HomeMy WebLinkAboutFibertel LLC 04.28.251 of 1
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A4L_iJ1<t.7 CERTIFICATE OF LIABILITY INSURANCE
FDATE Y)
5/1/2026
04/28/2025
/202
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 Lockton Companies, LLC
$ 1,000,000
DBA as Lockton Insurance Brokers, LLC in CA
CA license #0F15767
3657 Briarpark Dr., Ste. 700
PHONE X
E-MAIL
INSURERS AFFORDING COVERAGE NAIC #
Houston TX 77042
INSURERA: Old .Republic Insurance Company 24147
INSURED Fibertel, LLC
1394407 A QUANTA SERVICES COMPANY
PO BOX 1071
INSURER B
INSURER C :
INSURER -D: -
Springville UT 84663
INSURER E :
06/01/202
INSURER F:
ncvi�wia rYUrYroGri: AAAAAAA
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.
INSR ADDL SUB POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY
MMIDD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY MWZY 313093 25 05/01/202 06/01/202
EACH OCCURRENCE $ 2 000 000
A CLAIMS -MADE OCCUR MWZX 313095 25 05/01/202 06/01/2026 DAMAGE TO RE TED
$ 1,000,000
Y N MED EXP (Any oneperson) $ Excluded
PERSONAL & ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4.000.000
POLICY❑ PRO- ❑
JECT LOC
PRODUCTS - COMP/OP AGG $ 4,000,000
OTHER: $
A
AUTOMOBILE
LIABILITY
MWTB 313092 25.
05/01/202
06/01/202
Eaaeocld.ntSINGLELIMIT $ 1,000,000
AUTO
BODILY INJURY (Per person) $ XXXXXXX
OWNED SCHEDU_OWLED
Y
NAUTOSONLY
INJURY (Per accident) $XXXXXXX
1XXANY
AUTOSBODILY
HIREDAUTOS ONLY X AUTOS ONLY
PParr a .1Jent AMAGE $ XXXXXXX
$XXXXXXX
UMBRELLA LIAB
OCCUR
NOT APPLICABLE
EACH OCCURRENCE $ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
AGGREGATE $ XXXXXXX
DED I I RETENTION $
$
WORKERS COMPENSATION
X P R H-
A
AND EMPLOYERS' LIABILITY YIN N
M WC 313094 25
05/01 /202
05/01 /202
E
A
ANY
OFFICER/MEMBER EXCLUDED?
NIA NIA
N
MWC 31309426
05/01/202
06/01/202
E,L. EACH ACCIDENT $1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
(Mandatory In NH)
Ugs, describe under
E.L. DISEASE - POLICY LIMIT $ 1.000.000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Additional Insured in favor of the Town of Los Altos Hills, Its elective and appointed officers, employees, and volunteers on the General Liability and Auto Liability where and
to the extent required by written contract.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
21123317 T24 P1 AUTHORIZED REPRESENTATIVE
City of Los Altos Hills
26379 Fremont Road
Los Altos Hills CA 94022
• •--- _ % � � ' 1 ne --mu narne ana logo are reglsterea marKS of AGURD
May 1, 2025
Re: Quanta Services and all Subsidiaries
Renewal Certificate of Insurance
Dear Certificate Holder:
Enclosed for your records you will find the renewal Certificate of Insurance for Quanta Services
and its Subsidiaries.
To expedite the delivery of future renewal certificates, we are collecting email addresses for all
certificate holders. Please note that if no email address is on file, we will continue to mail a
certificate of insurance to the mailing address on file.
If you wish to receive E-mail version of renewal certificates going forward, please send the
email address at which you would like to receive your certificate as well as the Certificate
Holder number (see below for directions on how to locate this information) to the following
email address:
Houston-QuantaECertDelivery@lockton.com
Certificate Holder #
RTIFICATE HOLDER _
The Certificate Holder number is
12345678
the 8 digit number directly above
the Certificate Holder name and
12345678
address in the bottom left corner
of your enclosed COI.
SAMPLE
123 Main Street
Anywhere AL 12345
MRD 2.5 (2016/031
Regards,
Amy Barnett