HomeMy WebLinkAboutByldan Corporation 09.26.2024KIM! page of 11
Client #, `� 0 L l�
DATE (NIMIDDIVYYY)
CERTIFICATE OF LIABILITY
CORDTM.9/26/2024
THIS IS ISSUED MATT 14 F INFORMATIONONLY AND CONFERS N RIGHTS UPON �'H CERTIFICATE, HOWE x 'HIS
CER TIFI TE DOES NOT AFFIRMATIVELY NEGATIVELY AMEND, EXTEND OALTER THECOVERAGE AFFORDED THE POLICIES.
LOWS THIS CERTIFICATE F INSURANCE DOES NOT CONSTITUTE STITUT TRACT BETWEEN THE I' UjN i INSURER(S)yAUTHORIZED
REPRESENTATIVE1 PRODU ERR AND THE EAT'IFI A#TT H LDE
YI
T. If the c rtifi to + l er i an. IT'I NA►L IIS UI i�; tine po 1. (l ) art Dave I 'I ►I ASL INSURED provisions r beendorsed.
If SU T'IONf. IS WAIVED, u*ct.t . the tarps grad conditions of the policy, certain policies may require n nd r e rpt. st toI` ent n
this rtlf t dogs not confer n rights to the rtifi t . holder in Il l f a I� nor I rpt ).R
PRODUCES
I r Insurance Services LLQ ���I�I� � �ao)•
31�°''�' Canyon PISt+. + A�, Nc�, ext
WA IL rti l I riff cow
Sart! Ramon, CAS94583II iJ►N O () AFFORDINGIwI I
926,463'9672United.�IN$QRER A.Specialty, II'I� _12637
'INSURED InSUrance Company of: the West 27-847
By1dah Corporation
IIS u ...,United Financial, Casualty Company � 114770
.Box 6097
11 '� a�au�� �
Alto,
INSURER
w www. ww.ww.w��w �w . ... III% R
NUMBER.. REVISION NUMBER:
TNI I wry CERTIFY ' THAT TIy1 POLICIES Ir"il IIU ��I�, NCE LI T D BEI,.c�W DAVE B EI' ISSUED T THE INSU ,I I�IAM�I� ABOV Fo THE P LICY PERIOD
N TWITHq,. "ANDIN ANY , REQUIREMENT,TERM OR CONDITION OF .AW CONTRACT OR OTHER DOCUMENT ��"V'ITH RESPECT T WHICH THIS
INDICATED.
S .� M: ICI DESCRIBED. I~ EREIN IS SUBJECT TO ALL THE T
CERTIFICATE I�A�" I� 1,���,��� CIS I'�I�Y I�'�I�T`AIItil, T'l� ,I�i�►R,�I�A�I+ ,��'�'��I� ��` `TI�i POLICIES. �' �Ei�1'S;
" ��`. LIMITS SHOWN MAY HAVE BEEN. I��I I� �� Y PAID CLAIMS,
�.3��+Lt�It1'�I Aid !ILII"I"IN� �I� �H ILIiI�.�
. I�IR I�I�L U�R POLI.0Y EIilw � ,I �' E�' "v.n - - �.., ,"......
T TYPE OF INSURANCE. .120L CY NUMBER SII I���YYYY . �I�� /YY'YY LIMITS
_ I.' y _.Mwr .w_ ,... :
A COMM IAL EN 5RAL LIAI ILITY : N 612212024 05/221202.5 r~:�ACH,OCCURREN E 1 000
.w .....��ww.r
DAMAGE
CLAIMS. ADE" OCCUR r�ai
.r..w_
1 1 1 1 � IVI a ii r i; :05000
_.
_.� m.
PERSONAL &. ADV INJURY ;� I w
GENAL REGA E LIMIT APPLIES PER; G NERAL AGGREGATE � ��00
PRO-
JECT LO -C PRODUCTS COMP/OP AGG, $ 0000-000
LX1., F_..
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AUTOMOBILE, LIABILITY H 0.2/23/20214 3i� � Ea accicicnt �q 1ov�ocq
_
�r�Y AUTO
BbDILY INJURY (Per person)
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AUTOS ONLY � AUTOS
BODILY tN�I.EJRY (I� r.acc'i�ier7#) �'_
HII"-fiI�D NON -OWNED PROPERTY DAMAGE
Ar�I��r I�I�Y � a�;��►TOphll_�Y
{ger accid6iit
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U.r L LI Cur I BTN2461663 �� �� 05/2212026 EACH OCCURRENCE $
_ LIAR CLAIMS -MADE ADE AG REGAT l .�, :n., .�,..._ w �. $5�
' �LI�r I�E'"Iw�'nI""rl�ara $'� -_ .�
.......�x... .m
�rlroRKE.'R C IUII�IEN ATI 1� 1 1 + f I 15Tfaw
Y / I'
AND O i�A,R rN EO/EXECUTI l E,L. EACH ACCIDENT ` � 000
AI�� I�I�
OrNCE� IMI .EFI I-EXCLUDED?,LJ
II IA
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I#i����Iat� , p� I�I�I. - 1�I��A�� w �A �I�RL��f�Iw '�,_:_._.__._.,.
If' es, describe under "
SCnIPTION I OI�ERATION8 below E.L. DISEASE - POLICY Iw,.II� rr
.rrw....�_ . �.n.m..n,.��. �...�........._._,..a___.-...�..._�..._..�.. r....,r..._.. �m................ ..w _ � �. �.�"�..x,.: �...-
DESCRIPTION ' OPERATIONS /LOCATIONS �! VEHICLE...S (AC
I��D 101, Additional l Rem ark Schedule, may be ,attached If more space Is required)
I: 09d: AJ i d4 %.P X61 perm" R w IA R i [ Widening. _
.The City o 'I Ill s,,, its officers, officials, employeesn volunteers are included
as'Addition I InSUr respects ner l Liabilityn Auto Liability ~ required, written ontr + %
0 Days Notice Cancellation, Except for Days for Non-payment Premium. Excess .i il,i Follows
Form,
R IFI+ T' HOLDS CANCELLATION,
The Town f Los Altos'NHill SHOULD ANY F THE ABOVE DESCRIBED POLICIES B CANCELLED BEFORE
THE. PII ATRIO N DATE THE REOF, NOTICE I WILL BE DELIVERED Iii
its elective appointed officers, ACCORDANCE '�P#t'ITH THE ' POLICY PROVISIONS.
employee volunteers
26379 Fremont a AUTHORIZED II PRESS'�TATIV9
Los Altos, 9402
988-201 SACORD,CORPORATION. All rights reserved.
A (2016103). 1 of I The ACORD name and logo are registered marks of ACORD
41 #5363631 /M353 AMU
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THE "OWNOF LOS A 130S.
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26.3.79 FREMONTRD
LCUSALMS, CA.94022
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page 4 of I I
43
PROGRESSIVE
PO BOX 94739
CLEVELAND, CH
Policy numben 05922280
44101-8971
Underwritten by; nine Financial Casualty Co
insured;
BYLDAN CORPORATION
Policy Perind: Feb 23, 2024 - Feb 23, 2025
Mailin.g Address
Un ..1 . �,
T1 TOWN. OF LOS ALTOS
PO BOX 94739
L VEI ND, 01-144101-8971
6379 Fi'" RD
1-800-444-448
LOS.ALTO,S, CA 94022For
cus.tnmer service, 24 hours. a day,
7 clays Meek
So E a m ELF NT
WAIV E R'L� F A R' A`, A M, U K nn N
E) SO U K U (03 AT I U"t N P U
This endorsement: modifies Insurance provided under the following:
Commercial AUt,0 P IIC j
of r Tru ckL Cargo Lega I Lla biIIc ► era n.do rsement
Commercial General Liability Coverage Endorsement
We agree to waive any and all subrogation claim 5 agalnSt the person
or organization
designated el w.
r r'r ni anti n
` I- E TOWN OF LOS ALTO
.263,79 FREMONT RD
ALTOSLOS 9402.E
----- ---- - ------ -------- ------------- - -- -- - ------ ---- --- --- - --------- - ---------------------------------------------------------------
----------------------------------------------
T.i�endorsement p pli t� 05922280Policy t ur a
l u t : BYLPAN CORPORATION DBACLARUM HOMES
CL
Endorsement February 9
Expiration. February 2025
All other teras, limits and provisionsthis �� r main unchanged,,
Form 8.610 (02/19) M_jCL
43
CERTIFICATEOFLIABILITYINSURANCE
DATE (MMIDD/YYYY)
102/12120'24
THIS'CERTIFICATE IS ISSUED. AS A MATTER OF INFORMATION ONLY. AND CONFERS,NOIIT" UPN THECERTIFICATE* I-1t'LDEl. THIS
CERTIFICAM DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 8 T ND OR ALTER THE AFFORDED B THE POLICIES
'COVERAGE
BELOW. THIS CERTIFICATE F 'INS RA DOES NOT CONSTITUTE CONTRACT BETWEEN THE I SUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the. certificate holder Is an ADDITIONAL INSUREDthe olio '(ie ) must have ADDITIONAL INSURED provisions or be endorsed.
If SUB ROGATION I WAIVED, sublebt to the terms 'and conditions bf the policy, certain policies may require an endorsement. ent. A statement on
this certificate does not confer rights to the certificate holder in lieu of such hd rsement .
PRODCER
MCGRIFF INS ERVI E
7701 AlRP+ RT GTR ��300, C. kEENSI�3OkO, NG 2740
ONTAC T
SIAM PrC r S lv Car niercial ,,, Lin Customer and A int � rr�i�ln
PHONE'.'
A1+C�a til xt ; 'IM8i�0-444-
I � l:AI .' .. `' 1 r^4tM3ia�i'.Kr✓'rR�s�Jm
ADD �t p ogre 'si.vec� imiei tial erri it *
INSURER( ) AFFORDING COVERAGE NAic #.
COMMERCIAL GENERAL LIABILITY
INSURER A:, United Financial gasupl!y Company11'770
INSURED
BYLDAN CORPORATION D A: CLARUM HOMES & CLAFaUM COM
P 0 BOX 60970
INISURER B
IJgsI:ll�F.R.
I`N+ ORF. R D
PALO ALTO, CA 94.306
INSURER E :.
CLAIfVS4ADE OCCUR
I`NS1; 99R lw
CO
'E r�� EI TI I AT' . I ill llEEl : 4 'i i C �1 T�l84042 REVISION NUMBER:
THIS IS TO EI TIFY THAT .THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED .NAMED ABOVE FOR THE POLICY PERIOD.
INDIC ATF11 NOTWITHSTANDING ANY RFC UIt FMFNT, TFRM OR CONDITION F ANY CONTRACT OR OTHFI DOCUMENT WITH RF PFCT TO WHICH THIS
OERTII�.i ATE .�1AY BE. ISSUED. OR MAY. PERTAIN, THE INSIU N E AFFORDE0 BY FETE 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
LTA:
TYPE.OFINSUkANCE
ADDL
IND
SUBR
WVD
POLICY NUMBER
POLICY FF
(MMI lDNYYY)
POLICY EXIT
(MMIDDNYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
O CI""RRENC�EI'll ,
CLAIfVS4ADE OCCUR
AP�1A�E `i �NTE€�.
Iw~► lay` ����� °� .«� � �« �«��.
IVIED EXP Any,a to }.,r 1 oIM7) .. .www «ww.wMx�»w.
PER,80NAL & ADV INJURY
GEN'L. AGGREGATE LIMIT APPLIES P.ER.
GENERAL AGGREGATE
PRODUCTS.- +«,rOMPIOP AGG
EIPIRO-
POLICY . JECiT �� LO
OTHER.
4n
AUTOMOBILE LIABILITY
� CELE LIlt�11T
COMBIRDIN .
� �
ANY AUTO
�00IL;Y INJURY Per person).
-
A
- -C IP�I1 7 - - - F -I DUL. �? - :-- - -- --
A�T0 a. ONLY X AUI-08
---- -
Y
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06922280
- --- - - - ---
02/2.3/2024
- - - - ----
02/2312-025
—T-
BODILY INJURY Per accident
HIRED NONOWNED
AUTOS ONLY AUTOS ONLY
AMAGE
r��crd�rrt
LIMO ELL.ALIAD : OCCUR
EACH OCCURRENCE
E �
AGGREGATE
EXC ESS LIAR ICLAIMS-MADE
DE D RETENTION
$
WORKERS O1i PEN ATI N
AICD EMPLOYERSLIABILITY ILITY YIP,I
ANYF>R PRIETORIPARTNER/EXEC LJTIVE Lj
0"iCt�.i�Jl�l .�lRERE C�Lt�C�'ED?
