HomeMy WebLinkAboutDarling Family Corporation dba J&M Termite Control, Inc. 08.25.2025'I9 Mlnimm_ MIR11101"19 mkmxm� nm_
ACC?R" CERTIFICATE OF LIABILITY INSURANCE DATE JIVIMIDDIMY)
8/2512025
........ . .... ..
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
RE -PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
Al 1 0 1, d 1 % 1 r , , " 6� . . . . . . . . . . . . . . . . . . . . . . - - - - - - -
WkNWHmi WIN Awift miii '0 i I M 1, loy 1"I I Wo"I'm t I iL - i "i ! I I I — . . I .-
IMPORTANT: Ifthe cerfificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provis- Ions or endorsed.
ItSUBid OG;TI ONDN IS WAIVED, subject to the terms -and conditions of the policy, certain policies may require an ondorsement. A statement on
this certificatdoes not confer dahts to the certificate holder In lieu of, surph ondorse.ment S).
PRODUCERF-SPI Service Team
Edgewo-od Partners Ins. Center x
PHIONE
Na.,Exth (A/C. N9.):
1 G � 77 M, iteRock Rd. Suite 300 1�,.IAAIL
Lic#0829370 'cbro
Pepi kers,com
Rahcho Cordova CA 95670 &CIVAMMIhin AUCCAn
INSURED
Darling Fam ly Corporation DBA
J & M Termite Control, Inc.
1-59 N W hisman Rd
,M. oust in View CA94043
J�$URERA Accelerant-,Special Insurance Company_
iNsuri.En s United Financial Casual 11770
IQyrerS
Ili c Preferred Emp.1 Insurance Company
INSURER D
INS 0ASM _F:
COVERAGrz;5 CIERTIFICATE NUMBER: 1706686327
. ..... ...... . .. 16W~ft"
THIS IST CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS 'E TO 'THE ICESUR
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TIERM OR CONDITION OF ANY CONTRACT OR OTHER
CERTIFICATE MAY ISSUED OR MAY PERTAIN, "rHE INSUrRANCE AFFORDED BY THE POLICIES DESCRIBE,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM
31(a
R
AvaL a a
LT"." TYPS OF INSURANCE tu'j 11 (
-INSOU a POL10Y NUMSER
JjkQl.
A X COMMERCIAL GENERAL LIABILITY y y LIP0007OPK00064700 3/8/2025 318/202
CLAIMS -MADE OCCU R
Herbicide
GEN'L AGGREGATE 'LJMJTAPPLt. ES P ER:
Pot -ICY LOC)
.......... . ......
8 AUTOMOBILE LIABILITY y y 994.241405 9/812025 31,812026
ANY AUTO
OWNED X SCHEDUILED
ALITO$ ONLY Wros
HIRED NON -OWNED
AUTOS ONLY AU'rQ$ ONLY
UMBRELLA LIAR OCCUR
EXCESS LIAO HOLAIMS-MADE
C WORKERS COMPENSAVON Y PEG3,00756386 '1011 /2025 10/1/2026
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNEWEX E-CUTIVE
QFFIOER/Ml�rMSEIA EXCLUDED? NIA
(Mandatory In NIH)
If yegs,doscrfbe under
DESCRIPTION OF OPERATIONS / LOCATIONS I WHICLES (ACORD 101 , Additional Remarks fthadueo may be atisohed If more spe Is requi
or pefformed by Named InSLIred as per wn'tten contract.
:0 NAMED ABOVE FOR THE POLICY PERIOD
DOCUMENT WITH RESPECT TO WHICH THIS
3 HEREIN IS SUBJECT TO ALL THE TERMS,
LIMITS
s.1,000,000
__C-A0JJ000URRENCE
NTED
1, EUL ..a Aw mins
100, 000
MC:D FXP (An. one person)
$5,000
PERSONAL 8, ADV INJURY
1 00M
$9
-GENERAL AGGREGATE
$2,000,1000.
