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HomeMy WebLinkAboutTree Solutions (13)To: CONTRACTOR From: Town of Los Altos Hills Re: Agreement Transmittal Memo W Enclosed, please find the following documents: AGREEMENT — If you require a fully executed, signed original of the Agreement for your records, please photocopy the Agreement prior to signing the enclosed document. Return both originals with your signature to the Town and a fully executed Agreement will be returned. IRS FORM W-9 — Request for Taxpayer Identification Number (TIN) and Certification. This form is required for all vendors of the Town and it is important that you provide the Town with the correct TIN. If your company is a: Sole Proprietorship - The taxpayer identification number must be the social security number of the sole proprietor. Partnerships or Corporations —The taxpayer identification number must be the employer identification number issued to the partnership or corporation. Once all documents have been completed, please return the signed Agreement(s) and IRS Form W-9 to the following address: Town of Los Altos Hills Contracts 26379 Fremont Road Los Altos Hills, CA 94022 AGREEMENT THIS AGREEMENT is made and entered into on the day of October, 2424 by and between the TOWN OF LOS ALTOS HILLS (hereinafter referred to as "TOWN") and Tree Solutions (hereinafter referred to as "CONTRACTOR"). In consideration of their mutual covenants, the parties hereto agree as follows: 1. CONTRACTOR. Shall provide or furnish the following specified services and/or materials: Sudden Oak Death (SOD) Prevention service at the Byme Preserve Location which involves treating 238 tree trunks. 2. EXHIBITS. The following attached exhibits are hereby incorporated into and made a part of this Agreement: EXHIBIT A — Bid proposal from CONTRACTOR dated October 3, 2024 3. TERMS. The services and/or materials furnished under this Agreement shall commence October 31, 2022 and shall be completed by December 31, 2022, unless terminated pursuant to Section 5(f). 4. COMPENSATION. For the full performance of this Agreement: a. TOWN shall pay CONTRACTOR an amount not to exceed nine thousand seven hundred forty-six dollars and zero cents ($3,746.00) within thirty (30) days following receipt of invoice and completion/delivery of services/goods as detailed in Sections 1, 2, and 3 of this Agreement and only upon satisfactory delivery/completion of goods/services in a manner consistent with professional/industry standards for the area in which CONTRACTOR operates. TOWN is not responsible for paying for any work done by CONTRACTOR or any subcontractor above and beyond the not to exceed amount. b. Town shall not reimburse for any of CONTRACTOR's costs or expenses to deliver any services/goods. Town shall not be responsible for any interest or late charges on any payments from Town to CONTRACTOR. c. CONTRACTOR is responsible for monitoring its own forces/employees/agents/ subcontractors to ensure delivery of goods/services within the terms of this Agreement. TOWN will not accept or compensate CONTRACTOR for incomplete goods/services. Town of Los Altos Hills Page 1 of 5 snot f" Updated QW22 5. GENERAL TERMS AND CONDITIONS. a. HOLD HARMLESS. CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of personal injury (including death) and property damage of any nature, caused by or arising out of the performance of CONTRACTOR under this Agreement. With regard to CONTRACTOR'S work product, CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of any nature to the extent caused by the negligent performance of CONTRACTOR under this Agreement. b. INSURANCE. CONTRACTOR shall file with the TOWN a certificate of insurance before commencing any services under this Agreement as follows: WORKERS COMPENSATION INSURANCE: Minimum statutory limits. COMMERCIAL GENERAL LIABILITY AND PROPERTY DAMAGE INSURANCE: General Liability and Property Damage Combined. $1,000,000.00 per occurrence including comprehensive form, personal injury, broad form personal damage, contractual and premisesloperation, all on an occurrence basis. If an aggregate limit exists, it shall apply separately or be no less than two (2) times the occurrence limit. iii. AUTOMOBILE INSURANCE: $1,000,000.00 per occurrence. iv. ERRORS AND OMISSIONS INSURANCE: $1,000,000.00 aggregate. v. NOTICE OF CANCELLATION: The City requires 30 days written notice of cancellation. Additionally, the notice statement on the certificate should not include the wording "endeavor to" or "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives." vi. CERTIFICATE OF INSURANCE: Prior to commencement of services, evidence of insurance coverage must be shown by a property executed certificate of insurance and it shall name "The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers" as additional insureds. vii. To prevent delay and ensure compliance with this Agreement, the insurance certificates and endorsements must be submitted to: Town of Los PJtos Hills Page 2 of 5 ShW form Updated 4r9M Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 c. NON-DISCRIMINATION. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national origin, age, ancestry, religion or sex of such person. d. INTEREST OF CONTRACTOR. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the TOWN and CONTRACTOR. At all times CONTRACTOR shall be an independent contractor and CONTRACTOR is not authorized to bind the TOWN to any contracts or other obligations without the express written consent of the TOWN. In executing this Agreement, CONTRACTOR certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of TOWN. e. CHANGES. This Agreement shall not be assigned or transferred without advance written consent of the TOWN. No changes or variations of any kind are authorized without the written consent of the City Manager. This Agreement may only be amended by a written instrument signed by both parties. f. TERMINATION. This Agreement may be terminated by TOWN upon seven (7) days written notice to CONTRACTOR. Monies owed for work satisfactorily completed shall be paid to CONTRACTOR within 14 days of termination. g. RECORDS. All reports, data, maps, models, charts, studies, surveys, calculations, photographs, memoranda, plans, studies, specifications, records, files, or any other documents or materials, in electronic or any other form, that are prepared or obtained pursuant to this Agreement and that relate to the matters covered hereunder shall be the property of the TOWN. CONTRACTOR hereby agrees to deliver those documents to the TOWN at any time upon demand of the TOWN. It is understood and agreed that the documents and other materials, including but not limited to those described above, prepared pursuant to this Agreement are prepared specifically for the TOWN and are not necessarily suitable for any future or other use. Failure by CONTRACTOR to deliver these documents to the TOWN within a reasonable time period or as specified by the TOWN shall be a material breach of this Agreement. TOWN and CONTRACTOR agree that until final approval by TOWN, all data, plans, specifications, reports and other documents are preliminary drafts not kept by the TOWN in the `Ordinary course of business and will not be disclosed to third parties without prior written consent of both parties. All work products submitted to the TOWN pursuant to this Agreement shall be deemed a "work for hire.n Upon submission of any work for hire pursuant to this Agreement, and acceptance by the TOWN as complete, non- exclusive title to copyright of said work for hire shall transfer to the TOWN. The compensation recited in Section 4 shall be deemed to be sufficient consideration Town of Los Altos Hills Page 3 of 5 Short form Updated 4126!22 for said transfer of copyright. CONTRACTOR retains the right to use any project records, documents and materials for marketing of their professional services. h. CONTRACT ADMINISTRATION. The TOWN hereby designates the Utility Engineering Manager and the City Manager as Contract Administrator for this agreement. The CONTRACTOR shall only take direction regarding the services provided under this Agreement from the Contract Administrator. Furthermore, CONTRACTOR agrees that the Contract Administrator shall be included any meeting, teleconference or written communication between any Town representative including Committee members and the CONTRACTOR. The TOWN may modify the Contract Administrator at any time upon providing written notice to the CONTRACTOR. i. ENTIRE AGREEMENT. This Agreement represents the entire agreement between the Parties. Any ambiguities or disputed terms between this Agreement and any attached Exhibits shall be interpreted according to the language in this Agreement and not the Exhibits. 6. INVOICING. Send all invoices to the contract coordinator at the address below. This Agreement shall become effective upon its approval and execution by TOWN. In witness whereof, the parties have executed this Agreement the day and year first written above. CONTRACT COORDINATOR and representative for TOWN: Melissa Elian Assistant Engineer Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 Town of Los Altos Hills Short form Updated 428!22 CONTRACTOR: By: 4 *-. ignature Date 3cNme-5 NC -4c%, Print name, Title TOWN O O TOS HIL S: By: �� •2J.Z Peter Pirneja ity Manager Date Page 4 of 5 TREE SOLUTIONS October 3, 2024 Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 RE: Byrne Preserve Annual SOD (Sudden Oak Death) Prevention Treatment Fall 2024 Proposal Tree Solutions, Inc. will perform the Sudden Oak Death (SCID) prevention service at the Byrne Preserve location on Thursday, October 315' and Friday, November 1 SZ. The cost for thus said service is $9,746.00 which involves treating —238 tree trunks selected for treatment based on criteria previously established. Re s, Debb'e Crivelli debbie@treesolutions.com 831-425-1833 631-247-1696 www.treesolutions.com Form Ww9 I Request for Taxpayer Clive form to the (Rev. March 2024) ldentiflcation Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service Go to www.h&gov1FarmW9 for instructions and the latest information. before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. s enhttes, K is your employer identification number (EIN). h you do not have a number, we Flow to get a or 77N, later. Employer idetrtificaiion rrttnber Note: If the account is in more than dile dame, see tate instructions for line 1. See also Whet Name and Number To Give the Requester for guidelirtes on whose number to enter. 