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Home My WebLink AboutR.J. Dailey Construction Co. 09.26.2023"' . ,+ ' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/26/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH-E 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 be endorsed. If SUBROGATION 1S 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' CONTACT NAME: Carlyri Eaton Leavitt Pacific Insurance Brokers, Inc. HO Na Ext : (40 8) 28 8- 62 62 AA Na ; (4 08) 2 98-7 635 A/CLicense ##OD79674 E-MAIL carlyn-eaton@leavitt.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 1570 The Alameda, Suite 101 INSURERA: Capitol Specialty insurance. Cor oratior 10328 San Jose CA 95126 INSURED INSURER B: Nationwide Mutual Insurance CoLapany 23787 INSURER C: Redwood Fire & Casualty Insurance Corn z 11673 R.J. Dailey Construction Co. INSURER D: James River Insurance Co ftpany 12203 401 'First Street INSURER E: INSURER F: Los Altos CA 94022 COVERAGES CERTIFICATE NUMBER:23-24 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I'SS.UED 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 SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR PREMISETO RENTED 1.00 000 PREMISES, Ea occurrence MED EXP (Any one person) $ 5,000 X CT2019023305 10/1/2023 10/1/2024 PERSONAL. & ADV INJURY $ 110001000 GENERAL AGGREGATE $ 21000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY[X] PRO- LOC PRODUCTS - COMP/OP AGG $ 2 0 0 0 0 0 0 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1, 0 G 0, 0 0 0 _ BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACP3039889886 10/1/2023 10/1/2024 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident ..U.MBRELLA LIAR X-- OCCUR .EACH OCCURRENCE-. -. $ 5 , 000., 00.0 AGGRE-GATE - - - =--- -$- - 5 , 0 0 0 , U-0 0 - --A-- X - -EXCESS-LIAR- - -- - -CLAIMS-MADE -- - - -- - -- -- --------- -- - - -- — - - DED RETENTION $ $ CX2023022301 10/1/2023 10/1/2024 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A RJWC432613 10/1/2023 10/1/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 14001000 ----- E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1f000,000 B Rented/Leased Equipment ACP3039889886 10/1/2023 10/1/2024 Deductible $500 - Llmit 100,000 D Excess ,Liability/Umbrella 000959434 10/1/2023 10/1/2024 Each Occurrence/Aggregate 5 , 000 , 000 DE3CRIPTION .O' OPERATIONS I LOCATIONS / VEHICLES (AGORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: All California operations. Town of Los Altos Hills is named as additional insured per attached GL endorsement forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Mills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26379 Fremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE Fred Stafford/CHDUEN��,'{� 1088-2014 ACORD CORPORA"T"ION. Aii rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)