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HomeMy WebLinkAboutBell Plumbing of San Mateo Inc. 1.29.25 V2ACC>R � CERTIFICATE OF LIABILITY INSURANCE DAT 01/2 /2025 Y) 01/29/2025 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 an this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 CONTACT NAME: CLIENT CONTACT CENTER FAX IAPo, No, Ext!; 888-333-4949 (AID, No): 507-446-4664 AODRess: CLIENTCONTACTCENTER®FEDINS,COM - INSURERS AFFORDING COVERAGE NAIC# - INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 COMMERCIAL GENERAL. LIABILITY CLAIMS -MADE aOCCUR INSURED BELL BELL PLUMBING OF SAN MATED INC 1180 SAN CARLOS AVE BOX 704 INSURER B: CERTAIN UNDERWRITERS AT LLOYDS LONDON 15792 INSURER c: INSURER D: SAN CARLOS, CA 94070-241B - - INSURER E: MED EXP (Any one person) EXCLUDED INSURER F: - COVFR�r;Fc - - - neo�r,o,n nre �n u.n,-n. .... __--. -.... 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, INSR TYPE OF INSURANCE ADDLSUgR INSR WVb POLICY NUMBER p MMLgDIYVYV -' MM(DDIYYYY - ' LIMITS - - X COMMERCIAL GENERAL. LIABILITY CLAIMS -MADE aOCCUR - - EACH OCCURRENCE $1,000,000 qMAOE TO ELATED PREMISES Ea occurrence $100,000 MED EXP (Any one person) EXCLUDED A OEN'L - Y N - 9829156 - - - - 03!17/2025 - - - - 03/17/2026 - PERSONAL & ADV INJURY $1000000 AOOREOATE LIMIT APPLIES PER;. POLICY �.IPEC❑LOC OTHER: � GENERAL AGGREGATE ---------$2,000,000 PRODUCTS & COMP/OP ACC $2,000,000 - - AUTOMOBILE LIABILITY - X ANY AUTO - - - - - COMBINED SINGLE. LIMIT - (Ea accident) $1,000,000 BODILY INJURY (Par Person) - A - OWNED AUTOS ONLY gUTOSULED N N 9829156 _ 03/17/2025 03/17/2026 BODILY INJURY (Per Accident) - - HIRED AUTOS ONLY NON-OWND - - AUTOS O -Y - - - PROPERTY DAMAGE Per Accident X UMBRELLA LIAR X OCCUR _ _ - EACH OCCURRENCE $4,000,000 A EXCESS LIAR - CLAIMS -MADE N' - N 9829157 03/17/2025 03/17/2026 AGGREGATE $4,000,000 DED I RETENTION WORKERS- COMPENSATION AND EMPLOYERS'- LIABILITY - YIN ANY PROPRIETORIPARTNER/ EXECUTIVE - _ PER STATUTE THER E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? (mandatory in Ifyes. yes, describe under N/A - E.L DISEASE EA EMPLOYEE - DESCRIPTION OF OPERATIONS below - E.L DISEASE • POLICY LIMIT CONTRACTORS POLLUTION LIABILITY - Y Y CPL01016001 01/08/2025 01/08/2026 EACH LIMIT $1,000,000 B AGGREGATE $1,000,000 DESCRIPTION. OF OPERATIONS 1 LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached If more space Is required) SEE ATTACHED PAGE CERT F 1 ICATE HOLDER CANCELLATION 4vo n�i va ni��a 26379 W FREMONT RD 89 0 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED LOS ALTOS HILLS, CA 94022-2624 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE e e t O 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD ;. a AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 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 # 89.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 89.0 SEE CERTIFICATE # 89.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE THE PERMITTEE IS RESPONSIBLE FOR ALL LIABILITY FOR PERSONAL INJURY OR PROPERTY DAMAGE WHICH MAY ARISE OUT OF WORK HEREIN PERMITTED OR WHICH MAY ARISE OUT OF FAILURE ON THE PERMITTEES PART TO PERFORM HIS, HER, OR ITS OBLIGATIONS UNDER THIS PERMIT IN RESPECT TO MAINTENANCE. IN THE EVENT ANY CLAIM OR SUCH LIABILITY IS MADE AGAINST THE TOWN OF LOS ALTOS HILLS OR ANY AGENT, INDEPENDENT CONTRACTOR, OFFICER, OR EMPLOYEE OF THE TOWN, THE PERMITTEE SHALL DEFEND, INDEMNIFY, AND HOLD THEM AND EACH OF THEM HARMLESS FROM SUCH CLAIM. PURSUANT TO 7- 2.09, THIS PERMIT SHALL NOT BE EFFECTIVE FOR ANY PURPOSE UNLESS AND UNTIL THE ABOVE-NAMED RE: PERMITTEE FILES WITH THE TOWN THE FOLLOWING CERTIFICATES OF INSURANCE: PUBLIC LIABILITY IN THE AMOUNT OF $ 1,000,000 AND PROPERTY DAMAGE IN THE AMOUNT OF $1,000j000, WITH THE TOWN AND ITS OFFICERS, AGENTS, INDEPENDENT CONTRACTORS, AND EMPLOYEES NAMED AS ADDITIONAL INSUREDS. 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, ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED - BLANKET This endorsement, effective 12:01 a.rn., 1/8/2025 forms a part of Policy No. CPLO1016001 issued by Certain Underwriters at Lloyd's, London. THIS ENDORSEMENT CHANGESTHE 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(ies) have agreed in writing in a contract or agreement that such person(s) or entity(ies) be added as an additional insured on your policy, and any other person(s) or entity(ies) you are required to add as an additional insured under such contract or agreement, Such written contract or written ag[eernent, rnusl,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 insureds) listed above does not apply to a CLAIM, DAMAGESor liability arising out of the sole negligence or acts, errors or omissions of the entity(ies) listed above ALI. OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED CPL AIBLKT 07 24 i) U C P M 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. 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 chango(�): + r Section VII. 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 them 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 0622 ")UCP 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 b-- written contract and/oragreement 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 OTHERS TO 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 darnage 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 `0 U C P M Page 1 of 1 POLICY NUMBER: 9829156 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. , - A •11, f]qkJ A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Or Governmental Agency Or Subdivision Or Political Subdivision: n of Los Altos Hills '9 W Fremont Rd Altos Hill, CA 94022-2624 lInformation required to complete this Schedule if not shown above will be shown in the Declarations A. Section II - Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, 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. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. Insured: Bell Plumbing of San Mateo Inc 1180 San Carlos Ave Box 704 San Carlos, CA 94070-2418 2. This insurance does not apply to: a. 'Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. 'Bodily injury" or "property damage" included within the "products -completed operations hazard". B. 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. This endorsement shall not increase the applicable limits of insurance. Project or Reference: Additional Insureds Also Include: the Town and its Officers, Agents, Independent Contractors, and Employees. © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 12 12 19 Policy Number: 9829156 Transaction Effective Date: 03/17/2025