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HomeMy WebLinkAboutJoe A Gonsolves and Sons Inc. 03.21.2025t 3/21/2026' 8:44:51 PM PST (GMT -8) FROM: fax -TO: 16509413160 Page: 2 of 3 .- ACC>R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 3/21 /2025 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 require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER McGee & Thielen Insurance Brokers, Inc. 3840 Rosin Court, Suite 245(A/C. Sacramento, CA 95834 CONTACT NAME: PHONE FAX No Ext): 916-646-1919 A/C Noll: 916-646-0995 Ao RIESS: INSURER(S) AFFORDING COVERAGE MAIC # 6/17/2024 INSURERA : Travelers Indemnity Company of CT 25682 www.mcgeethielen.com 0633187 INSURED Joe A Gonsalves and Sons Inc. 10URER®. Hartford Accident and Indemnity Comp@nv 22357 & ADV INJURY $ Excluded 1201 K Street INSURER C: INSURER D: Suite 1850 Sacramento CA 95814 INSURERS: INSURER F 16609794P909 -TCT -24 C®VFRAGFR CFRTImr,&TF KIIIIARIP-R- lal=\/ICInKI KII I I M 9Zr-92- 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP - MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_v1OCCUR ElPERSONAL GE141AGGREGATE LIMIT APPLIES PER: ✓ POLICY El PRO JE CT LOC OTHER: 16609794P909 -TCT -24 6/17/2024 6/17/2025 EACH OCCURRENCE $Z0001000 DAMAG O RENTED PREMISES Ea occurrence $1001000 MED EXP (Any one person) s5,000 & ADV INJURY $ Excluded GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $41000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED ✓ AUTOS ONLY ✓ AUTOS ONLY 16609794P909 -TCT -24 6/17/2024 6/17/2025 Ea COMBINED LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ - UMBRELLA LIAB ----- -EXCESS-LIAB- -- - OCCUR --CLAIMS=MADE _ - - - -_ - _ _ EACH OCCURRENCE $ AGGREGATE - - _ _ -$_ ✓ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 57WECZ15671 4/1/2025 4/1/2026 PER STATUTE EOR 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 I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Town of Los Altos Hills is named as addtional insured with respects to general liability per the attached endorsement form CG D1 05. CERTIFICATE HOLDER CANCELLATION 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 Charlotte Brown © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 84481002 1 *25/26 Master GL/AL/WC I Charlotte Brown 1 3/21/2025 1:40:49 PM (PDT) I Page 1 of 2 `3/21x20258�44*51�PST (GMT -8) FROM: fax -TO: 16509413160 Page'.00fa COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED wmOWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: t WHO |8AMINSURED (SECTION U)|oamended boinclude apmminsured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in ewhtten contract, executed prior to /000 to name as additional inounad, but only with respect to UeLd|itv arising out of "your work" or your ongoing operations for that addi- tional insured performed b«you orfor you. 2. With respect to the insurance afforded hzAddi- tional |nmumds the following conditions apply: a. L|mitm of Insurance — The following limits of liability app|y- 1' The limits which you agreed to provide; or 2. The limits shown onthe declarations, whichever |eless. b' This insurance is excess over any «eUd and collectible insurance unless you have agreed in a written contract for this insurance to apply ona primaryorcontributory basis. 3. This insurance dmmm not apply: a. on any basis to any person or organization for whom you have purchased on Owners and Contractors Protective policy, b. to "bodily injury," "property damage," " e aonm| injury," or "advertising injury" arising out o/the rendering oforthe failure borender any professional aom|ceo by orfor you, in- cluding: 1. The prepodng, approving or failing to prepare or approve maps, drawings, opinions, reporto, eumeyo, change or- ders, designs or speciflcations, and r-dens.doe(gnaorspeciflooUona,ond 2' Supen/ioory, inspection or engineering services, CG D105 04 94 Copyright, The Travelers Indemnity Company, 1994 Includes Copyrighted Material from Insurance Services Office, Inc., y4481002 1 w25oeMaster aL/^L/WC / Charlotte Brown 1 3/21/2025 1.40.4e ev (PDT) / Page of 2 Page 1of1