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HomeMy WebLinkAboutAssociated Plumbing Inc. 08.23.20257 a AC"REY CERTIFICATE CSF LIABILITY INSURANCE DATE (MM/DDNYYY) 08/2312025 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, th6 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 FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES INCLUDING PRIMARY SOURCE INSURANCE AGENCY CONTACT NAME: CLIENT CONTACT CENTER PHONE FAX (A/C, No, Ext): 888-333-4949 (A/C, No): 507-446-4664 121 E.* PARK SQUARE OWATONNA, MN 55060• E-MAIL ADDRESS: CLIENTCONTACTCENTER&FEDINS.COM• INSURERS AFFORDING COVERAGE NAIC*# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 EACH OCCURRENCE $1,000,000 -INSUREDran WESTCHESTER SURPLUS LINES INSURANCE 10172' ASSOCIATED •PLUMBING INC 90 LEAVESLEY RD INSURER C: INSURER D: G I LROY, CA 95020-3605 INSURER E: AUTom6131COMBINED 1LE LIABILITY X ANYAUTO SCDL)LED OWNED AUTOS ONLY AUTOHES — HIRED AUTOS ONLY NON -OWNED AUTOS. ONLY INSURER F: N %..r- K.1 I r I LeA 1 r_ N U W1 t3r- K _. •1/% Kr_V1WLJr4 NUMUr-K: U 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 SHOWNWAY HAVE BEEN REDUCED BY PAID CLAIMS.' INSR LTR TYPE OF INSURANCE ADDL INSR SUBR- WVD POLICY NUMBER POLICY EFF (MMI DIYYYY) POLICY EXP (MMID'DIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR* Fx] GEN'L AGGREGATE �C, LIMIT APPLIES PER: P LICY - LOC 1 OTHER: Y N 9844435 10/22/2025 10122/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) EXCLUDED PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000. PRODUCTS &COMPIOP ACC0 $210001000 A AUTom6131COMBINED 1LE LIABILITY X ANYAUTO SCDL)LED OWNED AUTOS ONLY AUTOHES — HIRED AUTOS ONLY NON -OWNED AUTOS. ONLY N N 9844435 10/22/2025 • 10122/2026 INGLE LIMIT (Ea accident) S $1 oob,000' BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE (Per Accideni) A X UMBRELLA LIAR X EXCESS LIAB OCCUR' CLAIMS -MADE N. N 9844436 10/22/2025 10122/2026 EACH OCCURRENCE $5,000,000 AGGREGATE $510001000 DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE I— OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PER STATUTE �OTHER El EACH ACCIDENT El DISEASE -EA EMPLOYEE E.L DISEASE - POLICY LIMIT B CONTRACTORS POLLUTION LIABILITY Y _ 671673121 001 05/21/2025 .05121/2026 EACH LIMIT $1,000,000 AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) SEE ATTACHED PAGE - CERTIFICATE HOLDER CANCELLATION TOWN OF LOS ALTOS HILLS 1730 26379 W FREMONT RD SHOULD ANY OF THE * ABOVE DESCRIBED POLICIES BE CANCELLED LOS ALTOS HILLS, CA 94022-2624 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER. ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES ASSOCIATED PLUMBING INC 90 LEAVESLEY RD INCLUDING PRIMARY SOURCE INSURANCE AGENCY GILROY-, CA 95020-3605 POLICY NUMBER SEE CERTIFICATE # 173.0 CARRIER NAIL CODE EFFECTIVE DATE: SEE CERTIFICATE # 173.0 SEE CERTIFICATE # 173.0 ADDITIONAL REMARKS. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:.. 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE RE: 13428 CARILLO LANE, TOWN OF LOS ALTOS HILLS, CA REROUTE SEWER LINE ADDITIONAL INSURED ALSO INCLUDES HOGAN & PINCKNEY CONSTRUCTION . THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE,. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED ENDORSEMENT - ONGOING WORK OR OPERATIONS ENDORSEMENT FOR CONTRACTORS POLLUTION LIABILITY. -THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED ENDORSEMENT PRODUCTS -COMPLETED OPERATIONS HAZARD ENDORSEMENT FOR CONTRACTORS POLLUTION LIABILITY: THE CONTRACTORS POLLUTION LIABILITY COVERAGE CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER- SUBJECT TO THE CONDITIONS OF THE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US. INSURANCE PROVIDED BY THE CONTRACTORS.POLLUTION LIABILITY IS PRIMARY AND -NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT- TO THE—CONDITIONS' OF THE PRIMARY AND NON-CONTRIBUTORY - OTHER INSURANCE CONDITION. MOLD'COVERAGE IS INCLUDED UNDER CONTRACTORS POLLUTION LIABILITY. ACORD 101 (2008/01) 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 'COMMERCIAL GENERAL LIABILITY CG 20-33 *12 19 ^ THIS ENDORSEMENT CHANGES THE POLICY,.PLEASE READ IT'CAREFULLY. ADDITIONAL INSURED* OWNERS, LESSEES* OR CONTRACTORS'=AUTOMATIC. STATUS, WHEN REQUIRED]N-AWRITTENCONSTRUCTION AGREEMENT WITHIOU, - This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UAB|L[TYCOVERA�EPART ` ` A. Section II.- Is An !nsurmd is to ' B. include* as an additi-onal insured any person..or organization for whom you are perform' ing operations . vvham you and such* person or organization have agreed in writing in.a contract oragreement thateuoh person or organization be , added as an additional insured on your policy. Such person or organization is on additional insured 'only with. respect. to liabi-lity for "bodily injury". "p damage "or personal and advertising injury" caused, in whole orin part, by: 1- Your ucta�'r omissions; or 2. The aohy or omissions of those acting on your behalf;' ' ' in the performance .of your ongoing operations for the additional insured. 'Hovvover------ the--`i-n s uronce'afforded—to- —auoh additional insured: 1. Only applies to the extent ponndtad by law; ond' 2' Will not be'broader than that which you are required by the contract or agreement to provi.de for such additional insured. ' person's or organization's status om an additional insured undorthlo endorsement' ends � vvhen your operations for that additional insured are completed. - ` With reapeot to the insunan to theme additional insureds, the following addhiona| exclusions opp|)x This insurance' does hot. apply to: 1' "Bodi|y inj u ry""property damage" or "personal and. advertising hnjury^ahoing out of the rendering of, or the failure to nander, any ' professional onchitentuno|, engineering or ` aurvoynQaervi.ceu`incl'uding:. --' s, The preparing, approving, or foUing to pnapore.orapprnve.maps.shop drawings, opinions,* reports, oun/oyo. Uo|d ordora7 change orders or. drawings and specifications; or b. 8upomiaory, inopeotion, architectural or engineering activities. -'This-if-----the - o|ohna against any insured allege noQ|igon�wor other wrongdoing in the supervision, hiring, . enmploynn.ent, training.or monitoring of others by that insured, if the "occurrence" which -caused the "bodily injury" or "property damage".. or, the offense which caused the ' "personal and advertising injury" involved the rendering of or the failure to render any professional archikaotuna|, engineering or surveying oemiooa. Insurance Services Office, Ino.2O18 Page 1mf2 CG 20 33 12-19 Policy Number: 9844435 Transaction Effective Date: 1022/2025 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance . or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has. been put to its- intended use by any person or organization other than another contractor or subcontractor engaged in performing operations. for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III . - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: .1. Required by the contract or agreement you have entered into with the additional insured; or 2. .Available under the applicable limits of insurance;. whichever. is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9844435 Transaction Effective Date: 10/22/2025