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HomeMy WebLinkAboutChrisp Company COI 11.27.24Ac"R"® CERTIFICATE OF LIABILITY INSURANCE �.. DATE(MWDD/YYYY) 11/27/2024 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 endorsement(s), PRODUCER Arthur J. Gallagher Risk Management Services, LLC 2121 N California Blvd Ste 350 Walnut Creek CA 94596 Cc MT OT Certificate Department PHONE FAX �A/c No Ext): 925.299-1112 �NNC, o): 925-953-6270 E-MAIL ADDRESS: CertRequests@@Jg.com INSURER($) AFFORDING COVERAGE NAIC A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1_3�1 OCCUR _ INSURER A: Starr Indemnit & Liability Company 38318 Licenser: oD692 INSURED CLIENT CODE: CHRICOM-02 - 12/1/2024 Chrisp Company 43650 Osgood Road INSURER B: INSURER c INSURER D: Fremont, CA 94539 INSURER E; GEN'L INSURER F: $ 5,000 t;uvtHAuiz6." CERTIFICATE NUMBER! 2r7f1Q1ARRAA RF\/IQIr1Nl N11111ARIZIC1• 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 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. T�TYPE ILTR OF INSURANCE ADD D SUBR V — POLICY NUMBER POLICY EFF MM/DD/YYYY PgLICY EXP MM/ D YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1_3�1 OCCUR _ 1000025834241 - 12/1/2024 12/1/2025 EACH OCCURRENCE $ 2,000,000 JAAMAGt: I U � PREMISES (Ea occurrence $1,000,000 GEN'L MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000_ AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE 14,000,000 PRODUCTS - COMP/OP AGG — $4,000,000 – $ — A AUTOMOBILE X X LIABILITY ANY AUTO OWNED SCHEDULED HIRED AUTOS ONLY AUTOS AUTOS ONLY Ix AUTOS ONLY 1000198720241 12/1/2024 12/1/2025COMBINED SINGLE IMI7 Ea accldenU $2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ Poor ac ldentDAMAG� $ A .X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE 1000587463241 12/1/2024 1211/2025 EACH OCCURRENCE $10,000,000 AGGREGATE A� $10,OOtl,400 DED FX I RETENTION $ $ A WORKERS COMPESATION AND EMPLOYERS'LIBILIITY Y/N ANYPROPRIE7"OR/PARTNER/EXECUTIVE -1 OFFICERIMEMBEREXCLUDED? (Mandatory in NH) Ifes, describe under DESCRIPTION OF OPERATIONS below N/A 1000004442 12/1/2024 12/1/2025 X STATUTE RH E.L. EACH ACCIDENT _ $1,000,000 — E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Chrisp Jab #: 10L.20.001 RE: SCHOOL ZONE SIGNAGE, LOS ALTOS HILLS, CA, ADDITIONAL INSURED(§): TOWN OF LOS ALTOS HILLS, ITS ELECTIVE & APPOINTED OFFICERS, EMPLOYEES, & VOLUNTEERS. NOTICE OF CANCELLATION: The Producer will endeavor to mail 30 days written notice to the Certificate Holder named on the certificate if any policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall Impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOSS ALTOS HILLS CA 94022 US SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. )REPRESENTATIVE ©19882015 ACORD CORPORATION. All rlahts rAw-rvad ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J, Gallagher Risk Management Services, LLC 2121 N California Blvd Ste 350 Walnut Creek CA 94696 MD02024 00000907 02 TOWN OF LOS ALTOS HILLS 26379 FREMONT ROAD LOS ALTOS HILLS, CA 94022 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI,UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: CHRICOM-02 4. This Certificate Number: 2070935648 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www,ajg,com/us/privacy-policy/. 58 PA, *Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 ADDITIONAL INSURED- OWNERS, LESSEES, 0 CONTRACTORS - SCHEDULED PERSON 0 * A 4 Policy Number: 1000025834241 Effective Cate: 12/01/2024 Named Insured: Chrisp Company This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATION: AS REQUIRED PER WRITTEN CONTRACT (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION II -WHO IS AN INSURED is amended to include as an insured; The person or organization shown in the schedule, but only with respect to Liability arising out of your ongoing operations performed for that additional insured. B. With respect to the insurance afforded to these additional insureds, SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. -Exclusions, is amended to include the following additional exclusion; This insurance does not apply to "bodily injury" or "property damage occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or, (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. NAll other terms and conditions remain unchanged, OG 100 (04/12) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company, All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with Its permission, a �I * Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 to W VIM M, 1141 Policy Number: 1000026834241 Named Insured: Chdmp Company Effective Date: 12/01/2024 This endorsement modifies insurance provided under the SCHEDULE NAME OFADDITIONAL INSURED PERSON ORORGANIZATION: A8REQUIRED PER WRITTEN CONTRACT LOCATION AND DESCRIPTION OFCOMPLETED OPERATIONS: ASREQUIRED PER WRITTEN CONTRACT ADDITIONAL PREMIUM: (R No entry appears ubnva, infbnneUmn required to complete this endorsement will be shown in the Declarations oaapplicable tothe endomement.) SECTION 11 - WHO IS AN INSURED is amended to include as an insured; The person ororganization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule . of this endorsement performed for that additional insured and included in the "Products- completed All other terms and conditions remain unchanged. OG1D6(O4M2) .-"- 1of1 oo�nUht0o.xg�nCompany and u�n/nnemn L/*w/n«*"". a./. =.~..s.~~~.