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Home My WebLink AboutGladwell Governmental Services, Inc. 10.22.2024GLADGOV-01 S+GONZALEZ �k CERTIFICATE OF LIABILITY �NRAN DATE �I�IINtDDtYI�YYj 10122/2024 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 pol'Icy(ies) 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 endorsements). PRODUCER License # 0757776 HUB International Insurance Services Inc. PO Box 5345 • . Riverside, CA 92517 CONTACT Jordan Bartleson NAME: (A/C, Ext): (951) 779-8575 1 (AIC, No): (951) 231-2565 E-MAIL Jordan.Bartieson@hubinternational.colm INSURERS AFFORDING COVERAGE NAIL # 9/31/21 24 INSURER A: Hartford Underwriters Insurance. Company 39104 EACH OCCURRENCE $ 21908,900 INSURED INSURER B. Harford Accident and Indemnity Company 22357 INSURER C.- Harford Casualty Insurance Company 29424 Gladwell Governmental Services, Inc. INSURER D: United States Liability Insurance 25395 P.O. Box 82 Lake Arrowhead, CA 92352 INSURER E INSURER F LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NEE AUTOS ONLY NON-OWNED COVERAGES CERTIFICATE NUMBERS REVISION NUMBER: 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 LTR TYPE 4F INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEOCCUR FX _ 72SBABF4UI 2 9/31/21 24 � , /2925 EACH OCCURRENCE $ 21908,900 DAMAGE TO RENTED 21000,000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 19,898 PERSONAL & ADV INJURY $ 21,000,998 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY®000 GT � F� LOC OTHER: GENERAL AGGREGATE $ 41980,898 PRODUCTS .. COMP/OP AGG $ `1� , $ AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NEE AUTOS ONLY NON-OWNED 72UECPT0490 10/31/2024 19/31/2025 COMBINED SINGLE LIMIT 15000,000 Ea accident $ BODILY INJURY Per person $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y N OFFICERIMEMBER EXCLUDED? NN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below t A 72WECA1t7EWT 2111224 21112025 STATUTE ERH� STATUTE EACH ACCIDENT $,,� E.L. DISEASE - EA EMPLOYEE $ 110001000 E.L. DISEASE - POLICY LIMIT $ 11000,000 D D Professional Liab. Professional Liab. SP 1020955N SP 1020955N 10/31/2024 10/31/2024 10131/2925 10131/2025 Per Occurrence 110001000 Aggregate 210001000 DESCRIPTION OF OPERATIONS t LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mores ace is required) Town of Les Altos Hills is Additional Insured with regard to the General Liability policy when required by written contract per the attached endorsement form SL304210/13. J CERTIFICATE HOLDERR CANCELLATION ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and loge are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Hills Attn: Deborah Padovan, City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 28379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos Hills, CA 94922 ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and loge are registered marks of ACORD INSURED: Gladwell Governmental Services, Inc. POLICY NUMBER: 72SBABF4UK2 EFFECTIVE DATES: 10/31/2024 to 10/31/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A. The following is added to Section C. WHO IS AN INSURED: Designated Person Or Organization a. The person(s) or organization(s) shown in the Declarations as Additional Insured — Designated Person Or Organization is also an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations, or (2) In connection with your premises owned by or rented to you. b. If coverage provided to these additional insureds is required by a written contract or written agreement, or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision, the insurance afforded to these additional insureds will not be broader than that which you are required by the contract, agreement, or permit to provide for these additional insureds. c. The insurance afforded to these additional insureds only applies to the extent permitted by law. B. With respect to the insurance afforded such additional insured(s) by this endorsement, the following additional exclusion is added to Section B. EXCLUSIONS: This insurance does not apply to "bodily injury" or "property damage" included within the "products -completed operations hazard'. Form SL 30 42 10 18 @ 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) Page I of I