HomeMy WebLinkAboutTio and Tam InsuredTHE TOWN OF LOS ALTOS HILLS, ITS ELECTIVE AND APPOINTED OFFICERS,
EMPLOYEES, AND VOLUNTEERS, AS ADDITIONAL INSUREDS
26379 FREMONT RD
LOS ALTOS HILLS, CA 94022
Policy Number:
Named Insured:
Name of Additional Insured:
(Person or Organization)
Additional Insured Interest:
Location of Event:
Coverage L Limit of Liability:
Coverage period begins and ends at 12:01 A.M. Standard Time at the above designated location.
Effective Date: Expiration Date:
The definition of insured in the policy includes the person or organization named above as an Additional Insured, but only with respect to
bodily injury or property damage caused by the activities of the named insured in the use of the location designated above while it is rented
or leased to, or used by the named insured. This coverage is subject to the following provisions:
1. This coverage does not apply to bodily injury to any employee, or to property damage incurred by any employee, arising out of or in the
course of the employee’s employment by the Additional Insured;
2. This coverage does not apply to bodily injury or property damage for which the Additional Insured may be held liable:
a. as a person or organization engaged in manufacturing, distributing, selling, or furnishing alcoholic beverages if such liability is imposed by
reason of:
(1) any statute, ordinance, or regulation relating to the sale, gift, distribution, or use of alcoholic beverages; or
(2) the furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or that causes or
contributes to the intoxication of any person; or
b. as an owner or lessor of premises used for manufacturing, distributing, selling, serving or furnishing alcoholic beverages if such liability
is imposed by reason of any statute, ordinance or regulation relating to the sale, gift, distribution, or use of alcoholic beverages;
3. This coverage does not apply to bodily injury or property damage arising from products manufactured, sold, or distributed by the
Additional Insured, including reliance upon a representation or warranty made at any time with respect to such products;
4. The Coverage L limit of liability shown above applies only:
a. for damages as may be covered under this endorsement; and
b. during the coverage period designated above;
5. We will not be liable for an amount greater than the above stated Coverage L limit of liability; and
6. There will be no refund of premium in the event this endorsement is cancelled.
All other policy provisions apply.
TIO, ANDREW & TAM, JESSICA
01/25/25
HO-2402
ADDITIONAL INSURED - SPECIAL EVENT ENDORSEMENT (SECTION II)
TK 05-EL-P320-6 13-T 05-ELP3206 (02)
LOS ALTOS HILLS TOWN HALL
26379 FREMONT RD
LOS ALTOS HILLS, CA 94022
$1,000,000
01/26/25
State Farm General Insurance Comp
', Copyright, State Farm Mutual Automobile Insurance Company, 2016
05-EL-P320-6
HO-2402
151558.4 01-23-2024
Birthday Party - Owner of Venue/Municipality