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Certificate of Insurance
A E$'CERTIFICATE OF LIABILITY INSURANCE DA Y) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO 08/31/2021 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 Parker, Smith & Feek, Inc. 16201 E Indiana Ave, Suite 1000 Spokane Valley, WA 99216 CONTACT NAME: 1,J 509-789-8350 FAX 509-931-0794 wC No Ext: All No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # LIMITS INSURERA: Hartford Casualty Ins. Co. GENERAL LIABILITY INSURED Alta Planning +Design, Inc. INSURER B : Trumbull Insurance Company p y INSURER C : Twin City Fire Ins. Co. 711 SE Grand Ave Portland, OR 97214 INSURER D: Continental Casualty Company INSURER E: INSURER F: 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 SUBR D POLICY NUMBER MM% I D/YEYYY MM/DD/YFF EYYY LIMITS A GENERAL LIABILITY 52UUNOL5120 09/01/2021 09/01/2022 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY )( DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 CLAIMS -MADE 1K OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- K LOC $ B AUTOMOBILE LIABILITY 52UENOL.5676 09/01/2021 09/01/2022 COMBINED SINGLE LIMIT 1,000,000 Ea accident) $ X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ (Per accidenl A UMB;RELLA LIAB X OCCUR 52XHUOL5121 09/01/2021 09/01/2022 EACH OCCURRENCE $ 7,000,000 K EXCAB CLAIMS-MADEAGGREGATE $ 7,000,000 DEDRETENTION $ 10,000 $ C WORKERS COMPENSATION 52WE0L6H1T X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N 09/01/2021 09/01/2022 o LI T E E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F -]N / A (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below D Professional Liability MCH114135257 5,000,000 Each Claim/Aggregate; 10/17/2001 09/01/2021 09/01/2022 Knowledge Date DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project #00-2016-391 - Los Altos, CA Pathway Inventory and Assessment. Town of Los Altos Hills, is additional insured on the general liability policy per the attached endorsements/forms. 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 Los Altos, CA 94022 AUTHORIZED REPRESENTATIVE n ,L /// / u "IW36-ZU11U ACUKD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 3 of 10 SPC ID: K (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 4 of 10 SPC R K (CMC00) SECTION II -WHO IS AN INSURED 1. If youare designated in. the Declarations as: a. An individual, you and your spouse are insureds, but only with respect'to the conduct of a business of which you are the sole owner, b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of .your business: c. A limited liability company; .you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organ ization,other than a partnership,. joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of: the following i's also an insured: a: Employees And Volunteer Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insure ds,for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a. co"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To: the spouse, child, parent, brother or sister of that co -"employee" or that "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (1.)(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services: (a) Subparagraphs (1)(a), (1)(b) and (1)(c) above do not apply to any "employee" or "volunteer worker" providing first aid services; and (b) Subparagraph (1)(d) above does not apply to any nurse, emergency medical technician or paramedic employed by you. to provide such services. (2) "Properly damage" to property` (a) Owned, occupied.or used by, (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by You, any of your "employees", "volunteer workers", any partner or member (if .you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker"), or any organization while - acting as your real estate manager. c. Temporary Custodians Of Your Property. Any person or organization having proper temporary custody of your property if you die,. but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. Unnamed Subsidiary Any subsidiary, and subsidiary thereof, of yours which is a legally incorporated entity: of which you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part, HG 00 01 09 16 Page 11 of 21 The insurance" afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply to injury or damage with respect to.which such insured is also a named insured under another policy or would be a named insured under such policy but for its termination or the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or forrn, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest.of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the and of the policy period, whichever is earlier; b, Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or..formed the organization; and c. Coverage B does not apply to "personal and advertising injury arising out of an offense committed before you acquired or formed the organization_ Nonowned Watercraft 'll4'ith respect to watercraft you do not own that is less than 51 feet long and is not being used .to carry persons for a charge, any person is. an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no.other insurance of any kind is available to that person or organization for this liability. However, no. person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an inspired under this provision. S. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The following porson(s) or organization(s) are an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement_ A person or organization is an additional insured under this provision only for that period of time required"by the contractor agreement. However, no such person or organisation is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and made a part of this Coverage Part. a. Vendors Any persons) or organizations) (referred to below as vendor), but only with respect to. "bodily injury" or "property damage" arising out of "your products" which are disfribuled or sold in the regular course of the. vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". (1) The insurance afforded the vendor is subject to the following additional exclusions: This insurance. does not apply to: (a) "Bodily injury' or `property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the. contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the saleof the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or Page, 12 of 21 HG 00 01 09 16 (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those: of its employees or anyone else acting on its behalf,. However, this exclusion does not apply to: (i) The exceptions contained in Sub- paragraphs (d) or (f); or (ii) .Such inspections, adjustments, tests or servicing as the•vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the. distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b.. Lessors Of Equipment (1) Any person(s) or organization(s) from whom you lease equipment; but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such peruon(s) or organ ization(s),_ (2) With respect to the insurance afforded to these additional insureds this insurance -does not apply to any "occurrence" which takes place atter the equipment lease expires. .c. Lessors Of Land Or Premises Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part, -of the land 'or premises leased to you. With respect to the insurance afforded these additional insureds the following additional exclusions. apply: This insurance does not apply to., 1. Any "occurrence" which, takes place after you cease to lease that land; or 2. Structural alterations; new construction or demolition operations performed by or on behalf of such person or organization. Architects, Engineers Cr Surveyors Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations performed by you or on your behalf. With respect to the insurance afforded these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions,reports; surveys, field orders, change orders or drawings and specifications; or 2. 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 services by or for'you. e. Permits Issued By State Or Political Subdivisions Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. With respect to the insurance afforded these additional insureds, this insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and, advertising injury" arising out of operations performed for the slate or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard". f, Any'Other Party Any other person or organization who is not an additional insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property. damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations: HCS 00,01 09 16 Page 13 of 21 (2) In connection with your premises owned by or rented to you; or (3) In connection with "your work" and included within the "products -completed operations hazard", but only if (a) The written contract or agreement requires you to provide such coverage to such additional insured; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products - completed operations hazard". However; (1) The insurance afforded to such additional insured only applies to the extent permitted bylaw; 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, With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "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: (t) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities, This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in thesupervision, 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 services by or for you. The limits of insurance that apply to additional insureds is described in Section III - Limits. Of Insurance. How this insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in.Section IV - Commercial General Liability Conditions. No person or organization is an insured With respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III - LIMITS OF INSURANCE The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of; a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. General Aggregate Limit The General. Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard"; and c. Damages under Coverage B. 3. Products -Completed .Operations Aggregate Limit The. ProductsrCompleted Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products - completed operations -hazard" .. 4, Personal And Advertising Injury Limit Subject. to 2. above, the Personal and Advertising Injury Limit. is the. most we will pay under' Coverage $ for the sum of all damages because �of all "personal and advertising injury" sustained by any one person or organization. 5. Each Occurrence Limit Subject to 2, or 3, above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage. A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence", 6. Damage To Premises Rented To You Limit Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. Page 14 of 21 HG 00 01 09 16 Policy: 52WEOL6HIT Term: 09/01/2021-09/01/2022 States per carrier: Twin City Fire Ins Co (NAIC 29459) AK, AL, AR, AZ, CO, FL, GA, ID, KS, KY, LA, MA, MD, MI, MN, MT, NM, NV, PA, SC, TN, UT, VA, WA Stop Gap Hartford Casualty Ins Co (NAIC 29424) Hartford Accident and Indemnity Ins Co (NAIC 22357) CT, NY Trumbull Ins Co (NAIC 27120) IL, CA Hartford Underwriters Ins Co (NAIC 30104) MO, NC, HI, TX Hartford Fire Ins Co (NAIC 19682) OR 9 of 10 SPC IU: K (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 10 of 10 SPC ID: K (CMC00) Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 Town of Los Altos Hills 26379 Fremont Road Los Altos, CA 94022 1 of 10 SPC ID: K (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 2 of 10 SPC ID: K (CMC00) AR" O' ® CERTIFICATE OF LIABILITY INSURANCE DA TE 08/31/2021 Y) 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(ies) 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 - Parker, Smith & Feek, Inc. 16201 E Indiana Ave, Suite 1000 Spokane Valley, WA 99216 CONTACT NAME: PHONE 509-789-8350 FAX 509-931-0794 A/c No Ext): (AIC No) E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # A INSURER A : Hartford Casualty Ins. CO. INSURED Alta Planning +Design, Inc. 711 SE Grand Ave INSURER B: Trumbull Insurance Company INSURER c : Twin City Fire Ins, Co. INSURER D : Continental Casualty Company Portland, OR 97214 INSURER E: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FK] OCCUR INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR LTR I TYPE OF INSURANCE ADDL INSIR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY 52UUNOL5120 09/01/2021 09/01/2022 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FK] OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,090 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC $ B AUTOMOBILE LIABILITY 52UENOL5676 09/01/2021 09/01/2022 COMBINED SINGLE LIMIT 1,000,000 Eaaccident $ X ANY AUTO _ BODILY INJURY (Per person) $ 1 ALL OWNED SCHEDULED AUTOS AUTOS ) BODILY INJURY (Per accident $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ A UMBRELLA LAB X OCCUR 52XHUOL5121 09/01/2021 09/01/2022 EACH OCCURRENCE $ 7,000,000 AGGREGATE $ 7,000,000 X EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 10,000 1$ C WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 52WEOL6HIT 09/01/2021 09/01/2022 X WCSLATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Professional Liability MCH114135257 09/01/2021 09/01/2022 5,000,000 Each Claim/Aggregate; 10/17/2001 Knowledge Date DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project #00-2018-145 - Los Altos Hills CA Pathway Fee Study. Exhibit of Insurance. CERTIFICATE HOLDER CANCELLATION ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 3 of 6 SPC ID: Reissue 10/31 (CMC00) 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 AUTHORIZED REPRESENTATIVE 26379 Fremont Road Los Altos, CA 94022 /t�� //�6 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 3 of 6 SPC ID: Reissue 10/31 (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 4 of 6 SPC ID: Reissue 10/31 (CMC00) Policy: 52WEOL6HIT Term: 09/01/2021-09/01/2022 States per carrier: Twin City Fire Ins Co (NAIC 29459) AK, AL, AR, AZ, CO, FL, GA, ID, KS, KY, LA, MA, MD, MI, MN, MT, NM, NV, PA, SC, TN, UT, VA, WA Stop Gap Hartford Casualty Ins Co (NAIC 29424) Hartford Accident and Indemnity Ins Co (NAIC 22357) CT, NY Trumbull Ins Co (NAIC 27120) IL, CA Hartford Underwriters Ins Co (NAIC 30104) MO, NC, HI, TX Hartford Fire Ins Co (NAIC 19682) OR 5 of 6 SPC ID: Reissue 10/31 (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 6 of 6 SPC ID: Reissue 10/31 (CMC00) Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 Town of Los Altos Hills 26379 Fremont Road Los Altos, CA 94022 1 of 6 SPC Ib: Reissue 10/31 (CMC00) THIS PAGE INTENTIONALLY LEFT BLANK 2 of 6 SPC ID: Reissue 10/31 (CMC00)