HomeMy WebLinkAboutIzmirian Roofing & Sheet MetalA ® -
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
10/3/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. R, 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 - CONTACT
Arthur J. Gallagher & Co. NAME: Certificate Department
PHONE
Insurance Brokers of CA, Inc. LIC #0726293 ac a Extl: 925-299-1112 �AA/C, NoL925-953-6270
2121 N. California Blvd., Suite 350 E-MAIL
Walnut Creek CA 94596 ADDREss: CertReyuests@ajg,com
INSURED
Izmirian Roofing & Sheet Metal
229 S. Railroad Avenue
San Mateo, CA 94401-3339
A:
Rd
23140
11673
INSURERS
- - INSURER F
OVERAGES CERTIFICATE NUMBER. 630837099 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:_
TR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP- `--`--"—"'--
POLICYNUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
A
TC07MMERCIAL GENERAL LIABILITY AES104895005 10/1/2022 10/1/2023�� EACH OCCURRENCE $
LAIMS-MADE - i OCCUR DAMAGE 0 R TED I`
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? N/A
(Mandatory In NH)
If Ves, describe under
BA040000062222
IZWC311349
10/1/2022
10/1/2022
A /PER OCC_
$ 5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
$1,000,000
POLICY X 1 JECT
E]
PRODUCTS - COMP/OP AGG
$ 2,000,000
LOC
OTHER:
COMBINEDSINGLELIMIT
_1Eaaccident___
C
AUTOMOBILE LIABILITY
$
X
ANY AUTO
$
PROPERTYDAMAGC
(Per acr.Ident)
OWNED
SCHEDULED
AUTOS ONLY
AUTOS
X
HIRED
X
NON -OWNED
AUTOS ONLY
_
AUTOS ONLY
UMBRELLALIAO
OCCUfl
EXCESS LIAR
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? N/A
(Mandatory In NH)
If Ves, describe under
BA040000062222
IZWC311349
10/1/2022
10/1/2022
AGGREGATE_T $
10!1/2023 X STb_ -�q
E.L. EACH ACCIDENT $ 1
E.L. DISEASE_- EA EMPLOYEE $1
E.L. DISEASE - POLICY LIMIT S 1
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
RE: Evidence of Coverage
TE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town Of LOS Altos Hills ACCORDANCE WITH THE POLICY PROVISIONS.
26379 W Fremont Rd.
Los Altos Hills CA 94022-2624 AUTHORIZED REPRESENTATIVE
USA,.k,
O 19882015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
MED _EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY_i
$1,000,000
GENERALAGGREGATE
$2,OQO,p00
PRODUCTS - COMP/OP AGG
$ 2,000,000
1.0/1/2023
COMBINEDSINGLELIMIT
_1Eaaccident___
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTYDAMAGC
(Per acr.Ident)
--`
$
AGGREGATE_T $
10!1/2023 X STb_ -�q
E.L. EACH ACCIDENT $ 1
E.L. DISEASE_- EA EMPLOYEE $1
E.L. DISEASE - POLICY LIMIT S 1
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
RE: Evidence of Coverage
TE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town Of LOS Altos Hills ACCORDANCE WITH THE POLICY PROVISIONS.
26379 W Fremont Rd.
Los Altos Hills CA 94022-2624 AUTHORIZED REPRESENTATIVE
USA,.k,
O 19882015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD