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Home My WebLink AboutCertificate of InsuranceClient#: 8664 wRl=rn ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ADDT INSR 7/17/2012 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 12675 REUEIVEU HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR GENERAL LIABILITY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 06/27/13 510 465-3090 AUG _ 6 2012 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Casualty Insurance Co. WRECO Ly 1243 Alpine Road, Suite 10 YVN OF LOS ALTOS HILLk INSURER B: Travelers Property Casualty Co 25674 -INSURER C: XL Specialty Insurance Co. Walnut Creek, CA 94596-4431 INSURER D: Property & Casualty Ins Co of H INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADDT INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M /DD/YY POLICY EXPIRATION DATE (MMIDDIYYI LIMITS A GENERAL LIABILITY 57SBAAS9470 06/27/12 06/27/13 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY MADE 51OCCUR DAMAGE TO RSES (E.ENTED a $300,000 PREMCLAIMS MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000.000 X Contractual Liability GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: PRODUCTS-COMP/OPAGG $2000000 POLICY X PRO LOC JECT D AUTOMOBILE X LIABILITY ANY AUTO 57UECUP6164 06/27/12 06/27/13 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY X OCCUR EICLAIMS MADE 57SBAAS9470 06/27/12 06/27/13 EACH OCCURRENCE $5.000.000 AGGREGATE $5,000,000 DEDUCTIBLE X RETENTION $ 10000 $ B WORKERS COMPENSATION AND UB6492Y566 06/27/12 06/27/13 OTH- X WC STATLIMU- JR EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C OTHER Professional DPR9700310 05/01/12 05/01/13 $3,000,000 per claim Liability $3,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS General Liability Excludes Claims Arising Out of the Performance of Professional Services. Project: Prepare Permit Boundary Assessment and Geotechnical Investigation for Page Erosion at Matadero Creek. Town of Los Altos Hills, its elective and appointed officers, employees and volunteers are additional insureds as respects to General Liability per policy form wording. See attachment. _ IiCR 1 Irium 1 C n VLUCR UANUtLLA I JUN Town of Los Altos Hills Attn: Richard Chiu, Public Works Dir. 26379 Fremont Road Los Altos, CA 94022 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL j(kW({1(RkX§tMAIL _30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,j7(J x AUTHORIZED AUUKU Z5 (ZUU'I/U8) 1 of 1 #S343410/M335221 CCB 0 ACORD CORPORATION 1988 Insured: Insurer: Policy Number: Policy Effective Date Additional Insured: WRECO Hartford Casualty Insurance Co. 57SBAAS9470 06/27/12 Town of Los Altos Hills, its elective and appointed officers, employees and volunteers EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds 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, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other person or organization who is not an 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: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products- completed operations hazard, but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard. (2) 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: inspection, or engineering E.5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought. E.7.b.(7).(b) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. E.8.b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. EXCERPTS FROM CA 00001 (1001) HARTFORD BUSINESS AUTO COVERAGE Insured: WRECO Policy Number:57UECUP6164 Policy Effective Dates: 06/27/12 Additional Insured: Town of Los Altos Hills, its elective and appointed officers, employees and volunteers Additional Insured: SECTION II — LIABILITY COVERAGE 1. WHO IS AN INSURED: The following are "insureds" c. Anyone liable for the conduct of an "insured"... but only to the extent of that liability. Primary Insurance: SECTION IV — BUSINESS AUTO CONDITIONS B. General Conditions - 5. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provide by this Coverage Form is excess over any other collectible insurance. c. Regardless of the provisions of paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability assumed under an "insured contract". Cross Liability Clause: SECTION V — DEFINITIONS G. "Insured" means any person or organization qualifying as an insured in the Who is An Insured provision of the applicable coverage. Except with respect to the Limit of Insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or "suit" is brought. EXCERPTS FROM HA9916 (0302) HARTFORD COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT 15. WAIVER OF SUBROGATION — We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form.