N/A
M I*Iw
« ,
,L. EACH ACCIDENT $
-----------
(Mandaitory in ISH)
: _
C3ESC RIPTION OF OPERATIONS below
,�.«.EMPLOY�
- -- ------------------------------ ------ -----------------
E.L. DISEASE - POLICY LI11.!'lIT �
See AGORD 101 for additional coverage details.
$
Y
Y
05922280
02/23/2024
021231 025
DESCRIPTION OF OPERATIONS I LOCATIONS NS 1 VE141CLE(ACORD 101 Additional Remarks Schedule, maybe attached If more apa,co Is required)
CERTIFICATE HOLDER
DER
CANCELLATION
V 1933-:,ZU i 0 At;UKU 't;.UlR1JVHA I IVN. loll rignts re ervea.
44
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ED IN
THE TOWN OF LOS ALTOS
ACCORDANCE ITH THE POLICY PORI TION .
26379 FI EMONT ROAD
LOS ALTOS, CA 9402.E
AUTHORIZED REPRESENTATIVE
V 1933-:,ZU i 0 At;UKU 't;.UlR1JVHA I IVN. loll rignts re ervea.
44
page 6 of 11
AGENCY CUSTOMER ID:
LOC M,
AAC <>R0
ADDITIONAL REMARKS SCHEDULE. Page 1 of 1
ADIJITIONAL REMARKS
THIS ADOITIONAL REMARKS FORM l A SCHEDULE T ACORD 1N1 RM.
AGENCY
NAMED INSURED
MCG RIF F INS SERVICES.13YLDANORPORA
'ION IBA: GLARUM HOMES &LARUM POS!
P B 60971
PALO ALTO, CA 9430
POLICY NUMBER
0692229
. •..YP n .. _
w'Y.• # w w • . w . Y
-LJ ninsu red/U nderl ns tired Mottvist, $1.000,000 Co'mbined Single Limit
CARRIER
NAIC COD
EFFECTIVE DATE: 02123/2024
United, Financial asLialtry.�, Crop n�
1177.0
ADIJITIONAL REMARKS
THIS ADOITIONAL REMARKS FORM l A SCHEDULE T ACORD 1N1 RM.
FORMNUMBER: 25 FORM TITLE- Certificate of Liability Insurance
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Additional Coverages
Insurance coverage(s)
covere(s) Limits
w• .,• w • Y . • • • • • . a . . • . . . . . . • • . . .. n . ,
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-LJ ninsu red/U nderl ns tired Mottvist, $1.000,000 Co'mbined Single Limit
Description of Location/Vehicles/SPec"1 Item
Selh.edtiled autosonly
, . . M . F . . . . • . , . . , • • . . . . . . # . . . . Y • . . . . . . . . . . . . . . . . . . . , . r , . Y .. . . , t
. . • . . . . . . , . . . . . . Y • . . . . . . . V . . . . . • . + . . . { , N b , . I . S I , ., 1 .. ♦ . . .. .
. i . . . Y . .
2018 TESLA. . r�" ODEL 3 'J E I EA4JF0 4 �
6IiI� 2500 Dei
'Fire. in nd Theft wt CA $2,500 De
't ical Payments $5,00
... ..
.2020 MERCELDES-SENZ,M-ETRIS W03PG2EA9L3675298.
... ..I ...a. 1.,11
1lisi n $2,500. Dei
rr` 'd Th 'ft M(/ CAS 00 Ded
I` e is l Paymen, ,000
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202MERCEDES-BENZ #METRIS WD3PG2LEAXL3674466,
. . . . . . f.. . . , .
collision $2,500 Dei
mire nd1 Theft r I CAC $2,500 De
1 •. 1 • { , Y . V I 1 I .
• . . • ! . • . N . , b • • 14 i Y . . ! , 1 ♦ . N I , • .,, ,.! r t 1 . ! . . .. . 1 . . .I., • . , . . b
6 1 . 1 . N 1 • , 1 N , N , . • I A , r 1 N . ., • a 1 / ,. 1 1 i . N . . 1 N i ! , . ,1 . 1 1 > • Y b V • b , Y . I.1 { 1
2.021 TlE, LAMODEL5YJY+C DEEOMFO93698
Collision$2,50O.Ded
Fire Ind Theft w/ CAS ; OO Dei
lllrlrcl Payments------ ----------- ------ -- - - ';4�J--- --- - -- - - --- — - - -- _ -_ -
-
'R"IVI'A'I"i ISN'"'i"',7i' i"'AAA"0"Ni ll0 l 3"
Collision $2,500 De's
Fire arid Theft i CAS $2,5.00 Dee
Medical Payments ent 5,000
Liability coverage may not apply to all scheduled vehicles.
Additional Information
Certificate holder i listed as nn dditional Insured and Waiver of Subrogation Holder.
- ----- -
----------------------- - ----- - - ------------------------------ -
--
We will endeavor to provide 30 days notice. of cancp.11 tion to the certlftcate holder, h0t failure to doso shall impose no obligation or liability of any kind
upon ,the ins.ur r, a'ts agents or r6presentatives.
A O 1 (2008101
@ 2008 ACORD CORPORATION. All rights reservod.
The ACORD name and Iwo are realstered user's of ACORD
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IOW _ n1.IwlVn�w 1�awwnu�IM�1^MAIMMgMIflMMNA�XAC.wA�+N..
State Or Governmental Age'ney Or Subdivisi*ott Or Po'liti-cal Subdivision
A, Require. . WrittenContract,FullyExecut . rior The Named Insur r d' �p
"�.hp. j� yq�w ��ryp, �" j"�p rip required `� �y+�g +�1 s�yM� (�'�, M ( +yew Y��9y �,Jj, Aga
'. infor •,N..�Rris' MIDI). 6. *y,r' � .� o IRr�pA .i M+.J. Srs1 �wV` ul(l �. � � shown � ibki� ,Y . �. ,. �i ll iw.� a .ave' Yin', �t..N..iL h'k..!' Dec la 4 N+R.tj q ..s
to, .J11cl11 -. it " l t�B, � , .st or
a.t9 pp pp � � . damage" or
_ ----- - ry �. agency subdivision or -
'�yq ttie g�`�'y,
a0wMN "yj� �'�1Y �//M�yrr ayi®yyef ,L"yH�y�� �p��y{,+(��ye /Vyy`�'M�H, }�$'ylp�/y in
.II�rY•'No�vLr�'.$b►Jl. tir/^SJP �k..1�J 'Rl v.B J�'N✓�1%'�
- -- - -- - gip. � - » _p� yy
"` •'.}Iw� .W'''� 'j'y',`(• ('��.�ypy �} yf �J+�.
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'aWFV �R'.'h+/'.10.MiJ F.,d dtl�8'u.WMd. for rev,
subject t6 1116 following PrOV1s1ons4
federa, goverilment, state or
by yo
behalffar l ich thetAi r g rn:r nl
1b "'Bodily 111j"LlrOff. r PO � mag
in��within prod Ucs-
agency � rivisio . � lite .l
� I t � t �- �1�° �� 4
i�. � INIS1011 �� issued permit orj�y� �$�p .y]{�yy. �M /y, y�y� �{»v q!
v With: rest' e t t h insu forthese
,.
_________
.M_ _______ _________ ______________ _______._________________ __-______________-__ __-----------------------
--------- How,
_ ___ _ _ _ _
_- ---- __-----
1 afforded 41`1ip r� -suran 4 4, P a 1u4.✓b
r .If
add too :.I insured only lies t the
Verne rovided to f , .,
co �� ,
� �- it Contract r �� rune, t �.e
extentmw
m t w Nvill pay n , half o ffi �tlo
err i . d to the additional11I.
i is the amount 1��.1 sura : e w
insured :is required., b -y a. contract or
th6. Insurance afforded to
1. Required by'the contract or agreement- or
"t� 1a.greemlent
u n will not
• Available ailable ti er ,the applicable �.�,imit
d
.d
broader thail. that wbich you are
his trance shown n, the
required thecontract r agree e t to
whichever. i less.
providecar such additional insured-
�"��iendorsement �� 11 ��oinc.� , the
applicable Limit o isura shown i the
G 20 12 04 13 @ insurance Services Office, Inc., 2012 Pale I of 1
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