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Home My WebLink AboutGladwell Governmental Services, Inc. 11.01.2024C-,L_ADG0V-t11 SGONZALEZ CERTIFICATE F LIABILITY INURANE DATE(MMIDDIYYYY) 11 /11202,4 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(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 rewire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0757776 HUB International Insurance Services Inc. MAIAN LATS. R PO Box 5345 Riverside, CA 92517 CONTACT Jordan Bartleson NAME: PHONE FAX (A/C, No, Ext): (951) 779-8575 (A/C, No): (951) 231-2505 o IL . Jordan.Bartieson@hubinternational.com INSURERS AFFORDING COVERAGE NAIL # 72SBABF4UK2 INSURER A: Hartford Underwriters Insurance Company 30104 1013112925 INSURED INSURER B : Hartford Accident and Indemnity Company 22357 INSURER C.- Hartford Casualty Insurance Company 29424 Gladwell Governmental Services, Inc. INSURER D . United States Liability Insurance 25895 P.O. Box 62 Lake Arrowhead, CA 92352 INSURER E INSURER F: B nnVPPA P9 r__PPTt1=[C"AT1= N1IMRPP• RFVIRION I1 t]MRFR-- 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 OF INSURANCE ADDL AVSD SUBR wVD POLICY NUMBER POLICY EFF MMJDDIYYYY POLICY EXP MM/DQ LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 72SBABF4UK2 10/3112024 1013112925 EACH OCCURRENCE $ 21000;000 DAMAGES ( RENTED 2100%000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 100000 PERSONAL & ADV INJURY $ 21000,000 GEN`L AGGREGATE LIMIT APPLIES PER: POLICY®JECT F] LOC OTHER: GENERAL AGGREGATE $ 141000,000 PRODUCTS - COMP/OP AGC $ 4,0001000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREDNON-O NED AUTOS ONLY AUTOS NLY 72UECPT0490 1013112024 1013112025 EaaMaccidEen SINCL.E LIMIT $ 11000;000 BODILY INJURY Perperson) $ 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 PROPRIETOR/PARTNER/EXECUTIVE Y J N OFFICER/MEMBER EXCLUDED? NN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 1 A 72WECBK�4F2G 1013112ti2 1013112025 X7 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE �- EA EMPLOYEE $ ' � E.L. DISEASE - POLICY LIMIT $ 110003000 D D Professional Liab. Professional Liab. SP 1020955N SP 1020955N 1013112024 1013112024 1013112025 1013112025 Per Occurrence 110005000 Aggregate 21000,000 DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Town of Los Altos Hills is Additional Insured with regard to the General Liability policy when required by written contract per the attached endorsement form SL304210118. P.FRTIFICATF Iam nFR CANCFLLATION ACORD 25 (2016103) 031980-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Hills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Deborah Padovan, City Clerk 25379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos Hills, CA 94022 ACORD 25 (2016103) 031980-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo 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 1� 9] I i N -A 101*�1111 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 it yyl damage" or personal and advertising injurcaused, 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 ernmental 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'I . Form SL 30 42 10 18 @ 20187 The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) Page I of I ,..�••.r, %[._Anrnv.ni SGONZALEZ CERTIFICATEF LIABILITY INSURANCE DATE {MMIDD[YYYY} 11/1/2024 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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. �� Bob ��"�'� Riverside, CA 92517 CONTACT Jordan Bartleson NAME: FAX yry w� }� �+ / �y �w 779-8575 PHONEN�� Ext}` 959 I J y� 1 *1 (AIC, K 1 [ I ssslll VVV ■ V `M7i,� , No). 1 ' 1 r E-MAIL ADDRESS: Jordan.Bartleson C ' ubinternational.c+E�m INSURERS AFFORDING COVERAGE NAIL # INSURER A: Hartford Underwriters Insurance Company 301 Q4 INSURED Gladwell Governmental Services, Inc. P.O. Box 02 Lake Arrowhead, CA 92352 INSURER B : Hartford Accident and Indetnnity Company 22357 INSURER C., Hartford Casualty Insurance Company 29424 INSURER D: United States Liability Insurance 25595 INSURER E INSURER F: Y'*n11=0Af_%=4Z f*I=0TII=1rAT1= K111 nRIZIQ- RFVI..q[ON N[IMRFR"- 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 CONTRACTOR 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 ANIS CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICYFX ECT 7 LOC OTHER: 72SBABF4UK2 10/31/2024 10/31/2025 EACH OCCURRENCE $ 25000,000 DAMAGE AMA GETO R Ecco encu $ 21000,000 10000 MED EXP (Any one arson $' PERSONAL & ADV INJURY $ 21000,000 4000 GENERAL AGGREGATE $ '� 00 ' - PRODUCTS - COMP/OP AGG $ 4500+D,00 I $ AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 72UECPT0490 10/3112024 10/31/2025 COMBINED SINGLE LIMIT 11000,000 Ea accident $ BODILY INJURY Per erson $ BODILY INJURY Per accident $ PROPERTYaDAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS` LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y N OFFICER/MEMBER EXCLUDED? aE.L. (Mandatory in NH) If yes, describe under000 DESCRIPTION OF OPERATIONS below N 1 A 72WECBK4F2G 1013112024 10/3112025 STATUTE ER EACH ACCIDENT $ 1,000'00 E.L. DISEASE - EA EMPLOYEE $ 110005{ 00 E.L. DISEASE - POLICY LIMIT $ ' ' 000 D D Professional Liab. Professional Liab. SP 1020955N SP 1020955N 10131/2024 10/31/2024 10/31/2025 10131/2025 Per Occurrence 110001000 Aggregate 210005000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if; more s ace Is required) Town of Los Altos Hills is Additional Insured with regard to the General Liability policy when required by written contract per the attached endorsement term SL3042 90118. n=0T19:1r*ATI= wni r izp CANC:FI I ATION ACORD 25 (2€116/03) @ 1938-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Hills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Deborah Padovan, City Clerk 25379 Fremont Road AUTHORIZED REPRESENTATIVE -44. Los Altos Hills, CA 94022 ACORD 25 (2€116/03) @ 1938-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t 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 ic 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