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HomeMy WebLinkAboutCertificate of Insurance (4)'`' E'CERTIFICATE OF LIABILITY INSURANCE °AT08282°0200�' I TYPE OF INSURANCE ADDL NSR 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. 1707 Dock Street Tacoma, WA 98402 CONTACT NAME: PHONN Ext :253-359-9700 FAX No): AA _E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Hartford Casualty Ins. CO. 09/01/2020 09/01/2021 INSURED Alta Planning +Design, Inc. INSURERB: Trumbull Insurance Company K COMMERCIAL GENERAL LIABILITYX CLAIMS -MADE Fx_1 OCCUR INSURER C: Twin City Fire Ins. Co. 711 SE Grand Ave Portland, OR 97214 INSURER D: Continental Casualty Company PREMISES (Ea occur ence) $ 1,000,000 INSURER E : PERSONAL &ADV INJURY $ 1,000,000 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 NSR SUBR WVD POLICY NUMBER MM/DD�W MM/DD/YYYY LIMITS A GENERAL LIABILITY 52UUNOL5210 09/01/2020 09/01/2021 EACH OCCURRENCE $ 1,000,000 K COMMERCIAL GENERAL LIABILITYX CLAIMS -MADE Fx_1 OCCUR PREMISES (Ea occur ence) $ 1,000,000 MED EXP (Any one person) $ 10,000 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 K PEOT- K LOC $ B AUTOMOBILE LIABILITY 52ULJNOL5210 09/01/2020 09/01/2021 COaBINEDtSINGLE LIMIT 1,000,000 K ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( ) NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB K OCCUR 52XHUOL5121 09/01/2020 09/01/2021 EACH OCCURRENCE $ 7,000,000 K EXCESS LIAB CLAIMS -MADE AGGREGATE $ 7,000,000 DED K RETENTION$ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE1,000,000 OFFICER/MEMBER EXCLUDED? r N / A 52WEOL6H1T 09/01/2020 09/01/2021 K I WCSTATU- OTH- TORY LI ITS E E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 D Professional Liability MCH114135257 09/01/2020 09/01/2021 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 #00-2016-391 - 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. Town of Los Altos Hills 26379 Fremont Road Los Altos, CA 94022 ACORD 25 (2010/05) 3 of 10 SPC ID: K %,H N I. CL LH I IV IV 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 JxJ v 19aa-ZlJ1U ACURD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD (TEW00) THIS PAGE INTENTIONALLY LEFT BLANK 4 of 10 SPC ID: K (TEW00) Policy: 52W EOL6H 1T Term: 09/01/2020-09/01/2021 States per carrier: Twin City Fire Ins Co (NAIC 29459) AK, AL, AR, AZ, CO, FL, GA, ID, KS, KY, LA, MD, MN, MT, NM, NV, PA, SC, TN, UT, VA, WA Stop Gap Hartford Casualty Ins Co (NAIC 29424) CA Hartford Accident and Indemnity Ins Co (NAIC 22357) CT, NY Trumbull Ins Co (NAIC 27120) IL Hartford Underwriters Ins Co (NAIC 30104) MO, NC Hartford Fire Ins Co (NAIC 19682) OR 5 of 10 SPC ID: K (TEW00) THIS PAGE INTENTIONALLY LEFT BLANK 6 of 10 SPC ID: K (TEW00) 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 organization, 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 officersor 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 is 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 insureds 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) "Property damage" to property': (a) Qwned, .occupied or used by, (b) Reeled 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 A person or organization is an additional insured subsidiary not named in this Coverage Part under this provision only for that period of time as a named insured does not apply to injury required'by the contractor agreement. or damage with respect to.which such insured However„ no such person or organization is an is also a named insured under another policy insured under this provision if such person or or would be a named insured under such organization is included as an insured by an policy but for its termination or the exhaustion endorsement issued by us and made a part of of its limits of insurance, this Coverage Part. 3. Newly Acquired Or Formed Organization a. Vendors Any organization you newly acquire orform, Any person(s) or organizations) (referred to other than a partnership, joint venture or limited below as vendor), but only with respect to liability company, and over which you maintain "bodily injury" or "property damage" arising financial interest of more than 50% of, the voting out of "your products" which are distributed or stock, will qualify as a Named Insured if there is• sold in the regular course of the, vendor's no other. similar insurance available to' that business and only if this Coverage Part organization. However: provides coverage for "bodily injury" or a. Coverage'under this provision is afforded only "property damage" included within the until the 180t1) day after you acquire or form "products-completed operations hazard.". the organization or the end of the policy (1) The insurance afforded the vendor is period, whichever is earlier; subject to the following additional b. Coverage A does not apply to "bodily injury" exclusions: or "property damage" that occurred before This insurance. does not apply to: you acquired o.r. formed the organization; and (a) "Bodily injury" or "property damage"e" for c. Coverage B does not apply to "personal and which the vendor is obligated to pay. advertising injury" arising out of an offense damages by reason of the assumption committed before you acquired or formed the of liability in a contract or agreement. organization. This exclusion does not apply to 4. Nonowned Watercraft liability for damages that the vendor With respect-to watercraft you do not own that is would have in the absence of the less than 51 feet long and is not being used .to contract or agreement; carry persons for a charge, any person is. an (b) Any express warranty unauthorized by insured while operating such watercraft, with your you; permission, Any other person or organization (c) Any physical or chemical change in the responsible for the conduct. of such person is product made intentionally by the also an insured, but only with respect to liability vendor; arising out of the operation of the watercraft, and (d) Repackaging, except when unpacked, only if no.other insurance of any kind is available solely for the purpose of inspection, to that person or organization for this- liability, demonstration, testing, or the However, no person or organization is an insured substitution of parts under instructions with respect to: from the manufacturer, and then a. "Bodily injury" to a co-"employee'` of the repackaged in the original container; person operating the watercraft; or (e) Any failure to make such inspections, b. "Property damage" to property owned by, adjustments, tests or servicing as the rented to, in the charge of or occupied by you vendor has agreed to make or normally or the employer of any person who is an undertakes to make in the usual insured under this provision. course of business, in connection with 5. Additional Insureds When Required By the distribution or sale of the products; Written Contract, Written Agreement Or (f) Demonstration, installation, servicing Permit or repair operations, except such The following person(s) or organizatian(s) are an operations performed at the vendor's additional insured when you have agreed, in a premises in connection with the sale. of written contract, written agreement or because of the-product; a permit issued by a state or political subdivision, (g) Products which. after distribution or that such person or organization be added as an sale by you, have been labeled or additional insured on your policy, provided the relabeled or used as a container, part injury or damage occurs subsequent to the or ingredient of any other thing or execution of the contractor agreement. 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 crganization(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.3o,.you by such person(s) or organization(s).. (2) With respect to the insurance afforded to these additional insureds this insurance -does not apply to any "occurrence" which takes place after 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 teased to you. With respect to the insurance affarded these additional insureds the following additional exclusions apply: This insurance does not apply to:' 1. Any "occurrence" whichtakes 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 Or 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 HG 00'01 09 16 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 state 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 omissionsor the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations; 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:, (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. 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 1. 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" indUded in the "products- compleled operations hazard"; and c, barrages under Coverage B. 3. Products -Completed .Operations Aggregate Limit The Products -Completed 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".. Q. Personal And Advertising Injury Limit Subject to 2. above, the Personal and Advertising Injury Limitis the. most we will pay under Coverage S 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". ti. 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 Town of Los Altos Hills 26379 Fremont Road Los Altos, CA 94022 1 of 10 SPC ID: K (TEW00) THIS PAGE INTENTIONALLY LEFT BLANK 2 of 10 SPC ID: K (TEW00)