 8 [�/:/ Ak I Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10-01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Policy No: 6078951385 Page 1 of 2 Endorsement No: Effective Date: 09/15/2022 Insured Name: MARK THOMAS & COMPANY, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 70234549 1 MARKT-1 1 22-23 Mastex C0I I Pxabhjot Kaux 1 9/14/2022 3:19:49 PM (PDT) I Page 3 of Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) Policy No: 6078951385 Page 2 of 2 Endorsement No: Effective Date: 09/15/2022 Insured Name: MARK THOMAS & COMPANY, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 70239599 1 MARKT-1 1 22-23 Mastex COI I Pxabhjot Kaux 1 9/19/2022 3:19:49 PM (PDT) I Page 4 of 8 IvALIA Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organizations with whom you have agreed in writing in a contract or agreement to waive any right of recovery against such person or organization, but only if the contract or agreement: 1. Is in effect or becomes effective during the term of this policy; and 2. Was executed prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products -completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008XX (10-16) Page 1 of 1 Policy No: 6078951385 Effective Date: 09/15/2022 Insured Name: MARK THOMAS & COMPANY, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 70234549 1 MARKT-1 1 22-23 Master COI I Pxabhjot Kaux 1 9/14/2022 3:19:49 PM (PDT) I Page 5 of CNA71527XX (Ed. 10/12) ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations I "Any person or organization that you are required by written contract to make an additional insured under this insurance is an "insured", but only with respect to that person or organization's legal liability for acts or omissions of a person who qualifies as an "insured" for Liability Coverage under Section II — Who Is An Insured of this Coverage Form." 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II — LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the Policy remain unchanged. CNA71527XX (10/12) Page 1 of 1 Insured Name: MARK THOMAS & COMPANY, INC. Copyright CNA All Rights Reserved. 70234549 1 MARKT-1 1 22-23 Master C0I I Prabhjot Kaur 1 9/14/2022 3:19;99 PM (PDT) I Page 6 of 8 Policy No: 6078951371 Endorsement No: Effective Date: 09/15/2022 POLICY NUMBER: 6078951371 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: MARK THOMAS & COMPANY, INC. Endorsement Effective Date: 09/15/2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have agreed in writing in a contract or agreement to waive any right of recovery against such person or organization, but only if the contract or agreement: 1. Is in effect or becomes effective during the term of this policy; and 2. Was executed prior to loss Information required to com The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization, CA 04 4410 13 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 1 70234549 1 MARKT-1 1 22-23 Master COI I Prabhjot Kaur 1 9/14/2022 3:19:49 PM (PDT) I Page 7 of 8 51A VA(Ed. 1 11/97) /97) (Ed. WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One — Workers' Compensation Insurance G. Recovery From Others and Part Two — Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. G -19160-B (Ed. 11/97) Insured Name: MARK THOMAS & COMPANY, INC. Policy No: 6078951418 Effective Date: 09/15/2022 70239599 1 MARKT-1 1 22-23 Master COI I Prabhjot Kaur 1 9/19/2022 3;19;99 PM (PDT) I Page 8 of 8 Page 1 of 1