HomeMy WebLinkAboutCalifornia Surveying and Drafting Supply Inc COI 12.20.24CALISUR-04 KSHIPF
�.,. CERTIFICATE OF LIABILITY INSURANCE F
DATE(MMIDD/YYYY)
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 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 endorsementlsL
PRODUCER "RUGiiau fr; UIOf f 10
HUB International Insurance Services Inc.
4695 MacArthur Court
Suite 600
Newport Beach, CA 92660
Shippey
.Com
Town of Los Altos Hills
26379 Fremont Rd
Los Altos Hills, CA 94022
ACORD 25 (2016/03)
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
olme�
@ 1988-2
ACORD CORPORATION. All rights reserved.
INSURER A: The Travelers Indemnity Company of Connecticut 25682
INSURED
INSURER B: Travelers Property Casualty Company of America
25674
California Surveying And Drafting Supply, Inc.
INSURER C: Travelers Casualty & Surety Company of America
31194
4733 Auburn Blvd
Sacramento, CA 95841-3601
INSURER D :
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
REVISION NUMBER:
HAVE BEEN
ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR
PERIOD
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
EXCLUSIONS
OTHER DOCUMENT WITH RESPECT TO
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
WHICH THIS
TO ALL
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THE TERMS,
INSR ADDL SUBR
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
POLICY EFF POLICY EXP
A }( COMMERCIAL GENERAL LIABILITY
M DYY bYY LIMITS
CLAIMS -MADE X OCCUR
EACH OCCURRENCE _ $
1 000
,000 ,
630-9X535951
1/1/2025 4/1/2025 DAMAGETORENTED
PREMISES (Ea occurrence) $
300,000
MED EXP (Any oneperson) $
10,000
PERSONAL &ADV INJURY $
1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY ❑ JE LOC
GENERAL AGGREGATE $
2,000,000
PRODUCTS - COMP/OP AGG $
2,000,000
OTHER:
A AUTOMOBILE LIABILITYCOMBINED
SINGLE LIMIT
1,000,000
X ANY AUTO 810-A6810678
Ea accident $
1/1/2025 4/1/2025
OWNED SCHEDULED
BODILY INJURY Per person)$
AUTOS ONLY AUTOS
HIRED W
AUTOS ONLY ATOS
BODILY INJURY Per accident $
PROPERTY
ONLY
DAMAGE
per accident $
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE $
4,000,000
X
EXCESS LIAB
CLAIMS -MADE
EX -A7155942
1/1/2025
4/1/2026
AGGREGATE $
4,000,000
DED RETENTION $
$
C
WORKERS COMPENSATION
X PER
�RH
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? ®
N /A
UB -A6816702
1/1/2025
4/1/2025
E.L. EACH ACCIDENT $
1,000,000
(Mandatory in NH)
if yes, describe under
E.L. DISEASE - EA EMPLOYEE $
1,000,000
DESCRIPTION OF OPERATIONS below
1,000,000
_
E.L DISEASE -POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Re: Proof of Insurance.
CERTIFICATE 14ril nna
Town of Los Altos Hills
26379 Fremont Rd
Los Altos Hills, CA 94022
ACORD 25 (2016/03)
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
olme�
@ 1988-2
ACORD CORPORATION. All rights reserved.