HomeMy WebLinkAboutFuture Air, Inc. 01.16.25CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
F1/16/2025
TYPE OF INSURANCE
INSD
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION.ONLYAND 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($), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endorsement(s).
PRODUCER
Leavitt Pacific Insurance Brokers, Inc.
License ##OD79674
NAME: CONTACT Carlyn Eaton
PHONE (408) 286-6262 FAX(408)298-7635
&MAIL° E AIC No:
carl
ADDRESS;yri-eatOn@leavitt.COm
1570 The Alameda, Suite 101
San Jose CA 95126
INSURERS AFFORDING COVERAGE NAIC #
INSURERA;Travelers Indemnity Company 25666
INSURED
Future Air, Inc,
270 Kinney Drive
Philip Madera
San Jose CA 95112
C[1V1=QA(:FC /+CBTICIAA'TI_ \11IX�IYe�Ih.AC nP .._ _,_
INSURER B: Travelers Property CasualtyCompany of 25674
INSURERC;Forte ra Specialty Insurance 16823
INSURER D:Ironshore, Specialty Insurance Com an 25445
INSURER E:
INSURER F:
_
4-v1u1V 1Y IYVIYI�GR.
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 SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSRADDL
LTR
TYPE OF INSURANCE
INSD
SUBR
I POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
A
CLAIMS -MADE 51OCCUR
EACH OCCURRENCE $ 1,000,000
DA ACETO RI: FTMD
PREMISES Ea occurrence $ 300,000
4T22C01E097548TCT25
2/1/2025
2/1/2026
MED EXP (Any one person) $ 10,000
PERSONAL &ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JE� 7 LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS •COMP/OP AGG $ 2,000,000
OTHER:
$
B
AUTOMOBILE LIABILITY
X ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
AUTOS
X
BA3L2678472528G
2 1/2025
/
2/1/2026
COMBINED SINGLE LIMIT
Ea accident $ 1,000,000
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
Per accident $ - -
$
B
UMBRELLALIAB
X EXCESS LIAB
X
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
B
DED _ RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory In NH)
If a, describe under
N /A
CUP2J157959202S
UB1J061687202SG
2/1/2025
2/1/2025
2/1/2026
2/1/2026
$
X PER OTH-
STATUTE ER
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 below
ofessional Liab Claims -Made C100 005702 2/1/2025 2/1/2026 PerClalm/Aggregat° 1,000,000
IDP.11ution Liability I1EL1UW00159904 5/30/2024 5/30/2025 10,000 Dad 2,000,000
,DESCRIPTION OFOPERArIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
('pI7TICICATC Unl nen
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills CA
94022
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Fred Stafford/YVVALD�¢.� {/
^VVLV LO t4V 1-+/U 1) 1 ne AGUKu name and logo are registered marks of ACORD
INS025 (201401)