HomeMy WebLinkAboutO.C. McDonald Company, Inc.AcoREI CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
I TYPE OF INSURANCE
9/28/2022
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
Woodruff -Sawyer & Co.
50 California Street, Floor 12
San Francisco CA 94111
CONTACT
Chris KelleyFAX
PHONE
A/C No Ext : 415-402-6521 A/c No): 415 989-9923
E-MAIL
ADOREss: ckelley@woodruffsawyer.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA: Travelers Indemnity Company of CT
25682
10/1/2023
INSURED OCMCDON-01
O.C. McDonald Company, Inc.
P.O. Box 26560
INSURER 13: Travelers Prop Casualty Co of America
25674
INSURER C:
San Jose CA 95159-6560
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 907370742 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.
INSR
LTR
I TYPE OF INSURANCE
ADDL
SUBR
WV
POLICY NUMBER
MM DD/YEYYY
MMIDD/YYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE %� OCCUR
C09051X643
10/1/2022
10/1/2023
EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence $ 300,000
MED EXP (Any one person) $ 10,000
PERSONAL &ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JEC LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
8109047X513
10/1/2022
10/1/2023
Ea BINEDtSINGLE LIMIT $ 1,000,000
X
ANY AUTO
BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident) $
X
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident $
UMBRELLA LIAB
HOCCUR
EACH OCCURRENCE $
EXCESS LIAB
CLAIMS -MADE
AGGREGATE $
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBEREXCLUDED?
N/A
UB9049X217
10/1/2022
10/1/2023
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
(Mandatory in NH)
If yes, describe under
E.L. DISEASE- POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Work performed by the insured for certificate holder; permits/licenses.
City of Los Altos Hills
26379 Fremont Rd.
Los Altos Hills CA 94022
VMIY IiGLLF111VIY
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
G `laf5u-ZU1b ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
WOODRUFF SAWYER & COMPANY
50 CALIFORNIA ST FL 12
SAN FRANCISCO CA 94111-4646
CITY OF LOS ALTOS HILLS
26379 W FREMONT RD
LOS ALTOS HILLS CA 94022-2624