HomeMy WebLinkAboutDarling Family Corporation dba J&M Termite Control Inc 10.07.24M!flxle
AC"RV DATE (MMIDDIYYYY)
UtHTIRCATE 0- F LIABILITY INSURANCE 10/712024
. . . . . . . . . .
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 AMtNl), EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE$
BELOW'. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWE.EN THE ISSUING INSURER(S), AUTHORIZED
I
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDERO
�1,1.� .............. . ......... .. .......... ............ 6 .............. ...... ...... ...... .............. ..... ............ ...... ....... . ..... ...
It
IMPORTANTA It the certificate holder Is on.ADDITIONAL INSURE0., the pollcy(les) must have -ADDITIONAL INSURED provISIOnS 6or 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 ri s to the certificate holder In 1100, of such e M gll
ght ndorseen s
-,
A
PRODUCER NAME"r ESP[ S-_ ervice Team
Er d ewood Partners Ins., Center FAX
Exti:
10. 77 White.Rock Rd. Suite 300
Llc#OB29370 gsp, ESPIServiceTeamCM
_,eplebrokers.com
:Rancho Cordova CA 95670 Melt) 1ftMft114%_1 0% 01ff^ftn1 Mift-^^Wen A^= KI A k^."
INSURER A .- NOVA Iv coo any 42552
INSURED JMTERMI INSURER 0: Preferred EMP ers Insurance Com�parL
Darling Falms Corporation DBA 9 lyrINSUR01 C.-
J & M Termite Control Ino
159 N Whisman Rd
Mountain View CA 94043
INSURER E
RAGE$ CERTIFICATE NUMBER; 16727029:9
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR.
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CON DITIONOF ANY CONTRACT OR ,THER
CERTIFICATE M" BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE
EXCLUSIONS AND CONDITIONS OF SUCIA POLICIES. LIMITS SHOWN MAY HAVE BEEN DEDUCED BY PAID CL IME
QYP
Y.
,TR TYPE OF INSURANOE INSD WVD. POLICY NUNISER ALID' 11
.1011MID, lyYyy)
A X COMMERCIAL 0 ENERAL LIABILITY y POCMLIOOOG04808 3/8120,24 31812026
NN N. .✓m„�Y✓m C
OCCUR LAIMS-MADE
X Pesticido
y I y I POCMLei 000004,808
UMBRELLA LISA B OCCUR
EXCESS LI AS CLAIMS -MADE
1:D1:0 �NETENTION,$
8 WORKEASCOMPEN$ATION
AND EMPLOYMAS! LIABILIT Y YIN
ANYPROPRI.F.TORIPARTNEPI/EXEOUTIVr-- [::]
0FFI0ER/MEMe,EREX0LU0E0? NIA
(Mantlat6r�:IIS NH)
PEG300756386
3/8/2024 1 3/6120,25
10/1/2024 1 10/1/2,025
DESCRIPTION OF OPERATIONS 1LOCATIONS / VENICLIES (ACORD 10-1 , Additional Remarks Sohadule,. may be attoohed If more spece Is requAl
Work perforrned, by, named insured per wriften contract.
uflwxl�-;*
LLA"
07:1
" D NAMED ABOVE FOR THE POLICY PERIOD
)00,4UMENT WITH RESPECT TO WHIC%Hr THIS
HER -IS IS SUBJECT TO ALL THE TERMS,
LIMITS
EACH, OCCunRENCE $11000,000
8ENT5
P Lo $100,000
MED EXP:(Any one person) �mm$5,000
PERS'ONAL& AQV� INJURY 1�0001000
GENERAL AGGREGATE $2,000,000
PROD OT A OOMP/013 AGO $ 21000,000
------ 091T.
OMBINED I
$N i,000,000
BODILY t.NJURY (Per person)
BODILY INJURY tPer amident
Pi P of� Y DAMAG
;A
EACH OCCURRENCE $
AGGREGATE $
x PER OTH-
_ff'&T_Q*_re L11R_
El. �ACH A0010 ENT s 1,000,000
El. DISEA'SE - CA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT 00
ed)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN
Town of Los Altos HillsBuilding Inspection Dept,, ACCORDANCE WITH THE POLICY PROVISIONS.
