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Home My WebLink AboutCertificate of Insurance 2018 (2)CERTIFICATE OF LIABILITY INSURANCEDATE(MWDDNM) �•►'' 10/25/2018 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($), 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 cortificate does not confer rights to the certificate holder in Iteu of such endorsement(s). PRODUCER State&M Aleene Althouse Agency 1215 Mission Street ® Santa Cruz, CA 95080 CNAOMENTACT Laurie C. Crawford PHONE ExtIe 831-420-1555 1 Ax 831-480-1120 IC FA1C No n- -MAIL Laurie.C.Crawford.F77W(dstatefarm.COm INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: State Farm General Insurance Company 25151 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1 OCCURDAMAGET INSURED INSURER B : *Mate Farm Mutual Automobile Insurance Company 25178 Kelleher, Patrick DBA Lynx Technologies 1350 41st Avenue Ste 202 INSURER C: INSURER 0: Capitols, CA 95010 wsuRER E INSURER F: WVLKAUL5 CERTIFICATE NUMBER: RFVIA111Al MIIru1pCD. 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR TYPE OF INSURANCE ADDL 8 BR POLICY NUMBER POLICY EFF RWR POLICY EXP MMIDb LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1 OCCURDAMAGET X 97 -QE -4200-7 05/1012018 05/18/2019 EACH OCCURRENCE $ 2,000,000 REMISES Ea occuEra $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL &AOV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PEOT FE LOC OTHER: GENERAL AGGREGATE S 4,000,000 PRODUCTS-COMP/OPAGG S S B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONLY IRED NON-OVvNEDPPerOecEcnid X 288-4299-E29-05 05/29!2018 11/29/2018 COMBINED SINGLE LIMIT $ a ace' ent BODILY INJURY (Per person) $ 1,000,000 BODILY INJURY Per accident S 1,000,000 ( ) DAMAGE $ 1,000,000 a UMBRELLA UAB EXCESSUAB OCOUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEO I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE ❑NIA OFFICERIMEMBER EXCLUDED? (Msndatory In NH) If yes, dascribe under DESCRIPTION OF OPERATIONS below STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE -EA EMPLOYE $ E,L, DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addklonal Remarks Schedule, may be attached If more space is requlmd) CERTIFICATE HOLDER CANCELLATION Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03.16.2016 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Las Altos Hills, Its Officers, Officials, Employees, ACCORDANCE WITH THE POLICY PROVISIONS. Agents, Contractors & Volunteers AUTHORIZED REPRESENTATIVES 011 Los Al Fremont Road Los Altos Hills, CA 94022 Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03.16.2016 LYNXT-1 OP In- pVi/ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD DtYYVYI ,...,.�- O(MMI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFCIR. DED 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(ies) 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 408-526-1112 Professional Ins ASSOC. Shepherd & A.ssoc Ins. Services 1100 Industrial Road #3 San Carlos, CA 84070 Pam Wess c roar Pam Wens PHONE 4013-526.1118 --��• F --AX 408,526-1777 Arc; No, Ext): I (t No): E• AIL Chris'@shepherd-insurance:com - INSURERS AFFORDIFfG COVERAGE NAIL # INSURERA: Hiscox Insurance Company, Inc. INSURED LYNX Technologies, InaINSURER 1350 41 at Ave, Ste 202 B ; -- IN$URER C ; Capitola, CA 95010 INSURER D : DAMAGE T9 RENTED P EM16ES EA_occurrencei__„ INSURER155: INSURER F ------- -- reGV7.9.If:/IV IV611VIk5CF(: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT O(2 OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESgR15ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R INSSUER TYPE OF INSURANCE INaO "D POLICY NUMBER POLICY EPF POLICY EXP LIMITSW COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE �- DAMAGE T9 RENTED P EM16ES EA_occurrencei__„ ,$ MEO EXPJA�one erson $ PERSONAL & ADV INJURY $ GENLAGGREGATE LIMITAPPLIES PER; POLICY J ECT ❑ PRO" ❑ LOC GENERAL AGGREGATE PRODUCTS-COMP/OP AGO $ OTHER: AUTOMOBILE -- LIABILITY ANY AUTO OWNED SCHEDULED---.--- AURTESSONLY AUTOS t� AUTOS ONLY BONN COMBINED -SINGLE LIMIT Ea acclda,lwj„_ $ BODILY INJURY Perperson) 130DILYINJURY PeraccldentZ $ PROPERTY DAMAGE Peraccident $ UMBRELLA LIAR EXCESS LIAB HOCCUR CLAIMS -MADE EACH OCCURRENCE $ _ AGGREGATE DED RETENTION $ — A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN AFRCEO{M6IMgO�wEXCLUD�D? ECUTIVE �Manda ory in NH) if yes, describeunder ' DESCRIPTION OF OPER TIONSbeow Errors S omissions NIA UDC-1S278e4•E048 09/0412010 09/04/2019 PER UTE ORTH_ E.L. EACH ACCIDENT $ El. DISEASE - EA EMPLOYEE A E.L,DISEASE- POLICY LIMIT $ Ea. Claim 1,000,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached ifmors space is required) Evidence of Professional Liability coverage. 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 / Pam Wess 47,��,� ^vim^v — Je V'u�r V 1US1J-XU15 AGORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC®'l 6r CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 114.� 05/16/2018 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 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 CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. 1 Adp Boulevard Roseland, NJ 07068 aCC No Ext): FAX No ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Technology Insurance Company, Inc. 42376 INSURED LYNX TECHNOLOGIES INC INSURER B : INSURERC: 1350 41st. Ave, Suite 202 INSURER D : Capitola, CA 95010 INSURER E : GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JPRO- D LOC OTHER: INSURER F : PRODUCTS - COMP/OP AGG $ COVERAGES CERTIFICATE NUMBER: 900972 REVISION 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, INSRD LTR TYPE OF INSURANCE INS WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE 10 RENTEL) PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JPRO- D LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEM ER EXCLUDEDPROPRIETOR/PARTNER/EXECUTIVE ] (Mandatory in and If yes, describe under DESCRIPTION OF OPERATIONS below NIA N TWC3708132 05/16/2018 05/16/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) CER T IFiCA 1 t HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Los Altos Hills, Its Officers, Officials, Employees, ACCORDANCE WITH THE POLICY PROVISIONS. Agents, Contractors & Volunteers 26379 Fremont Rd Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE 988-2014 ACORD CORPORATION. All riahts ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD