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HomeMy WebLinkAboutB & D Excavation and Construction COIRR.OFXCA.IIi .ICASTANFnA A `URL►" CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 5/9/2025 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 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 R% cT Milian Castaneda Walsh Carter & Associates Insurance Services, LLC 423 Washington Street, #500 San Francisco, CA 94111 PHONE FAX (A/C, No, Ext): (A/C, No): an RIEss: jcastaneda@walshcarter.com INSURERS AFFORDING COVERAGE NAIC # 4/1/2025 INSURER A: Gemini Insurance Company EACH OCCURRENCE $ 1,000,000 INSURED INSURER B: Infinity Select INSURER C: James River Insurance Co. B & D Excavation and Construction INSURER D: Berkle net 138 Del Oro Lagoon Novato, CA 94949 INSURER E : The Hartford INSURER F: AUTOMOBILE COVERAGES CERTIFICATE NIIMRF_R- RFVl-glnM NIIMRFR- 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 IND SUBR W D POLICY NUMBER POLICY EFF MWDDNYYYI POLICY EXP (MM/DDNYYY)LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X VIGPO30498 4/1/2025 4/1/2026 EACH OCCURRENCE $ 1,000,000 DAMET occ100,000 ue MED EXP (Any oneperson) 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ ippaT LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO OWNEDXSCHEDULED AUTOS ONLY AUTOS ONLY XAUOSyON X X 50009700301 6/1/2024 6/1/2025 (EaBIKED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident rct AMAGE PeacR�XVIEPS C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 00134914-2 9/2/2024 9/2/2025 EACH OCCURRENCE $ 5,000,000 X AGGREGATE DED I I RETENTION $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANFYPROWPREIETOR/PARTNER/EXECUTIVE Y/N Mandatory In NH) EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below N / A X BNUWC0163477 8/5/2024 8/5/2025 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E,L. DISEASE - POLICY LIMIT 1,000,000 E Inland Marine/Person 04-IM054562 12/12/2024 12/12/2025 Limit 131,786 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mores ace Is required) *30 Day Cancellation Written Notice and 10 day for Non -Payment of Premium /Non -Reporting of Payroll. Matadero Creek Restoration and Bank Stabilization Project Town of Los Altos Hills is named as additional insured. Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 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: VIGPO26713 CG 24 0412 19 Insured Name: B & D Excavation & Construction Number: 31 Effective Date: 04/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Person(s) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an `occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. All other terms and conditions of this Policy remain unchanged. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number: VIGPO26713 VE 09 73 04 20 Insured Name: B & D Excavation & Construction Number: 38 Effective Date: 04/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other Commercial General Liability insurance available to an additional insured under your policy, but only if: (1) The additional insured is a Named Insured under such other Commercial General Liability 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 Commercial General Liability insurance available to the additional insured. Coverage granted to an additional insured remains subject to all terms, conditions, limitations, and exclusions set forth in the endorsement form that conferred the additional insured status. In the event of conflict between this endorsement and an endorsement conferring additional insured status, then the endorsement conferring additional insured status shall govern the scope of coverage available to the additional insured. All other terms and conditions of this Policy remain unchanged. VE 09 73 04 20 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission Policy Number: VIGPO26713 CG 20 10 0413 Insured Name: B & D Excavation & Construction Number: 39 Effective Date: 04/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Any person or organization when you have agreed All locations for which you have agreed in a -written- in a written and executed contract prior to an and executed contractp rior to an 'occurrence." "occurrence", that such person or organization be added as an additional insured on your policy. Information 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 the person(s) or organization(s) shown in the Schedule, but 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(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "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 CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 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. C. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 Policy Number: VIGPO26713 CG 20 37 04 13 Insured Name: B & D Excavation & Construction Number: 40 Effective Date: 04/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Organization(s): Operations Any person or organization when you have agreed All locations and completed operations for which in a written and executed contract, prior to an you have agreed in a written and executed "occurrence", that such person or organization be contract prior to an 'occurrence." added as an additional insured on your policy. Information 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". However: 1. The insurance afforded to such additional insured 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. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BNUWC0163477 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA (Blanket) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreemnt from us.) You must maintain payroll records accurately segregating the rmuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.0200100 % of the California workers' compensation premium otherwise due on such remuneration. State Schedule Description CA Any party with whom the insured agrees to waive subrogation in a written contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective Date: Policy Number: BNUWC0163477 Endorsement No.: Insured Name: Insurance Company: StarNet Insurance Company Countersigned By-�'.- GENERAL LIABILITY ENDORSEMENT TOWN OF LOS ALTOS HILLS 26379 Fremont Road Los Altos Hills, CA 94022 Attention: Astha Khanal A. POLICY INFORMATION 1. Insurance Company: Policy Number: 2. Policy Term: From: To: Endorsement Effective Date: 3. Named Insured: 4. Address of Named Insured: 5. Limit of Liability Any One Occurrence/Aggregate $2,000,0001$4,000,000 6. Deductible or Self -Insured Retention Nil unless otherwise specified): 7. "Claims Made" coverage: Retroactive Date: Tails: B. POLICY AMENDMENTS This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto it is agreed as follows: 1. INSURED: The Town, its elected or appointed officials, employees, and volunteers are included as insured with regard to damages and defense of claims arising from: (a) activities performed by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises owned, leased or used by the Named Insured. CONTRIBUTION NOT REQUIRED: As respects: (a) work performed by the Named Insured for or on behalf of the Town; or (b) products sold by the Named Insured to the Town, or (c) premises leased by the Named Insured from the Town, the insurance afforded by this policy shall be primary insurance as respects the Town, its elected or appointed officials, employees or volunteers; or stand in an unbroken chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the Town, its elected or appointed officials, employees or volunteers shall be excess of this insurance and shall not contribute with it. 3. SCOPE OF COVERAGE: The policy: (1) if primary, affords coverage at least as broad as Insurance Services Office form for Broad Form Commercial General Liability Insurance and Insurance Services Office form for Broad Form Commercial General Liability endorsement; or (2) if excess, affords coverage which is at least as broad as the Primary Insurance form referenced in the preceding Section (1). Contmct Matadero Creek Restoration and Bank Stabilization Project 27 4. SEVERABILITY OF INTEREST: The insurance afforded by this policy applies separately to each insured seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. 5. PROVISIONS REGARDING THE INSUREDS DUTIES AFTER ACCIDENT OR LOSS: Any failure to comply with reporting provisions of the policy shall not affect coverage provided to the Town, its elected or appointed officials, employees or volunteers. 6. CANCELLATION NOTICE: The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits except after THIRTY (30) days prior written notice by Certified Mail Return Receipt Requested have been given to the Town. Such notice shall be addressed as shown in the heading of this endorsement. C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, (print/type name), warrant that I have authority to bind the below -listed insurance company and by my signature hereon do so bind this company. Signature of Authorized Representative (original signature on endorsement furnished to the Town) ORGANIZATION: ADDRESS: aij 11110114 TELEPHONE: Contract Matadero Creek Restoration and Bank Stabilization Project AUTOMOBILE LIABILITY ENDORSEMENT TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOS ALTOS HILLS, CA 94022 Attention: Astha Khanal A. POLICY INFORMATION 1. Insurance Company: Policy Number: 2. Policy Term: From: To: Endorsement Effective Date: 3. Named Insured: 4. Address of Named Insured: 5. Limit of Liability Any One Occurrence/Aggregate $1,000,000 6. Deductible or Self -Insured Retention Nil unless otherwise specified): 7. "Claims Made" coverage: Retroactive Date: Tails: B. POLICY AMENDMENTS This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto it is agreed as follows: 1. INSURED: The Town, its elected or appointed officials, employees, and volunteers are included as insured with regard to damages and defense of claims arising from: (a) activities performed by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises owned, leased or used by the Named Insured. 2. CONTRIBUTION NOT REQUIRED: As respects: (a) work performed by the Named Insured for or on behalf of the Town; or (b) products sold by the Named Insured to the Town, or (c) premises leased by the Named Insured from the Town, the insurance afforded by this policy shall be primary insurance as respects the Town, its elected or appointed officials, employees or volunteers; or stand in an unbroken chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the Town, its elected or appointed officials, employees or volunteers shall be excess of this insurance and shall not contribute with it. 3. SCOPE OF COVERAGE: This policy affords coverage to the Named Insured which is at least as broad as Insurance Services Office form for Automobile Liability, Code 1 ("any auto"). 