26379 W Fremont Rd
Los Altos 1-111111s, CA 94022 AUTHORIZED REPRESENTATIVE
USA
0 1988*2015 ACORD CORPORATION., All rights reserved,
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACRD
6117: 2 " of 1(
[X
Herbicide
CREWL AGGREGATE -LIMIT APPLIF-8 PER:
0j
POLICY j"r�
LOC
........
.....
.. ..
AYMPMWNW>rtWRId.MYYNMA�INVl
A
AUTO MOSILEUABILITY
X
ANY AUTO
OWNED
SCHEDULED
AUT.08 ONLY
AUTO$
MI .5
X
NON - OWNED
AUTOS: ONLY
L�_J
AUTO$ rOILY
y I y I POCMLei 000004,808
UMBRELLA LISA B OCCUR
EXCESS LI AS CLAIMS -MADE
1:D1:0 �NETENTION,$
8 WORKEASCOMPEN$ATION
AND EMPLOYMAS! LIABILIT Y YIN
ANYPROPRI.F.TORIPARTNEPI/EXEOUTIVr-- [::]
0FFI0ER/MEMe,EREX0LU0E0? NIA
(Mantlat6r�:IIS NH)
PEG300756386
3/8/2024 1 3/6120,25
10/1/2024 1 10/1/2,025
DESCRIPTION OF OPERATIONS 1LOCATIONS / VENICLIES (ACORD 10-1 , Additional Remarks Sohadule,. may be attoohed If more spece Is requAl
Work perforrned, by, named insured per wriften contract.
uflwxl�-;*
LLA"
07:1
" D NAMED ABOVE FOR THE POLICY PERIOD
)00,4UMENT WITH RESPECT TO WHIC%Hr THIS
HER -IS IS SUBJECT TO ALL THE TERMS,
LIMITS
EACH, OCCunRENCE $11000,000
8ENT5
P Lo $100,000
MED EXP:(Any one person) �mm$5,000
PERS'ONAL& AQV� INJURY 1�0001000
GENERAL AGGREGATE $2,000,000
PROD OT A OOMP/013 AGO $ 21000,000
------ 091T.
OMBINED I
$N i,000,000
BODILY t.NJURY (Per person)
BODILY INJURY tPer amident
Pi P of� Y DAMAG
;A
EACH OCCURRENCE $
AGGREGATE $
x PER OTH-
_ff'&T_Q*_re L11R_
El. �ACH A0010 ENT s 1,000,000
El. DISEA'SE - CA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT 00
ed)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN
Town of Los Altos HillsBuilding Inspection Dept,, ACCORDANCE WITH THE POLICY PROVISIONS.
26379 W Fremont Rd
Los Altos 1-111111s, CA 94022 AUTHORIZED REPRESENTATIVE
USA
0 1988*2015 ACORD CORPORATION., All rights reserved,
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACRD
6117: 2 " of 1(
ri 1
M :ML
1,
IL
This endorsement modifies insurance provided under the following,,
101TAII 0 1 : 3: 0"'1 It LAI 0,
11 1-IM10-5 I
The following is added to SECTION IV' — COMMERCIAL GENERAL LIABILITY CONDITION,$,
Paragraph 4:
IT-Trrn"
Notwithstanding the provisions of sub -paragraphs, a, b, and c of this paregraph 4, with respect to
tho Third Party as defined below, 'it I'�S Understood and,, agreed thatin the event of a claim or "suit"
a i Ither
rising out of the Named InSUred's negligence,: this insurance shall be primary and any o
insurance maintained by the additional insured narnedas the Third Party below shall be excess and
non-contributory.
This endorsement applies only to those third parties required to be named as an Additional Insured
'n
as Pma
riry and Non -Contributory coverage specified in a written, contract with the Named
under this policy, entered into prior to the "loss" or 11,occurrance".
The Third Party to whom this endorsement applies is:
ANYPERS;ON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT THAT YOU
HAVE AGREED TO PRIOR TO A LOSS,
All other terms, conditions and exclusions Linder this policy remain unchanged,
AGL 01 15 06 09 Includes o 'rl ht material of Insurance Services Office, Inc.,
with its permission.
