HomeMy WebLinkAboutSmelly Mel's Plumbing Inc.Q)Allstate.
Yotere In good hands.
01,
Cl CW A02 1011
This certificate is Issued for informational purposes only. It certifies that the policies listed In this document have been issued
to the Named Insured. It does not grant any rights to any party nor can it be used, In any way, to modify coverage provided
by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage
is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other
contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at
the policy inception. Subsequent paid claims may reduce these limits.
Certificate Holder:
TOWN OF LOS ALTOS HILLS
26379 W FREMONT RD
LOS ALTOS HILLS, CA USA 940222624
Named Insured:
SMELLY MEL'S PLUMBING, INC.
300 SHAW RD
S SAN FRANCISCO CA 94080-6606
Automobile Liability
Insurer Name: Allstate Insurance Company
Polis Number: 048926827
X
1 --Any Auto
2 - Owned Autos Only
3 - Owned Priv. Pass. Autos Only
4 -- Owned Autos Other Than Priv.
Pass. Autos Only
5 - Owned Autos Subject to
No Fault
6 - Owned Autos Subject to a Compulsory UM Law
7 -- Specifically Described Autos
18 Hired Autos Only
9 - Nonowned Autos On1v
Policy Effective Date 12-20-2022 Policy Expiration Date: 12-20-2023
Limits of
$1,000,000
Combined Single Limit (each accident)
Insurance:
BI Per Person
BI Per Accident PD Per Accident
Description of Operations/Locations/Vehicles/Endorsements/S - clal Provisions
Interested Party Type: Additional insured - Project Owner
THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER.
IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST
EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL
INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH
POLICY LANGUAGE OR ENDORSEMENT,
Producer:
JAN HANNAH
Authorized Representative:
Date: 10-27-23
IU114-3 CICWA021011
Includes copyrighted material of Insurance Services Office, Inc., with its permission
Allstate Insurance Company
Additional Insured Copy
Page 1 of 1
Q)Allstate.
You're In good hands.
POLICY NUMBER: 048926827
Lve, 11
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
COMMERCIAL AUTO
CA 20 48 10 13
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage
provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named insured: SMELLY MELS PLUMBING, INC.
Endorsement Effective Date: 10-27-2023
SCHEDULE
Name Of Person(s) Or Organization(s):
TOWN OF LOS ALTOS HILLS
26379 W FREMONT RD
LOS ALTOS HILLS, CA USA 940222624
I Information reguired to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section 11 —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
BU114-3 CA 20 48 10 13
@ Insurance Services Office, Inc., 2011
Addiflonal Insured Copy
Page 1 of 1
WAllstate.
You're In good hands.
BU114-3
CUSTOMER NUMBER: 92331
JAN HANNAH
2225 TARAVAL ST
SAN FRANCISCO, CA 94116-2251
TOWN OF LOS ALTOS HILLS
26379 W FREMONT RD
LOS ALTOS HILLS, CA 94022-2624
100002310270489268272715000290001003 Additional Insured Copy
RUN DATE: 10-27-23