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HomeMy WebLinkAboutBell Plumbing of San Mateo Inc. 01.29.2024A -0R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/29/2024 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 NAME CT CLIENT CONTACT CENTER PHONE A CNNo, Ext): 888-333-4949 FAX , No): 507-446-4664 a DRIESS.- CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURERS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 161-783-6 INSURER B: BELL PLUMBING OF SAN MATEO INC 1180 SAN CARLOS AVE BOX 704 INSURER C: — INSURER D: SAN CARLOS, CA 94070-2418 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 75 REVISION NUMBER: 0 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE I—XI OCCUR DAMAGE TO RENTED PREMISES $1003000 MED EXP (Any one person) EXCLUDED A Y N 9829156 03/17/2024 03117/2025 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ["JF R 0"LOC ECT F GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINEDEa accident SINGLE LIMIT $130003000 BODILY INJURY (Per Person) X ANYAUTO BODILY INJURY (Per Accident) A OWNED AUTOS ONLY SCHEDULED AUTOS N N 9829156 03/17/2024 03/17/2025 DAMAGE HIRED AUTOS ONLY NON-OWNEDPROPERTY AUTOS ONLY X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 A EXCESS LIAR CLAIMS -MADE N N 9829157 03/17/2024 03/17/2025 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER STATUTE7�THER E.L EACH ACCIDENT ANY PROPRIETORIPARTNER/ EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory, in NH) NIA E.L DISEASE -EA EMPLOYEE If yes, describe under E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ADDITIONAL INSURED INCLUDES: THE TOWN AND ITS OFFICERS, AGENTS, INDEPENDENT CONTRACTORS, AND EMPLOYEES. GENERAL LIABILITY COVERAGE CONTAINS CG 25 03 DESIGNATED CONSTRUCTION GENERAL AGGREGATE LIMIT ENDORSEMENT APPLICABLE TO EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. CERTIFICATE HOLDER CANCELLATION 161-783-6 TOWN OF LOS ALTOS HILLS 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 75 0 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 w C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marls of ACORD j POLICY NUMBER: 9829156 IA -0 I RE QT1 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Designated Construction Project(s): Each construction project as required by written contract or written agreement. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. For all sums which the insured becomes legally obligated to pay as damages caused by .0occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project - - -Gene-ra-I—Agg-reg-ate—Li-m-i-t--a-ppl-i-e-s--- -to --each -- designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is, the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical .expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarati-o-n-s-nor shall they reduce any other Designated Construction Project General Aggregate Limit for any otherdesignated construction project shownin the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 r% no For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section- I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A,for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not . reduce any Designated Construction P rojodt- General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications pecifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section 111 - Limits Of Insurance not otherwise modified by this endorsement shall continue.to apply as stipulated. Page 2 of 2 @ Insurance Services Office, Inc., 2008 CG 25 03 05 09