Page 1 of I
INSURED 6117: 3 " of 10
COMMERCIAL GENERAL LIABILITY
CG 20 10 12 19
�!l q
tA_.__:kFfl 0411
Arft r% 1S.'s 1 0 ts c r" 0%
UU]TIONAL INSURED now OWNERS, LEO"O""'r—S UR
CONTRACTORS � SCHEDULED PERSON OR
GRGANIZATION
This endorsement modifies insurance provided under the following:
SCHEDULE
Name Of Ad4iflonal Insured Pers
Or rNanizatio!1(�1 .. YF59' 1?'M:FhF'?w^ !Mlin11R1F%MkkN1 .. N1Y.R.1MF Loca-t1on(s) Of Covered OLerations
4111141 ffiltl,1�1111
ANY PERSON OR ORGANIZATION
WHEN REQUIRED BY WRITTEN Work performed by named insured,
CONTRACT THAT YOU HAVE AGREED
TO PR[OR TO A LOSS.
,.information required to corgis l
,eute thisc
. Shedule,if nOt ,,-shownabove, will bshown in the clarations.
: e De
A. Section If — Who Is An Insured 'is amended to
include as an additional InWred the person(s) or
organization(s) shown in the Schedule, but 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 orinissions of those acting on yoUr
behalf;
in the performance of you:r ongoing operations for
the additional insur'ed(s) at the location(s)
designated above.
70 "SIT4, M_
1. The "insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If ,coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to Mich additional incurod
will not be broader than that which you ate
required by the contract or agreement to
provide for such additional [nsure d.
B. With respect to the 'insurance afforded -to these
additional insureds, the following additional
exclusions applyll
This insurance does not apply to "bodily, injury" or
"property damage" occurring after:
1. All work, 'including materials,, pails or
equipment furnished in connection with such
work,, on the project (other then service,
maintenance or repai,m) to -be performed by or
on behalf of the additional insured(s) at the
location of the covered operations has been
completed,,, or
2. That portion of "your world" out of which the
i njury 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,
@insurance Sorvices Office, Inc., 2018
INSURED x117:4 " of V
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf. of the additional insured is the
amount of insurance.,
1. Required by the contract or agreement; or
ZMI��
2. Available under the
insurance;
whichever is less.
This endorsement shall
applicable limits of insurance
C Insurance Services Office, Inc., 2018
applicable limits of
not increase the
INSURED 5117: 5 " of 10
, 0 MMERCIAL GENERAL LIABILITY
CG 20 37 12 19JINMi
...... ......
L ffljy�JWI �gral' Py
W4 I MUN.M1101 LIMAN M1,0011 Irv,
Name MAdditional Insured Person(s)
Or Otganization
Location And Deserl tion Of Completed Op ,raflons
ANY PERSON OR ORGANIZATION
WHEN REQUIRED By WRITTEN
Work peilormed by named insured.
CONTRACT THAT YOU HAVE AGREED
TO PRIOR TO A LOSS.
J. ..... . .........
Information re tred to corn te this, Schedule if n6t shown above., will be shown in the Declarations.
A. Section 11 — Who Is An Insured is amended to
B. With respect to the insurance afforded to these
d,
include as an additional 'insured the person(s) or
additional insureds, the following is added to
organization(s) shown in the Schedule, but only
Section 11-1 — Limits Of Insurance:
with respect to liability for "bodily 111jury" or
If coverage provided to the additional insured is
"property damage" oaused, in whole or in, part,, by
required by a contract or agreement., the most we
"your work" at the location designated and
will pay on beel f of the additional insured is the
described in the Schedule of this endorsement
amount of insurence:
performed for that additional 'insured and incl udod
1. Required ired by the contract or agreement, or
in the "Products -completed operations hazard",
2. Aval lable under the applicable limits of
However:
insurance;
11. The insurance afforded to such additional
whichever i's less,,
insured only applies to the extent permitted by
This endorsement shall not inorease the
law, and
applicable limits of insurance,
2,x If covetage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
0 Insurance Services Office, I no,, 2018
INSURED 5117: 6 " of
COMMERCIAL GENERAL LIA131LITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGEPART
LIQUOR LIABILITY'COVERAGE PART
POLLUTIONLIABILITY COVERAGE PART,DESIGNATED SITES
1POLLUTIDN LIABILITY LIMITED COVERAGE PART DES:[GNATED SITES
PRODUCTSMOMPLETED 0PTIONS LI:' ABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
0
Name Of Person(s) Or Organization (s) H
Applies to Any Person or Organization when soch waiver I*$ required by a written Contrad
that you have agreed to prior to loss,.