2 6 —Ill $ 3 8 0 $ 5 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me); and 2, 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report 0kn4irest and dividends jonur tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of s ured property, cancel 'debt, contributions to an individual retirement arrangement ORA), and, generally, payments other than interest and drvidenda you re riot requi o sicertification, but you must provide your correct TIN. See the instructions for Part Il, later. Sign n Here I us�n ) v Date General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Forrn W-9 and its instructions, such as legislation enacted after they were published, go to www.rrs,gov1FbmriW9. What's New Line 3a has been modified to clarify how a disregarded entity completes New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or benefiiciees, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). this line. An LLC that is a disregarded entity should check the purpose of Form appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification. An individual or entity (Foram W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat No. 10231 X Form w -a (Rev. 3-2024) 1 Name of wTtityAndMduaL An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name online 1, and enter" busineWdisregarded entity's name on line 2.) 2 Business nameldisregarded entity name, If different from above. Tree Solutions, Inc. m 9a Check the appropriate box for federal tax classification of the entityCndividuaf whose name is entered on line 1. Check 4 Exemptions (codes apply only to 0 only one of the following seven boxes, certain entities, not individuals; nr--t e t�t [] Indivldual/soie proprietor i' I C corporation ❑ S corporation ❑ Partnership ❑ Trustfestate see Instructions on page 3): ❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Pannership) Exempt payee code Cd any) Q Note; Check the "LLC" box above and, In the entry space, enter the appropriate code (C, S. or P) for the tax �t o classification of the LLC, unless It is a disregarded entity. A disregarded entity should instead check the appropriate Exemption tram Foreign Account Tax Compliance Act box for the tax classification of its owner. (FATCA) reporting ❑ otter (see Instructions) code (h anyl CL (APPS to accounts maintained 3b if an fate 3a you checked "Partnership' or 'Trust/estate," or checked "LLC" and entered "P" as Its tax classification, and you are providing this form to a partnership, bust, or estate in which you have an ownership interest, check box if have foreign beneficiaries. See instructions ❑ outside the Ou'ted States) this you any partners, owners, or cn 5 Address (number, street, and apt. or suite no.). See instructions. Requester's name and address (optomo PO Box 66158 Town of Los Altos Hills 26379 Fremont Road 6 city, state, and ZIP code Scotts Valley, CA 95067 Los Altos Hills, CA 94022 7 List acsount number(s) here (optional) IMM Taxpayer Identification Number IN Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social sec urtyr number M backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other � _ _ enhttes, K is your employer identification number (EIN). h you do not have a number, we Flow to get a or 77N, later. Employer idetrtificaiion rrttnber Note: If the account is in more than dile dame, see tate instructions for line 1. See also Whet Name and Number To Give the Requester for guidelirtes on whose number to enter. 2 6 —Ill $ 3 8 0 $ 5 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me); and 2, 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report 0kn4irest and dividends jonur tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of s ured property, cancel 'debt, contributions to an individual retirement arrangement ORA), and, generally, payments other than interest and drvidenda you re riot requi o sicertification, but you must provide your correct TIN. See the instructions for Part Il, later. Sign n Here I us�n ) v Date General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Forrn W-9 and its instructions, such as legislation enacted after they were published, go to www.rrs,gov1FbmriW9. What's New Line 3a has been modified to clarify how a disregarded entity completes New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or