4. SEVERABILITY OF INTEREST: The insurance afforded by this policy applies separately to each insured seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. Contract Matadero Creek Restoration mid Bank Stabilization Project 29 5. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS: Any failure to comply with reporting provisions of the policy shall not affect coverage provided to the Town, its elected or appointed officials, employees or volunteers. 6. CANCELLATION NOTICE: The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits except after THIRTY (30) days prior written notice by Certified Mail Return Receipt Requested has been given to the Town. Such notice shall be addressed as shown in the heading of this endorsement. C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, (print/type name), warrant that I have authority to bind the below -listed insurance company and by my signature hereon do so bind this company. Signature of Authorized Representative (original signature on endorsement furnished to the Town) ORGANIZATION: 919*1*3 30 TITLE: TELEPHONE: Contract Matadero Creek Restoration and Bank Stabilization Project WORKERS COMPENSATION/EMPLOYEES LIABILITY ENDORSEMENT TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOS ALTOS HILLS, CA 94022 Attention: Astha Khanal A. POLICY INFORMATION 1. Insurance Company: Policy Number: 2. Endorsement Effective Date: 3. Named Insured: 4. Employer's Liability Limits (coverage B) $1,000,000.00 B. POLICY AMENDMENTS: This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto it is agreed as follows: 1. CANCELLATION NOTICE: The insurance afforded to this policy shall not be suspended, voided, canceled, reduced in coverage or in limits except after THIRTY (30) days prior written notice by Certified Mail Return Receipt Requested have been given to the Town. Such notice shall be addressed as shown in the heading of this endorsement. 2. WAIVER OF SUBROGATION: The Company agrees to waive all rights of subrogation against the Town, its elected or appointed officials, agents and employees for losses paid under the terms of this policy which arise from work performed by the Named Insured for the Town. C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, (print/type name), warrant that I have authority to bind the below -listed insurance company and by my signature hereon do so bind this company. Signature of Authorized representative (original signature on endorsement furnished to the Town) ORGANIZATION: ADDRESS: TITLE: TELEPHONE: Contract Matadero Creek Restoration and Bank Stabilization Project 31 CERTIFICATE OF INSURANCE TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOS ALTOS HILLS, CA 94022 Attention: Astha Khanal This certifies that the following described policies have been issued to the insured named below and are in force at this time. Insured Address Description of operations/locations/products insured (show Contract name and/or number if any). POLICIES AND INSURERS LIMITS EXPIRATION Bodily Injury Property Damage DATE Policy Number Worker's Compensation Employer's Liability $ Insurer Commercial General Liability Each Occurrence Each Occurrence Aggregate Aggregate Insurer Combined Single Limit Business Auto Policy Liability Each Person Each Accident Coverage Symbol Each Accident Combined Single Limit Insurer Umbrella Liability Occurrence/Aggregate $ Self -Retention $ Insurer The following covers es or conditions are in effect: Yes ❑ No ❑ The Town, its officials, and employees are named on all liability policies described above as insured as respects: (a) activities performed for the Town or on behalf of the named insured, (b) products and completed operations of the named insured and (c) premises owned, leased or used by the named insured Products and com leted operations: Yes ❑ No ❑ The undersigned will mail to the Town 30 days written notice of cancellation or reduction of coverage or limits, cross liability clause (or equivalent wording). Yes ❑ No ❑ Personal Injury, erils A, B, and C. Yes ❑ No ❑ Broad form property damage. Yes ❑ No ❑ X, C, U hazards included. Yes ❑ No ❑ Contractual liability coverage applying to this Contract. Yes ❑ No ❑ Liquor liability. Yes ❑ No ❑ Coverage afforded the Town, its officials, employees and volunteers as an insured applies as primary and not excess or contributing to any insurance issued in the name of the City. Yes ❑ No ❑ Waiver of subrogation from worker's compensation insurer. Contract Matedero Creek Restoration and Bank Stabilization Project 32 This certificate is issued as a matter of information. This certificate is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate or insurance 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. Agency or Brokerage Address Name of Person to be Contacted Telephone Insurance Company Home Office Authorized Signature Date NOTE: Authorized signature may be the agent's, if agent has placed insurance through an agency agreement with the insurer. If insurance is brokered, authorized signature must be that of official of insurer. Contract Matadero Creek Restoration and Bank Stabilization Project 33