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HomeMy WebLinkAboutCertificate of Insurance 2/9/2021A&?FH CERTIFICATE OF LIABILITY INSURANCE FDATE/9/2D021YYYY) 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 pOIICy(IGS) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollCles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Dealey, Renton & Associates License # 0020739 P. 0. Box 12675 CONTACT NAME: Nancy Ferrick PHONE 510-465-3090 as Ne ; E-MAIL ADDRESS: nferrick@dealeyrenton.com Oakland CA 94604-2675 INSURERS AFFORDING COVERAGE NAIC 0 INSURERA: USSpecialty Insurance Company 29599 EACH OCCURRENCE $2,000,000 INSURED CSWSTUBER1 CSW/Stuber-Stroeh Engineering Group Inc. 45 Leveronl Court INSURER B: Sentinel Insurance Company 11000 INSURERC: Twin City Fire Insurance Company 29459 INSURER D: Hartford Accident and Indemnity Company 22357 Novato CA 94949 INSURERS: PRODUCTS - COMPIOP AGO $ 4,000,000 INSURER F: D COVERAGES CERTIFICATE NUMBER: 1151871299 REVISION NUMBER: '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, ILTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS 8 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y Y 57SBWD05183 9/1/2020 9/1/2021 EACH OCCURRENCE $2,000,000 DAMAGE (R TED PREMISESS(Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY [K jR 0 7 LOC OTHER: GENERAL AGGREGATE $4,000,000 PRODUCTS - COMPIOP AGO $ 4,000,000 $ D AUTOMOBILE IX X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y Y 57UEGPC4887 9/1/2020 9/1/2021 EOaeBBIN DtSINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident B X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 57SBWD05183 9/1/2020 9/1/2021 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE N OFFICER/M EMBER EXCLUDED? (Mandatory In NH) Use, describe under DESCRIPTION OF OPERATIONS below NIA Y 67VVEGZR3304 9/1/2020 9/1/2021 X STATUTE ETH — _ E,L.EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 A1$4,000,000 Professional Liability USS2030666 3/31/2020 3131/2021 $2,000,000 per Claim Annual Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Addltlonal Remarks Schedule, inay be attached If more space Is required) Re: CSW Project No. 2110011. The Town of Los Altos Hills, Its elective and appointed officers, employees, and volunteers are named as Additional Insureds as respects General and Auto Liability as required per written contract or agreement, General Liability insurance is Primary/Non-Contributory per policy form wording. Insurance coverage includes Waiver of Subrogation per the attached endorsement(s). 30 Days Notice of Cancellation. CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Los Altos Hills 26379 Fremont Road AUTHORIZED REPRESENTATIVE r Los Altos Hills, CA 94022 ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD