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HomeMy WebLinkAboutBayscape Management Inc.eZ\`&9 dd4 \ KIM - r ,4c`oR®1 CERTIFICATE OF LIABILITY INSURANCE �--'' DATE(MMIDDIYYYY) 10/4/2024 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(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 License # OC32169 Rancho Mesa Insurance Services, Inc. 2355 Northside Drive Suite 200 San Diego, CA 92108 CANEACT PHONE FAX A/c, No, Ext): (619) 937-0164 A/c, No AE -MAIL S: INSURERS AFFORDING COVERAGE NAIC # 10/1/2024 INSURERA:Middlesex Insurance Company 23434 EACH OCCURRENCE $ 1'000'000 INSURED INSURER B: INSURER C: Bayscape Management, Inc. INSURER D: PO BOX 880 Alviso, CA 95002 INSURER E INSURER F: A CnVFRAGFS r.FRTIFICATF NIIMRFR• RFVISInNI NIIIMRFR- 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF M DD Y YY POLICY EXP M DD VYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ OCCUR X X A0263406004 10/1/2024 10/1/2025 EACH OCCURRENCE $ 1'000'000 DAEASET RELATE ace $ 300'000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1'000'000 GE N'L AGGREGATE LIMIT APPLIES PER: POLICY I X I JE 0 1-1 LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE IXANY LIABILITY AUTO OWNED SCHEDULED AIUTOS ONLY AUTOS AUT OS ONLY X ANON-OWNEDUTY A0263406001 1011/2024 10/1/2025 COMB(Ea acIINEeD SINGLE LIMIT $ 1,000,000 BODILY INJURY Per erson $ BODILY INJURY Per accident $ Pe�accRdent AMAGE $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE A0263406005 10/1/2024 10/1/2025 EACH OCCURRENCE $ 5'000'000 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY /MEMBE�EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PER E OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) RE: OPERATIONS OF THE NAMED INSURED AS CERTIFICATE HOLDERS INTEREST MAY APPEAR. TOWN OF LOS ALTOS HILLS IS INCLUDED AS ADDITIONAL INSURED WITH REGARDS TO GENERAL LIABILITY PER ATTACHED FORMS. WAIVER OF SUBROGATION APPLIES WITH REGARDS TO THE GENERAL LIABILITY PER THE ATTACHED FORMS, TOWN OF LOS ALTOS HILLS 16379 FREMONT RD. LOS ALTOS HILLS, CA 94011 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: A0263406004 COMMERCIAL GENERAL LIABILITY CG 7125 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the coverage provided under the following Coverage Form(s): COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Coverage enhancements are listed below. For details of each coverage, please read the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds - Automatic Status for 13 Additional Insured Types A. Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You B. Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) C. State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations D. Lessor of Leased Equipment E. Owners or Other Interests From Whom Land Has Been Leased F. Manager or Lessor of Premise G. Mortgagee, Assignee, or Receiver H. Controlling Interest I. Co-owner Of Insured Premises J. Executors, Administrators, Trustees Or Beneficiaries K. State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises L. Vendors M. Grantor of Franchise 2. Primary and Noncontributory - Other Insurance Condition 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. Additional Insureds - Automatic Status for 13 Additional Insured Types Section II - Who Is An Insured is amended to include the following as additional insureds when you have agreed to add that person or organization as an Additional Insured on your policy in a written contract or written agreement with that person or organization, or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or issuance of the permit and while the contract, agreement or permit remains in effect. CG 7125 06 22 A0122140 Middlesex Insurance Company 00003 0000000000 24086 0 N A. Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You 1) A person or organization with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. eb8bel96-3bb8-44df-9822-03a9de5f6975 Page 1 of 5 10/1/2024 A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. b. "Bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. B. Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) 1) Any person(s) or organization(s) with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for that additional insured and included in the "products -completed operations hazard", but only when that portion of the "products -completed operations hazard" is not excluded by endorsement. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, subject to the following provisions: 1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 2) This insurance does not apply to: Page 2 of 5 Includes copyrighted material of Insurance Services Office, Inc., CG 71 25 06 22 A0122140 with its permission. 10/1/2024 Middlesex Insurance Company a. "Bodily injury", "property damage" or F. Manager or Lessor of Premise "personal and advertising injury" arising Any person(s) or organization(s) with respect out of operations performed for the to liability for "bodily injury", "property federal government, state or damage" or "personal and advertising injury" municipality; or caused, in whole or in part, by you or those b. "Bodily injury" or "property damage" acting on your behalf in connection with the included within the ownership, maintenance or use of that part of "products -completed operations the premises leased to you by the additional hazard". insured person(s) or organization(s), subject to D. Lessor of Leased Equipment the following additional exclusions: 1) Any person(s) or organization(s) with This insurance does not apply to: respect to liability for "bodily injury", 1) Any 'occurrence" which takes place after "property damage" or "personal and -you cease to be a tenant in that premises. advertising injury" caused, in whole or in 2) Structural alterations, new construction or part, by your maintenance, operation or demolition operations performed by or on use of equipment leased to you by such behalf of the person(s) or organization(s) person(s) or organization(s). shown in the Schedule. 2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. E. Owners or Other Interests From Whom Land Has Been Leased 1) Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you by the additional insured person(s) or organization(s). 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. Any 'occurrence" which takes place after you cease to lease that land; b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured person(s) or organization(s). CG 71 25 06 22 A0122140 Middlesex Insurance Company 00003 0000000000 24085 0 N G. Mortgagee, Assignee, or Receiver Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of a premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured person(s) or organization(s). H. Controlling Interest 1) Any person(s) or organization(s) with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. 2) This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. I. Co-owner Of Insured Premises Any person(s) or organization(s) with respect to their liability as co-owner of a premises co -owned by you and covered under this insurance. J. Executors, Administrators, Trustees Or Beneficiaries Any executor, administrator, trustee or beneficiary of your estate or living trust while acting within the scope of their duties as such. Includes copyrighted material of Insurance Services Office, Inc., with its permission. eb8beI96-3bb8-44df-9822-03a9de5f6975 Page 3 of 5 10/1/2024 K. State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or 2) The construction, erection or removal of elevators; or 3) The ownership, maintenance or use of any elevators covered by this insurance. L. Vendors 1) Any person(s) or organization(s) (referred to throughout this endorsement as vendor), but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However: a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2) With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: 1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2) Any express warranty unauthorized by you; 3) Any physical or chemical change in the product made intentionally by the vendor; 4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or 8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or Page 4 of 5 Includes copyrighted material of Insurance Services Office, Inc., CG 7125 06 22 A0122140 with its permission. 10/1/2024 Middlesex Insurance Company (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. M. Grantor of Franchise Any person(s) or organization(s) with respect to their liability as grantor of a franchise to you. However: 1. The insurance afforded to such additional insureds only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. CG 7125 06 22 A0122140 Middlesex Insurance Company 00003 0000000000 24085 0 N This endorsement shall not increase the applicable limits of insurance. If there is any difference in coverage afforded to an additional insured in this endorsement and that provided under another additional insured endorsement attached to this policy, the broader coverage will apply to that additional insured. 2. Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured, 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. Includes copyrighted material of Insurance Services Office, Inc., with its permission. eb8beI96-3bb8.44df-9822-03a9de5f6975 Page 5 of 5 10/1/2024