HomeMy WebLinkAboutO.C. McDonald Company, Inc. (2)ACC)R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY)
9/28/202 wA I
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. re
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI r
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR
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
Woodruff -Sawyer & Co. PHONE Chris KelleyFAX
50 California Street, Floor 12 (AIC, No E.Q: 415-402-6521 vc No ; 415-989-9923
San Francisco CA 94111 ADDRESS: ckellevCcr)woodruffsawver.com
INSURER A: Travelers Indemnity Company of CT 25682
INSURED OCMCDON-01
O.C. McDonald Company, Inc. INSURER B: Travelers Prop Casualty Co of America 25674
P.O. Box 26560 INSURER C:
San Jose CA 95159-6560 INSURER D:
INSURER E:
COVFRAGFS RFRTIRIltATC All IM01=0- annnnonnn
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
TYPE OF INSURANCE
!'WDLSUBR
D
D
POLICY NUMBER
MMIDD/YYYY
MM/DD YYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
C09051X643
10/1/2023
10/1/2024
EACH OCCURRENCE $1,000,000
CLAIMS -MADE FRI OCCUR
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:
GENERALAGGREGATE $2,000,000
POLICY PEC D LOC
PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER:
$
A
AUTOMOBILE
LIABILITY
8109047X513_,..8
10/1/2023
10/1/2024
E° aoc deDtSINGLE LIMIT $1,000,000
X
ANY AUTO
BODILY INJURY (Per person) $
OWNED SCHEDULED
BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
X
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
PROPERTY DAMAGE $
Per accident
$
UMBRELLA LIAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE $
EXCESS LIAB
AGGREGATE $
DED RETENTION $
$
B
WORKERS COMPENSATION
UB9049X217
10/1/2023
10/1/2024
X
AND EMPLOYERS' LIABILITY Y / N
STATUTE EERH
E.L. EACH ACCIDENT $ 1,000,000
ANYPROPRIETOR/PARTNER/EXECUTIVEOFFICER/M
EREXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYEE $1,000,000
(Mandatory In
(Mandatory in NH)
If yes, describe under
E.L. DISEASE -POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / 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.
-- %IMMIL-LLH I IVItl
City of Los Altos Hills
26379 Fremont Rd.
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
v 1 UBB-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD