HomeMy WebLinkAboutCalvey Heating & Air 02.02.2026CERTHOLDER COPY
COMPENSATION P.O. BOX 8192, PLEASANTON, CA 94588
INSURANCE
FUND'
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-30-2026 GROUP:
POLICY NUMBER: 9394472-2026
CERTIFICATE ID: 3
CERTIFICATE EXPIRES: 01-29-2027
01-29-2026/01-29-2027
LOS ALTOS HILLS - BUILDING DEPARTMENT NA
26379 W FREMONT RD
LOS ALTOS HILLS CA 94022-2624
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
Authorized Representative President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2572 ENTITLED BLANKET WAIVER OF SUBROGATION EFFECTIVE
2026-01-29 IS ATTACHED TO AND FORMS A PART OF THIS POLICY
ENDORSEMENT #1651 BERNARD CALVEY T - EXCLUDED.
EMPLOYER
CALVEY HEATING & AIR
247 E ST UOHN STREET
SAN DOSE CA 95112
(REV.7-2014)
NA
M0408
PRINTED 02-02-2026
NA
CERTHOLDER COPY
P.O. BOX 8192, PLEASANTON, CA 94588
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 02-03-2026
TOWN OF LOS ALTOS HILLS - BUILDING DEPT NA
26379 W FREMONT RD
LOS ALTOS HILLS CA 94022-2624
GROUP:
POLICY NUMBER: 9394472-2026
CERTIFICATE ID: 7
CERTIFICATE EXPIRES. 01-29-2027
01-29-2026/01-29-2027
THIS CERTIFICATE SUPERSEDES AND CORRECTS
CERTIFICATE # 3 DATED 01-30-2026
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
-,eex
Authorized Representative President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2572 ENTITLED BLANKET WAIVER OF SUBROGATION EFFECTIVE
2026-01-29 IS ATTACHED TO AND FORMS A PART OF THIS POLICY
i
i ENDORSEMENT #1651 - BERNARD CALVEY T - EXCLUDED.
EMPLOYER
CALVEY HEATING & AIR NA
247 E ST.JOHN STREET
SAN JOSE CA 95112
M0408
(REV.7-2014) PRINTED 02-04-2026
NA