Loading...
HomeMy WebLinkAboutZicovich Builders Inc. 09.09.24ACC>RhPCERTIFICATE �..--- CATS ®F LIABILITY INSURANCE DATE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 9/9/2029 OLDER. TH CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTTHE POLICIESIS 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 polio 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 ondorsement(s). PRODUCER NAME; Lauri Tatum Leavitt Pacific Insurance Brokers, Inc. PHONE AC No Ext: (408)288-6262 FAX LiCeriSe #OD79674 E-MAIL AIC�No): (400)298-7635 1570 The Alameda, Suite 101 ADDREss:lauri-tatum@leavitt,com — San Jose CA 95126 INSURER(S) AFFORDING COVERAGE INSURED INsuRERA:Mesa Underwriters Specialty Tnsurance C 36838_ Zicovich Builders, Inc, INSURER Security Tnsurance Company 24082 761 University Ave, Ste, C INSURER c:scottsdale Insurance Company 41297 uoum❑n u : zverest Yremier Insurance Compat__iy__ 16045 Los Gatos INSURER E: CA 95032 — INSURER F-: COVERAGES' CERTIFICATE NUMBER.24-25 — THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE REVISION NUMBER: LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM ABOVE FOR THE 1::: PERIOD N CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORQED BY THE POLICIES EXCLUSIONS DESCRIBED HEREIN AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID INSR IS SUBJECT TO ALL THE TERMS, ADDL SUBR CLAIMS, LTR TYPE OF INSURANCE1= WVD POLICY NUMBER POLICY EFF POLICY FXP X COMMERCIAL GENERAL LIABILITY M /DO/ YY MM/DD/YYYY LIMITS A CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1,000,00 _ DAMAGE TOR - TED _ — - MP0082001008614 9/13/2024 PREMISES Ea ooLqrrqncpj $ 100,00 9/13/2025"— MED EXP (Any one person) $ 5,00 GEN'LAGGREGATE LIMIT APPLIES PER: PERSONAL &ADV INJURY $ 1,000,001 POLICY a PRO ❑ LOC GENERAL AGGREGATE $ 2,000,001 OTHER; PRODUCTS •COMP/OP AGG $ 2,000,001 AUTOMOBILE LIABILITY Employee Benefits - $ 1, 000_'0 0 B X ANYAUTO COMBINED SINGLE LIMIT Ea accident $ 1,000,00( ALL OWNED SCHEDULED AUTOS BODILY INJURY (Per person) $ AUTOS BAS57498524 9/10/2024 9/10/202.5 HIRED AUTOS NON -OWNED BODILY INJURY (Per accident) $ AUTOS PROPERTY DAMAGE '—' Per accident $ UMBRELLA LIAB - }{ OCCUR Uninsured motorist combined single $ 1 , 000 , 00 C C }{ EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE _-^ $ �� 3,000,000 DED RETENTION $ XLS1228152 9/13/2024 AGGREGATE $ 3,000,000 WORKERS COMPENSATION 9/13/2025 AND EMPLOYERS' LIABILITY $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER rH- STATUTE ER D EXCLUDED? N /A _ (Mandatory in NH) 7600017395241 If yes, describe under 3/10/2024 3/10/2025 E.L. EACH ACCIDENT $ 1 ,, 000, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 , 000.000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more spa e is required) Re: 13300 Robleda Road, Los Altos Hills, CA, CERTIFICATE HOLDER CANCELLATION esteta@losaltoshills,ca,gov Town of Los Altos Hills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26379 Fremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE Fred Stafford/JOROME ACORD 25 (2014/01) The ACORD name and logo are registered @ 19 - ACORD CORPORATION, All rights resert INS025 (201401) POLICY NUMBER: MP0082001008614 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR RR This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any person.'or organization to which you are obligated by virtue of a written contract to provide insurance such as is afforded by this policy, but only with respect to (1) occurrences taking place after such written contract has been executed and (2) occurrences resulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. A person or organization that qualifies as an "insured" under the above paragraph of this Endorsement shall be an additional insured solely with respect to such additional insured's liability for "bodily injury," property damage" or "personal and advertising injury" caused in whole or in part by your acts or omissions in the performance of "your work" for the additional insured on or at "commercial construction projects." For the purposes of this Endorsement, "commercial construction projects" are defined as buildings or structures constructed for commercial use and also includes apartments, hotels, homes for the aged, dormitories or barracks. However, "commercial construction projects" shall not include any building or structure which contains individual owner occupied units or dwellings. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) 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 work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 11 POLICY #MP0082001008614 COMMERCIAL GENERAL LIABILITY CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • "' a -• � � • � , ,,Ego This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured, A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. E. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "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: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. 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 architectural, engineering or surveying services. CG 20 33 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2