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HomeMy WebLinkAboutFidelity National Information Serv. Inc. 04.03.25, • '�'�►� CERTIFICATE F LIABILITY INSURANCEpATlz(MiYI/DD/YYYY) TIil5 CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO Oa/p3/2026 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTA T: f the certificate holder is an ADDITIONAL INSURED, the policy(es) must have ADDITIONAL INSURED previsions or be endorsed: If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement($). PRODUCER Aon Risk Insurance Services West, Inc. CO ACT D Denver co office 200 Clayton street, suite 800 Max.(A/Ext): (866) 283-7122 PAX (800) 865-0105 a {A p.No.h Denver CO 80206 USA ADDRESS: a O _Z INSURERS) AFFORDING COVERAGE NAIC # INSURED Fidelity National Information serv. Inc. INSURER A: QBE Insurance Corporation 39217 and all subsidiaries INSURER B: National Fire & Marine Ins Co 20079 347 Riverside Ave Jacksonville FL 32202 USA INSURER 0: Continental casualty Company 20443 INSURER D: American Casualty CO. of Reading PA 20427 INSURER E: Transportation Insurance Co. 20494 COVERAGES CERTIFICATE NUMBER: 570111962341 INSURER F: The continental insurance company 3.5289 �. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE REVISION NUMBER: 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. ADDI Limits shown are as requested I L R TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY INSO WV POLICY NUMBER EFF FOLIC YYYY PO MM DD/Y YY LIMITS CLAIMS -MADE " OCCUR EACH OCCURRENCE $2, 000, 000 DAMAUE1 Q RENTED$2,000,000 `- PREMISES Ea occurrence) - ^-- -- ---- _ MED EXP (Any one person) $10,000 _ PERSONAL&ADVINJURY $2,000,000 N GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $4,000, POLICY ❑ PRO• JECT I LOC 00 L ; L�J OTHER: PRODUCTS •COMP/OP AGG $4,000,Q00' O AUTOMOBILE LIABILITY BUA 7036257962 04/01/2025 04/01/2026 COMBINED SINGLE LIMIT Ea a olden $2,000,000 iX ANY AUTO BODILY INJURY ( Per person) [ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) z HIREDAUTOS ONLY NON -OWNED AUTOS ONLY PROPERTYDAMAGE Per acoldent f F X UMBRELLALIAB X OCCUR 7018146359 04/01/2025 04/01/202-6 EACH OCCURRENCE T25,000,00 EXCESS LIAB CLAIMS -MADE AGGREGATE $25,000,000 DED X RETENTION$10,000 _•_ ----- D WORKER EMPLOYSCOMPENSATIgNAND EMPLOYERS`OR/P IRY Y/N WC70 62579 6 04 0.1 025 0-470-172026 X PER STATUTE TTH. j E ANY PROPRIETOR/ PARTNER/ EXECUTIVE N AOS eXCept CA R I OFFICER/MEMBEREXCLUDED? (Mandatory In NH) N/A WC7036292615 04/01/202504/01/2026 E`L'EAgHAGgiDENT $1,000,000-_ i If yyes describe under 0E8 RIPTION OF OPERATIONS below AZ, MA, OR, WI E,L. DISEASE -EA EMPLOYEE $1,000,000 A Cyber Liability 02/01/2025 02/0 /2026 E,L, DISEASE -POLICY LIMIT $1,000,000 Cybec/E&O/Aggregate 10,000,000 - -- --- claims Made claims mag SIR applies per policy ter s &condi ipns DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Sohedulo, may be attached If more space Is required) y Certificate Holder is included as an additional insured for General Liability and Automobile Liability coverage if required by contract, but only with respect to activities or obligations a performed under the contract and only to the limits required by the contract per the terms and conditions of the policies. i I I I CERTIFICATE HOLDER CANCELLATION a " �`i SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE _o EXPIRATION DATE THEREOF, NOTICE WILL BE .DELIVERED IN ACCORDANCE WIT THE POLICY 3 ' City Of LOS Altos Hills 26379 PROVISIONS, AUTHORIZED REPRESENTATIVE c� Fremont Rd. Los Altos Hills - CA 94022 USA �{ e(a"':fO1fCR.�9AAGGttZ a iG#�t�i d a a .��tG 8 0 0 ACORD 25 2016/03 01988-2015 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000098648 LOC #: Page of ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Aon Risk insurance services West, Inc. Fidelity National information serv. Inc. POLICY NUMBER see Certificate Number: 570111962341 5 CARRIER See Certificate Number, 570111962341 T� EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACCIRL) t-UHM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIL # INSURER G Great American Spirit ins Co 33723 INSURER H Everest National Insurance Co 10120 INSURER LIMITS - — ---- INSURER ADDITIONAL.POLICIES If a policy below does not include litnit information, refer to the corresponding policy on the ACORD certificate form for policy limits. I TYPE OF INSURANCE ADDL IVSD SUBR WVD POLICYNUMBER. POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DJ)Iyyyy) LIMITS - — ---- INSR rUrR EXCESS LIABILITY G EXC5867053 12.5pox25x25 04/01/2025 04/01/2026 Aggregate $12,500,000 xC4EX00550251 12.5pox25x25 04/01/2025 04/01/2026 Aggregate $12,500,000 H Each Occurrence $12,500,000 — WORKERS COMPENSATION D N/A WC7036292601 CA 04/01/2025 04/01/2026 E N/A WCE7036298219 OH 04—/0-1/2025 04/01/2026 SIR applies per policy to ms & conditions - — OTHER B cy7e7iability Excess 42EPP M08102 claims made 10 x10 b2/01/2025 (:F2/01/2026 Zyber/Ei&O/A 9 gregate 10, 000,000 ©2000 ACORD CORPORATION. All rights reserved. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD V9 AGENCY CUSTOMER ID: 570000098648 LOC #: # ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY Aon Risk insurance services West, Inc. NAMEDINSURED Fidelity National Information Serv. Inc. POLICY NUMBER See certificate Number: 570111962341 CARRIER See certificate Number: 570111962341 MAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS ASCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance excess E&o, Cyber - 2/1/2025 - 2/1/2026 All Policies are claims Made Underwriting company - Policy Number - Aggregate Limit(s) 02 - Indian Harbor Insurance company - MTE003915712 - $10m x $20m 03 - Lloyd's Underwriter syndicate No. 4711 ASP - FSCE02502015 - $10M x $30m 04 - Columbia Casualty company - 768772491 - $10M x $40M ACORD 101 (2008/01) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0 Certificate No: 5701 1 1 962341 City of Los Altos Hills 26379 Fremont Rd. Los Altos Hills CA 94022 USA Thursday, April 3, 2025 To whom it may concern: U�J Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570111962341) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment, Aon Risk Services 5801 Postal Road PO Box 818037 Cleveland, Ohio 44181-9600 ■ III,