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HomeMy WebLinkAboutBell Plumbing of San Mateo Inc. 1.14.25 V2I A b CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/14/2025 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 pollcy(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 FEDERATED MUTUAL INSURANCE COMPANYo HOME OFFICE: P.O. BOX 328 NAME: CLIENT CONTACT CENTER E FAX IA/C, No, Ext): 888-333-4949 IA/C, No): 507-446-4664 OWATONNA, MN 55060 A�Daess:CLIENTCONTACTCENTER®FEDINS.COM INSURERS AFFORDING COVERAGE NAIC /i 03/17/2024 INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 EACH OCCURRENCE $1,000,000 INSURED INSURER B: CERTAIN UNDERWRITERS AT LLOYDS LONDON 15792 BELL PLUMBING OF SAN MATEO INC 1180 SAN CARLOS AVE BOX 704 INSURER C: INSURER D: SAN CARLOS, CA 94070-2418 INSURER E: INSURER F: AUTOMOBILE LIABILITY JANY AUTO AUTOS ONLY gUTODULED HIRED AUTOS ONLYNON-OWNND AUTOSO Y COVERAGES CERTIFICATE NUMBER: 75 REVISION NUMBER: 2 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 INSR SUER WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X —71 COMMERCIAL GENERAL LIABILITY C LAIMS-MADE OCCUR Y N 9829156 03/17/2024 03/17/2025 EACH OCCURRENCE $1,000,000 AM cc . TOrence RENTED PREMISES $100,000 Ea occur GEN1 MED EXP Any one person) EXCLUDED PERSONAL& ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY X JEST ❑ LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP ACC $2,000,000 AOWNED AUTOMOBILE LIABILITY JANY AUTO AUTOS ONLY gUTODULED HIRED AUTOS ONLYNON-OWNND AUTOSO Y N N 9829156 03/17/2024 03/17/2025 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) ROPERTY DAMAGE Per Accident A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 9829157 03/17/2024 03/17/2025 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/ PARTNER/ EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE THER E.L EACH ACCIDENT E.L DISEASE EA EMPLOYEE E.L DISEASE • POLICY LIMIT BAGGREGATE ONTRACTORS POLLUTION LIABILITY Y Y CPLO1016001 01/08/2025 01/08/2026 EACH LIMIT $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION TOWN OF LOS ALTOS HILLS 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 75 2[ACCORDANCE ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WITH THE POLICY PROVISIONS. © 1968-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: �~ ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY BELL PLUMBING OF SAN MATEO INC 1180 SAN CARLOS AVE BOX 704 SAN CARLOS, CA 94070-2418 POLICY NUMBER SEE CERTIFICATE # 75.2 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 75.2. SEE CERTIFICATE # 75.2 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED INCLUDES: THE TOWN AND ITS OFFICERS, AGENTS, INDEPENDENT CONTRACTORS, AND EMPLOYEES. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED = BLANKET ENDORSEMENT FOR CONTRACTORS POLLUTION LIABILITY. INSURANCE PROVIDED BY THE CONTRACTORS POLLUTION LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. CONTRACTORS POLLUTION LIABILITY COVERAGE CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER SUBJECT TO THE CONDITIONS OF THE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US. GENERAL LIABILITY COVERAGE CONTAINS CG 25 03 DESIGNATED CONSTRUCTION GENERAL AGGREGATE LIMIT ENDORSEMENT APPLICABLE TO EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED - BLANKET This eniiorsemcnt, effective 12:01 a.m,, 7./8/2025 forms a part of Policy No. CPLO1016001 issued by Certain Underwriters at Lloyd's, London. THIS ENDORSEMENT CHANGES THE POLICY— PLEASE READ IT CAREFULLY in consideration of the premium charged, the insured and the Company agree to the following Policy change(s): It is hereby understood and agreed that Section III. WHO IS AN INSURED of the above referenced Policy is amended to include the following person(s) or entity(ies): Any person(s) or entity(ies) for whom you are performing operations when you and such person(s) or entity(les) have agreed in writing in a contract at, agreement that such person(s) or entity(ies) be added as an additional insured on your policy; and any other person(s) or entity(les) you are required to add as an additional insured under such contract or agreement. Such written contract or written agreement must have been executed and in effect prior to a LOSSto which this insurance applies. But solely as respects their liability arising out of YOUR WORK performed during the policy period to which this insurance applies. The coverage provided to the additional insured(s) listed above does not apply to a CLAIM, DAMAGE5or liability arising out of the sole negligence or acts, errors or omissions of the entity(ies) listed above ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALLAPPLY AND REMAIN UNCHANGED CPL AIBLKT 07 24 Page 1. of 1. PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement, effective 12:01 a.m., 1/8/2025 forms a part of Policy No. CPL01016001 ,sued by Certain Underwriters at Lloyd's, London THIS ENDORSEMENT CHANGES THE POLICY— PLEASE READ IT CAREFULLY in consideration of the premium charged, the insured and the Company agree to the following Policy change(s): Section \ill. CONDITIONS of the above policy is amended by the following addition to Paragraph M. OTHER INSURANCE: This policy shall be considered primary and non-contributing to any valid and collectible insurance available to third parties in respect to work performed for there by you under any written contractual agreement which requires that you provide primary insurance ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED CPL PNC 06 22 a>� Page 1. of 1. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement, effective 12:01 a.m., 1/8/2025 forms a part of Policy No. CPL01016001 Issued by Certain Underwriters at Lloyd's, London THIS ENDORSEMENT CHANGES THE POLICY— PLEASE READ IT CAREFULLY In consideration of the premium charged, the insured and the Company agree to the following Policy change(s): Schedule Name of Person(s) or Organization(s): Blanket as required by written contract and/or agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section VII. CONDITIONS of the above policy is amended by the following addition to Paragraph Q. TRANSFER OF RIGHTS OF RECOVERY AGAINST' Ol'HERS'10 US: We waive any right of recovery against the person(s) or organization(s) shown in the above Schedule because of payments we make for injury or damage arising out of your ongoing operations or YOUR WORK done under a written contract with that person or organization and included in the PRODUCTS -COMPETED OPERATIONS HAZARD. This waiver applies only to the person(s) or organization(s) shown in the above Schedule. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN. UNCHANGED CPL WOS22 10 23 'UCpM Page ]. of 1 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "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: 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", 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. © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9829156 Page 1 of 2 Transaction Effective Date: 03/17/2024 2. 'Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section III - Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable limits of b. That portion of "your work" out of which insurance; the injury or damage arises has been put whichever is less. to its intended use by any person or organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable limits of insurance. operations for a principal as a part of the same project. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9829156 Transaction Effective Date: 03/17/2024 POLICY NUMBER: 9829156 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Each construction project as required by written contract or written agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I - Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I - Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally C. obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical D. expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09