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HomeMy WebLinkAboutNatomas Labs, Inc. 01.26.2024Ac"R"LIABILITY INSURANCE CERTIFIGATE OF X44 DATE (MM/DD/YYYY) 1/26/2024 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 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 Newfront Insurance Services (Construction) 777 Mariner Island Blvd; Suite 250 San Mateo, CA 94404 CONTACT NAME: Construction Team PHONE FAX A/C No Ext): 415-754-3635 AIC No): E-MAIL Constructioncertre uest Newfront.com INSURER(S) AFFORDING COVERAGE MAIC # INSURER A: Capitol Specialty Insurance Corporation 10328 www.Newfront.com INSURED Natomas Labs, Inc. dbaNatVilla Homes INSURER B: National Specialty Insurance Company 22608 INSURER C: Midwest Employers CasualtyCompany 23612 INSURER D: 1 Letterman Drive, Building C_#3500 INSURER E: San Francisco CA 94129 INSURER F: COVERAGES CERTIFICATE NUMBER: 78411092 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 OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M M/DD/YYYY POLICY EXP M M/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CT20230017-02 1/26/2024 1/26/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE a OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [i] PR� F_� LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY GMI-0833-00- 1/26/2024 1/26/2025 (Ea aBINEDtSINGLE LIMIT $1 000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE $ Per accident $ ✓ Comp/Coll. D . $ 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED J I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? y N / A BNUWC0153320 1/26/2024 1/26/2025 ✓ PER STATUTE ORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE- EA EMPLOYEE $1 ,000,000 (Mandatory in NH) 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) RE: Encroachment Permit. The Town of Los Altos Hills, its elective and appointed officers, employees and volunteers are named additional insured with respects to general liability, as required by written contract. Endorsements Attached. CERTIFICATE HOLDER CANCELLATION RE: Encroachment Permit 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 Rod Sockolov ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 78411092 1 24-25 GL-Auto-WC-XS-Prof/Poll-XS Prof -Equip I Serena Childs 1 1/26/2024 1:52:57 PM (PST) I Page 1 of 2 POLICY NUMBER: CT20230017-02 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: As required by permitting agency or municipality to pull permits necessary to perform the insured's work. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 12 12 19 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section 111111 — Limits Of Insurance: If- cover -age provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2.. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. @ Insurance Services Office, Inc., 2018 78411092 1.24-25 GL-Auto-WC-XS-Prof/Poll-XS Prof -Equip I Serena Childs 1 1/26/2024 1:52:57 PM (PST) I Page 2 of 2 Page 1 of I Newfront Insurance Services (Construction) 777 Mariner Island Blvd, Suite 250 San Mateo, CA 94404 Town of Los Altos Hills 26379 Fremont Road Los Altos Hills CA 94 022 Please see the attached 24-25 renewal certificate of insurance. Let us know if you should need anything further. MAIL DOCUMENT Certificate of Insurance Delivery by ecertsonlineTM :.::.:.:.:.. Serena Childs ...........: - - 415 754 3635 ':G::,:.:<: - - Cert No. 78411092 Natomas Labs Inc. 2024-2025 - Renewal Certificate of lnsurance ........................................................... .......... .... /2 / 1 6 2024 .:.................................. www.Newfront.com THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW, IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions, Inc. All rights reserved.