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HomeMy WebLinkAboutDe Mattei Construction Inc 05.01.25DEMACON-01 PPARI r 14<7"R", CERTIFICATE OF LIABILITY INSURANCE FDAT5(MMIDD/YYYY) TYPE OF INSURANCE 5/1 /2025 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 10 Al t Insurance Services, Inc, 10 Almaden Boulevard, Suite 650 San Jose, CA 95113 CONTACT Certificate Requests (A/C0C Ne, Ext); (408) 352-6700 Ale, Ne);(408) 352-6759 AEDMDRAILEss: sjcertificates@alliant.com INSURERS AFFORDING COVERAGE NAIC # X INSURER A: Navigators Specialty Insurance Company 36056 LA25CGLZO1 PTKIC INSURED INSURER B: Starr Indemnity & Liability Company 38318 INSURER C: De Mattei Construction, Inc. 1794 The Alameda San Jose, CA 95126 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NIIMRFR- DcXnernra K11 11013=M -- IIIYLI\. 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 BE 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. IN LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP M DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X LA25CGLZO1 PTKIC 4/30/2025 4/30/2026 EACH OCCURRENCE $ 1,000,000 DAMAGE AMAG ETO a ENcurrence $ 50,000 PREMIMED EXP (Any oneperson) $ Excluded PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X J LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible/OCC $ 5,000 Ee sacdeDtSINGLE LIMIT $ 1,000,000 B OTHER: AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS A TOS ONLY AR O0 ONELY 1000198660251 4/30/2025 4/30/2026 BODILY INJURY Per arson $ BODILY INJURY Per accident $ PROPERTY DAMAGE $ Per accident Comp/Coll Ded $ 2,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ --rDEDT AGGREGATE $ EXCESS LIAB CLAIMS -MADE RETENTION $ AND KERS COMPENSATION LIABILITY IONX ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBE EXCLUDED? a in and If If yes, describe under DESCRIPTION OF OPERATIONS below $ SER UTE ORH B N / A 1000004187 4/30/2025 4/30/2026 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 I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 2E: Job #4136, Permit #EP21-0164, Preconstruction Meeting -12131 Oak Park Ct. 'own of Los Altos Hills is included as Additional Insured as respects Liability arising out of operations (work) performed by or on behalf of the Named Insured In accordance with the policy provisions of the General Liability policy. Town of Los Altos Hills 26379 Fremont Road 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. HORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: LA25CGLZ01PTKIC ' COMMERCIAL GENERAL LIABILITY CG 20 12 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any State or Governmental Agency or Subdivision or Political Subdivision for whom during the policy period you and such State or Governmental Agency or Subdivision or Political Subdivision have agreed in writing in a contract or agreement that such State or Governmental Agency or Subdivision or Political Subdivision be added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you .or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. if coverage 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. 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 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1