~.. Includes copyrighted material vfISO Properties, |nv..used with Its permission. . *Starr Indemnity &Liability Company Dallas, TX 1-866-619-2522 Policy Number: 1000025834241 Effective Date: 12/01/2024 Named Insured: Chrisp Company This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. SECTION IV -, CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following Is added to paragraph 4.a. of the Other Insurance condition: This Insurance Is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional Insured on which the additional Insured Is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President Nehemiah E Ginsburg, General &3ounsel OG 107 (04/11) Page 1 of 1 Copyright 0 C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of 180 properties, Inc., used with Its permission. 10" of POLICY NUMBER: 1000025834241 COMMERCIAL GENERAL LIABILITYCG 24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. Information required to com late this Schedule, if not shown above, will be shown in the Declarations The following Is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 a insurance Services Office, Inc., 2008 Page 1 of I *StarrIndemnity & Liability Company Dallas, TX 1-866-519-2522 Additional Insured - Where Required under Written Contract or Written Agreement Endorsement Policy Number:1000198720241 Effective Date: 12/01/2024 at 12:01 A.M. Named Insured: Chrisp Company This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the declarations page. Please read the endorsement and respective pollcy(ies) carefully. Business Auto Coverage Form THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. It is hereby agreed that SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, is amended to include the following: d. Any person or organization whom you become obligated to include as an additional insured under this policy, as a result of any written contract or written agreement you enter into which requires you to furnish Insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said written contract or written agreement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President and ' Chief Executive Officer SICA 1016 (04/14) A4044 I &i�6t Nehemiah E. Ginsburg, General Ca: nsel Copyright © Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Page I of I *,- Starr Indemnity & Liability Company Dallas, TX 1-866-619-2522 THIS ENDORSEMENT CHANGES TH E POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS To CERTAIR ADDITIONAL INSUREDS Policy Number: 10001 98720241 Named Insured: Chrisp Company This policy bamended aofollows: Effective Date, 12/01/2024 ad12:01AM BUSINESS AUTO COVERAGE FORM ' Section IV — Business Auto Conditions, B., General Conditions, 6., Other Insurance,c., Is amended bythe addition ofthe following sentence: The insurance afforded under this policy rd| to an additional Insured will apply aoprimary Insurance for such additional insured where so required under an agreement executed prior to the date of accident. VVewill not ask any Insurer that has Issued other insurance bosuch additional Insured to contribute hothe settlement ofloss arising out nfsuch accident. All other terms and conditions remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY 1 &6t)Steve Blakey, President an Nehemiah E. Ginsburg, General CoUnsel Chief Executive officer i m� 1 0N�A 1017 __=_ C.\( & and Starr | &uwb|8x All rights reserved.�' ' Includes copyrighted material vfISO Properties, mo..used with its permission. 0 POLICY NUMBER: 1000198720241 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM E.A. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Chrisp Company Endorsement Effective Bate: 12/01/2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): Where required by written contract or written agreement. Information required to complete this Schedule, if not shown above, will be shown In the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 441013. © Insurance Services Office, Inc., 2011 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the. Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged In the work described In the Schedule. The additional premium for this endorsement shall be 2.0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Where required by contract Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. This endorsement changes the policy to which it Is attached and Is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective: 12/01/2024 Insured: Chrisp Company Insurance Company: Starr Indemnity & Liability Company WC 04 03 06 (Ed. 04-84) Policy No.: 1000004442 Endorsement No.: Premium: Countersigned by: Page I of 1 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE os/oa/aola Chrisp Company Additional Description of Operations/Remarks from Page 1: Additional Information: GENERAL LIABILITY: * Additional Insured if required by written contract per attached Form OG 185(04/12) and OG 180(04/12) * Coverage is Primary/Non-Contributory if required by written contract per attached OG 107(04/11) * Waiver of Subrogation if required by written contract per attached Form CG 24 04 05 09 AUTOMOBILE LIABILITY: * Additional Insured if required by written contract per attached Form SICA1016(04/14) * Coverage is Primary if required by written contract per attached Form SICA 1017 (02/12) * Waiver of Subrogation if required by written contract per attached Form CA 04 44 10 13 WORKERS' COMPENSATION: * Covered States: California, Nevada, Oregon * Waiver Of Subragaticn if required by written contract per Form WC 04 03 06 UMBRELLA LIABILITY: * Underlying: General Liability, Automobile Liability, and Employer's Liability NN,