benefiiciees, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). this line. An LLC that is a disregarded entity should check the purpose of Form appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification. An individual or entity (Foram W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat No. 10231 X Form w -a (Rev. 3-2024) / AC40RO CERTIFICATE OF LIABILITY INSURANCE DATE (MWODNYYY) 10/18/2024 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(ios) must be endorsed. N SUBROGATION IS WAIVED, subject to tF 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 NAME: Danielle Holloway PHONE (538)361-6285 FAX Nn. s�o_jr x -Ino ARM Multi Insurance Services, Inc / CLCA 11 W Court St. E— RD Esg Danielle. Holloway@arm-i.aom INSURER(S) AFFORDING COVERAGE NAIC Suite D INSURERA:Western World Insurance Co. 13196 Woodland CA 95695 INSURED INSURER B 19SURER C : Tree Solutions Inc IMSLWdat D: PO Box 66158 INSURER E: AUTOMOBILE INSURER Scotts Valley CA 95067 COVERAGES CERTIFICATE NUMBER_24/25 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 CONTRACTOR 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. R SLTR TYPE UP INSURANCE L 26379 Fremont Road POLICY NUMBER Y EFF POLICY VY LIMITS iL X COMMERCIAL GENERAL LIABILITY CLAtMSdAADE OCCUR X 41,000 Deductible per Claim C'na StanleyllAURA xPF8043759 9/20/2024 9/20/2025 EACH OCCURRENCE $ 1, 000 , 000 IS S 100,000 MED EXP (Any ori. pon;w) S 5,000 PERSONAL d ADV INJURY $ 1;000,000 GENLAGGREGATE LIMIT APPLIES PER- . pqPOLICYED JECT M LOC OTHER: GENERALAGGREGATE $ 2,000,000 PRODUCTS -COMROPAGO S Included Prurc v..+L.fa ay $ Included AUTOMOBILE LIABILnY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS C aMrnIS NOLE L IT S BODILY INJURY (Par pomn) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Perd 'oentl UMBRELLA LUIS EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S DED RETENTION S WORKERS COMPENSATION AND EMPLOYERSLIABIIRT YIN ANY PROPRIETO WARTNERIEXECUTNE OFFICERIW-MBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERAT70NS below NIA PER DTH. E.L. EACH ACCIDENT $ E,L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Ramada; Schedule, may be aftwhed H mom space is required) Evidence of Coverage CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) INS025 poiaoi) ® 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE CANCELLED BEFORE Torry of Los Altos Hills THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN 26379 Fremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Loa Altos Hills, CA 94022 AUTHORMED REPRESENTATIVE C'na StanleyllAURA ACORD 25 (2014101) INS025 poiaoi) ® 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �- , ACf]REY CERTIFICATE OF LIABILITY INSURANCE UATE(MMIUDD(YYYY) 10118!2034 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 poBcy(fes) must have ADDITIONAL INSURED provisions or be endorsed. r if SUMOGATION IS WAIVED, subject to the terms and conditions: of the policy, certain policies may require an endarsement. A statement on this certificate does not confer rights to the Certificate holder In lieu of such endorsement(s). PRODUCER Moore & Miller Insurance Box 75T Capltota CA 95010 CONTACT Diana Wilson NAME: PHOS` (831) 462-6900 Fax Nor (831) 534-7147 M Ne- LaP.O. aDDREss: diana@rnooremiker.com wSUkE 3) AFFORDING COVERAGE NAIL A e1guRERA: State Compensation Ins. Fund 35076 INSURED Tree Solutions, Inc. P.O. Box 56158 Scotts Valley CA 95067 INSURER B atsURMC. INSURER D : INSURER E INSUR13t F. I ]A CnVERAr;E4 CERTIFICATE NUMBER- GL24101512554 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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. LTR TYPE OF INSURANCE INSO.719 POLICY NUMBER MMUDD LIMITS Los Altos Hills CA 94022 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MA4EOCCUR PREMISES fE2 o=rroanco3 MFJ7 EXPfAny one Peracn) 5 PERSONAL Q ADV INJURY S GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY Q JECT LOC PRODUCTS -COMP:'OPAGG 5 $ OTHER: AUTOMOBILE LIABILITY COMBINEDISINGLE LIMIT 5 BODILY INJURY (Per wson) S ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE S Par sodden HIRED NON -OWNED AUTOS ONLY AUTOS ONLY S UMBRELLA UAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAR MAIMS -MADE DED I I RETENTION $ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILJTY YIN ANY PROPRIETOPWARTNERIEXECUTHVE OFFICERdMEMBEREXCLU0E09 Q (Mandatory In NH) NIA 9035984-23 12/11/2023 1211112(J24 STATUTE I I ER E.L.EACH ACCIDENT S 1.000.000 E.L. DISEASE - EA EMPLOYEE S 1,000.000 If yes. describe under DESCRIPTION OF OKRATIONS below E.L. DISEASE - POLICY LIMIT $ 1,DOD,D00 -E DESCRIPTION OF OPERATMS r LOCATIONS f VBIICLES (ACORD 101, Addrd" Remarks Sdwdule, may be attacked if more space is required) Evidenc of Insurance CERTIFICATE HOLDER CANCELLATION ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN Town of Los Altos Hills ACCORDANCE WITH THE POLICY PROYRSIONS. 26379 Fremont Road AUTIK>RIZED REPRESENTATWE Los Altos Hills CA 94022 ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD