HomeMy WebLinkAboutLewis and Tibbitts, Inc. 12.27.2024_-'
AC C)R" CERTIFICATE O LIABILITY INSURANCE DATE (MM/DD/YYYY)
12/27/20
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR
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 CONTNAME:
Rose Amoroso
& Co. PHONEFAX
50 California Street, Floor 12 A/C No.
o Ext): 415-402-6607 A/c No):
San Francisco CA 94111 E-MAIL
ADDRESS: ramoroso woodruffsaw er.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Hartford Fire Insurance Company 19682
INSURED LEWIAND-01
Lewis and Tibbitts, Inc. INSURER B: Hartford Casualty Insurance Company 29424
1470 Industrial Avenue INSURER C: Sentinel Insurance Company, Ltd. 11000
San Jose CA 95112 INSURER D:
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: 331567686 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IND WVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY 57UEABAOZC4 1/1/2024 1/1/2025 EACH OCCURRENCE $ 1,000,000
_7 CLAIMS -MADE FRI OCCUR DAMAGE TO RENTED
REMISES Ea occurrence $ 300,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY E C FLOC
PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
A AUTOMOBILE LIABILITY57UEAZM1416 1/1/2024 1/1/2025 COMBINED SINGLE LIMIT $ 1,000,000
)( ANY AUTO Ea accident
OWNED SCHEDULED BODILY INJURY (Per person) $
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
X HIRED X NON -OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident $
B X UMBRELLA LIAB )(
OCCUR ---- - --- 57HHABAOZC6- ----- -- --1/1/2024-- - 1/1/2025----- -OCGU- ---
-- EACH RRENCE - - -$-1-0-000-000---
EXCESS /IAB CLAIMS -MADE AGGREGATE $ 10,000,000
DED RETENTION $
PER C WORKERS COMPENSATION 57WEAPK7544 1/1/2024
AND EMPLOYERS' LIABILITY Y / N 1/1/2025 X STATUTE ER
H $
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? NIA
E.L. EACH ACCIDENT $ 1,000,000
❑
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
All California Operations performed by the Named Insured for the certificate holder
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town of Los Altos Hills ACCORDANCE WITH THE POLICY PROVISIONS.
26379 Fremont Rd
Los Altos Hills CA 94022 AUTHORIZED REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD