HomeMy WebLinkAboutBell Plumbing of San Mateo Inc. 01.12.2026�-CERTIFICATE CSF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
E01/12I2026
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 AND ITS AFFILIATES
INCLUDING PRIMARY SOURCE INSURANCE AGENCY
NAME: CLIENT CONTACT CENTER
PHONE FAX
(AIC, No, Ext1:888-333-4949 JAIC, No): 507-446-4664
121 E. PARAMN55SQUARE
OWATONNA, MN 55x60
E-MAIL CLIENTCONTACTCENTER FEDINS.COM
�
INSURERS AFFORDING COVERAGE NAIL #
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED
INSURER B: CERTAIN UNDERWRITERS AT LLOYDS LONDON 15792
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:
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
INSR
SIJ¢R
'"DD
P6LICY NUMBER
POLICY EFF
M IDDIYYYY
'`POLIOY E)(P
MMIDDIYYYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $130002000
CLAIMS MADE OCCUR
DA occ E T RENTED PREMISES(Ea $100,000
MED EXP (Any one person) EXCLUDED
A
Y
N
9829156
03/17/2025
03/17/2026
PERSONAL & ADV INJURY $1,000,000
GEN1 AGGREGATE LIMIT APPLIES PER:
POLICY [BxECT 7- LOC
GENERAL AGGREGATE $2,000,000
PRODUCTS & COMP/OP ACC $210003000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident) $110003000
X ANYAUTO
BODILY INJURY (Per Person)
A
OWNED AUTOS ONLY AUTODULED
N
N
9829156
03/17/2025
03/17/2026
BODILY INJURY (Per Accident)
HIRED AUTOS ONLY NON -OWNED
AUTOS ONLY
PROPERTY DAMAGE
(Per Accident)
X UMBRELLA LIAB X OCCUR
EACH OCCURRENCE $x,000,000
A
EXCESS LIAB CLAIMS -MADE
N
N
9829157
03/17/2025
03/17/2026
AGGREGATE $3,000,000
DED RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNERI EXECUTIVE
OFFICERIMEMBER EXCLUDED? L
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
_
PER STATUTE THER
E.L EACH ACCIDENT
E.L DISEASE EA EMPLOYEE
_E.L_DI_SE.ASE-P_0LI_CM LIMJT _
CONTRACTORS POLLUTION LIABILITY
Y
Y
CPLI0201 16001
01/08/2026
01/08/2027
EACH LIMIT $21000,000
B
AGGREGATE $2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
SEE ATTACHED PAGE
%05.rx I I Iti..raa 9- N Iv. Lim. am WAN L;rLLA I IUPJ
TOWN OF LOS ALTOS HILLS
26379 W FREMONT RD 75 0 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
d 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2416605) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LCC #:
ADDITIONAL REMARKS SCHEDULE
Page 1 of 1
AGENCY
NAMED INSURED
FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES
BELL PLUMBING OF SAN MATEO INC1180
SAN CARLOS AVE BOX 704
INCLUDING- PRIMARY SOURCE INSURANCE AGENCY
SAN CARLOS, CA 94070-2418
POLICY NUMBER
SEE CERTIFICATE # 75.0
CARRIER
NAICCOD E "
EFFECTIVE DATE: SEE CERTIFICATE x#'75:0
SEE CERTIFICATE ## 75.0
ADDITIONAL REMARKS
THIS ADDITIONAL REMARkS' FOR' 'M :IS A ' SCHEDU LE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE —CERTIFICATE OF LIABILITY INSURANCE'
POLICY COVERAGE AS OF.01/08/'2026.
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.
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED ENDORSEMENT FOR
CONTRACTORS POLLUTION LIABILITY. TYPE OF POLICY. THE CONTRACTORS POLLUTION LIABILITY COVERAGE CONTAINS A WAIVER OF
SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER SUBJECT TO THE CONDITIONS OF THE WAIVER OF SUBROGATION. IINSURANCE
PROVIDED BY THE CONTRACTORS POLLUTION LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE
CONDITIONS OF THE PRIMARY NON-CONTRIBUTORY.
ACORD 101 (2009/01) @ 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
CG 20 33 12 19
111�1!9
IL
ire],
ADDITIONAL INSURED m OWNERS, LESSEES OR
CONTRACTORS = AUTOMATIC STATUS WHEN
REQUIRED IN A WRITTEN CONSTRUCTION
AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section 11 - Who Is An Insured is amended to
include as an additional insured any person or
organization for whom you are performing
operations when you and such person or
organization have agreed in writing in a contract
or agreement that such person or organization be
added as an additional insured on your policy.
Such person or organization is an additional
insured only with respect to liability for "bodily
injury,", "property damage" or "personal and
advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured.
-------H-o--w--e-v--e-r--,- t e insurance -- afforded- to such
additional insured:
1. Only applies to the extent permitted by law;
and
2. Will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
A person's or organizations status as an
additional insured under this endorsement ends
when your operations for that additional insured
are completed.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to:
1.
"Bodily injury", "property damage" or
"personal and advertising injury" arising out of
the rendering of, or the failure to render, any
professional architectural, engineering or
surveying services, including:
a. The preparing, approving, or failing to
prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and
specifications; or
b. Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment, 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 architectural, engineering or
surveying services.
@ Insurance Services Office, Inc., 2018
CG 20 33 12 19 Policy Number: 9829156
Page 1 of 2
Transaction Effective Date: 03/17/2025
2. "Bodily injury," or "property damage"
C. With respect to the insurance afforded to these
occurring after:
additional insureds, the following is added to
a. All work, including materials, parts or
Section III - Limits Of Insurance:
equipment furnished in connection with,
The. most we will pay on behalf of the additional
su*Ch,-'vor project ec than
k -on the' t"'.(6ther"
red-
i ns: 6' the 'amount; of
"is -insurance:,
service, maintenance or repairs) to be
.1. Required by. the contract or agreement you
performed .by ,or on behalf ,of the. additiona[-,.'.....:
-have'erito"red into With"t e additional insured;
Ii additi
insured,(8).--at -the". loc'Ati6h"of the ` covered
or
operations has been topleted;or'
m
I Available under the applicable limits of
b. That portion of "your work" out of which
insurance;
the injury or damage arises has been put
whichever is less.
to its intended use by any person-- or
organization other than another contractor'
This endorsement shall not increase the
or subcontractor engaged in performing
applicable limits of insurance.
operations for a principal as a part of the
same project.
Page 2 of 2 @ Insurance Services Office, Inc., 2018
CG 20 33 12 19 Policy Number: 9829156 Transaction Effective Date: 03/17/2025
POLICY NUMBER: 9829156
'A' A
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.
COMMERCIAL GENERAL LIABILITY
CG 25 03 05 09
I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. -1
A. For all sums which the insured becomes legally
3. Any payments made under Coverage A for
obligated to pay as damages caused by
damages or under Coverage C for medical
"occurrences"' under Section I - Coverage A, and
expenses shall reduce the Designated
for all medical expenses caused by accidents
Construction Project General Aggregate Limit
under Section I - Coverage C, which can be
for that designated construction project. Such
attributed only to ongoing operations at a single
payments shall not reduce the General
designated construction project shown in the
Aggregate Limit shown in the Declarations nor
Schedule above:
shall they reduce any other Designated
1. A separate Designated Construction Project
ConstructionProject General Aggregate Limit
General- —A—ggregate Limit applies to each
--- ------for any other designated construction project
designated construction project, and that limit
shown in the Schedule above.
is equal to the amount of the General
4. The limits shown in the Declarations for Each
Aggregate Limit shown in the Declarations.
Occurrence, Damage To Premises Rented To
2. The Designated Construction Project General
You and Medical Expense continue to apply.
Aggregate Limit is the most we will pay for the
However, instead of being subject to the
sum of all damages under Coverage A, except
General Aggregate Limit shown in the
damages because of- "bodily - injury" or
Declarations, such limits-wil-I be subject to the
"property damage" included in the "products-
applicable Designated Construction Project
completed operations hazard", and for medical
General Aggregate Limit.
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 "Its"I
CG 25 03 05 09 @ Insurance Services Office, Inc., 2008 Page 1 of 2
B. 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 Project 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 or timetables, the project will still
be deemed to be the same construction project.
E. The provisions of Section III - 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