In,forma-tion reqit to complete this Schedule. if not shown move, will be shown in the, Declarations,
The following is added to Paragrraph 8, Transfer Ot
ffigdhts Of 'Recovery Agath$t Others 'To Us of
M
Section IV - Condifions.
a
We waive any right of'recoveryagainst-the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part., Such walver by us applies only to the extent that
the insured. has waived its right of: recovery spinst
m I n(s) prior to loss. This
s0oh person(s) or org- Ozatio 1.
endorseme ' nt applies only to the person(s) or
organization(s) shown in the Schedule above.
CG 24 04 12 19 @Insurance Services Office, Inc., 2018 Page 1 of 1
INSURED 5117: 7 * of 10
11 111 111
EM
14
Name of PeIrsonor Organization,,
ANYPERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT THAT YOU HAVE
AGREED TO PRI:OR TO A LOSS.
Any person or organization when such walver Is required by a written contract that you have
ag reed to prior to loss,
'if no entry aPpears above, information required to complete this endorsement will be shown in th
Declarations as applilcable to this endorsement)
Its]
The Transfer of Ri, ghts ofRecovery Against Others to Us condition (SECTIONIV — BUSINESS AUP"
CONDITIONS) is amended by the addition of the following:
We waive the right of recovery we may have agai . nst the person or organization shown in the Sched-ul,
above because of payments we make for InjUry or damage arising out of your ongoing operations. Thl
:e lgnated'in the $chedule.
welver applies anly to the p rson or organiz6bon des" I
Page 1 of I
INSURED 51'17: 8 * of 1(
POLICY NUMBER,* POC -ML -10000048-08
COMMERCIAL AUTO
It
F i
-- I YCIRWt 20-01,
This endorsement modifies insurance provided under the following:
Any person or organization required to be named as an Additional Insured in a written contract
with the Named Insured under this policy, entebredinto prior to the "loss" or "occurrence".
It is hereby agreed that SECTION 11 X, 114 — Who Is an insured is amended to include as an
ins the person or organization, truste-e, estate or Governmental entity- to whom or to which
U. are obligated, by virtue of a legally enforceable written contract or by the issuance or
existence of a perr itjo provide insurance SLIch as is afforded by this policy, but only with resipect
to operations performed by you or on your behalf or to facilities used by you and then only for the
limits of liability specified in such contract, but in no event for limits of l,iablility in excess of the
applicable limits of liability of this policy; provided that such person, organization trustee, estate
or Governmental entity shall be an Insu,red only with respect to such "loss" or "accident" taking
place after such written contract has been executed or such permit has been 'issued,
Coverage under this endorsement appliesonl. as respects a legally enforceable written
y
contract or permit with the named insured under this policy and only for lia'bility arising out
of or relating to the Named I nsui,,,ed's neg,ligence.
It is further under -stood and agreed that irrespective of the number of entities named as
insureds under this policy in no event shall the Company's lifnits ofliability exceed, the
limits of liability designatedire the Declarations of this policy.
All other terms, conditions and exclusions under! the policy are applicable to this, endorsement
and remain unchanged.
Page 1 of 1
INSURED 5117: 9 "' of 10
red E
rs
IN N C E C A N Y
MATWR� M
WilliPill[i
We have the right to recover our payments from any0ne liable for an injury covered by this policy. We mill not
enforce our right against the person or organization f which, you perform work under written contract that
retiresyou to obtain this agreement t0M LIS.
The preLry)JILIM charge for this endorsement shall be 3% of the Worker's Compensation premium, subject to a
minimum charge of $500,00
This endorsement changes the pofloy to which it is- atts-ch od effective on the date Issued unless, otherwise stated.
(The Information below Is required only when this endortement Is Issued subsequent to preparation of the policy.)
Endorsement Effective 10101124 Policy No. PEG300756386 Endorsement NO, 2
Insured DARLING FAMILY CORPORATION DBA J & M TERMITE CONTROL INC.
Insurance Company PREFERRED EMPLOYERS INSURANCE COMPANY
Countersigned By
5117: 10 ' of'
Edgewood Partners Ins. Center
10877 White Rock Road Ste 300
Lic#01329370
Rancho Cordova, CA 9567 ►
.»M
TOWN OF w
26379 W FREMONT RD
LOS ALTOS HILLS, CA a. 5117
5117: 1 " of 10