PRODUCTS - COMWOPA070
$2,000,000
... .......
COMBIN - I I L Lll tlIT
$1,000,000
BOWLY INJURY (Per person)
$
II Ilwlll''IL�!Iff�
$
'PE,
R_=%%w.,-*'�m}+Yt..._>...1�a•-�hHt.w..
1,
EACH OCOURRENCE
AGGREGATE
RAU H-
T
.'
El. EAOH ACCIDENT
$ i'0001000
E.I.. DISEASE - EA EMPLOYEE
$1 000 000
KE,L',"P!8,EA,3E - F0LtQY LIMIT
10001000
ed)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
To of Los Altos Hills Building Inspection Dept. ACCORDANCE WITH THE. POLICY PROVISIONS.
26379 W Fremont Rd
Los Altos Hills CA 94022 AUTHORIZED REPRESENTATIVE
USA
1"Aleffl.1. On -
0 1988,-2016 ACORD CORPORATION. All fights reserved.
ACORD 25 (2016/03) The ACORNS name and-l!ogo are registered marks of CO,
468: 2 - Al of 7
PROGRESSIVE
PO BOX 94739
CLEVELAND, OH 44.101
Darling Family Corporation
DBA Name: J&M Termite Control, Inc.
15-hisman Rd
Mountain View, CA 94043
The attached endorsements listed below applies to pollcy nb ,
-n -, 1k
er9914241405
Form 2366 (02/11) Blanket Additional Insured Endorsement
Form 2367 (06/10) Blanket Waiver of Subrogation En-dorsement,
Endorsement effective,, September 8, 2025
Endorsements listed above are effective until pollancellation date.
468: 3 * of
....... .. . ..... . ..... . . . . . . . . . . . .
Form 2366 (02/11) M—CL
111pliq 1111111�� 11'11111;���
=-,- , i
L#111R.1 I i n -f-, 11 *Tor 0 , �
This endorsement modifies insurance provided by the Commercial Auto Policy, Motor Truck Cargo Legal
Liability Coverage Endorsement, and/or Commercial General Liability Coverage Endorsement, as appears
I *
on the declarations page. All -terms and conditions of the. policy apply unless modified by tnts
endorsement.
If you pay the fee for this Blanket Additional Insured Endorsement, we, agree with you that anyperson
or organization with whom you have executed a written agreement prior to any loss is added as an
additional Insured with respect to such: liability coverage as "is afforded by the policy, but thisins urance
applies to :such additional insured only as a person or organization liable for your operations and they
only to the extent of that, liability. Thi' s endorsement does not apply to acts, ornissions, products, work,
or operations off` the additional insured.
Regardless of the provisions of paragraph aw and b. of the "Other Insurance" clause of this policyif the
person or organization w1ith, whom you have executed a written agreement has other ins u ran under
which it is the first named insured and thatinsurance also applies, then this insurance is primary to and
non-contributory with that otherinsurance when the written contract or agreement between you and
that arson *zation signed and- exe - by you before the bodily Injury or property dam, age
pe o r arga in I cuted.
OCCUrs and in effect during the policy period, require's this insurance to be primary and non-
contributory.
In no way does this endorsement waivethe "Other Insurance" clause of the policy, nor make this policy
1
pri I mary to third parties hired by the 'Insured to perform work for the Insured or on the Insured's behalf,
466, 4 * of 7
zm�
1111�;IRiii I 111pill I P7jj ''I�ilill
I , 1111;1;111�[0 ",
S
This endo,rsement modifies insurance provided by the Commercial Auto Policy, Motor Truck Cargo Legal
Liability Coverage Endorsement, and/or Commercial 'General Liability Coverage Endorsement,
as appears on the declarafions page, All terms and conditions of the policy apply unless modified by
thi's endorsement.
a A
If you pay the fee for this Blanket Waiver of Subrogation Endorsement, we agreeto waive any
and allsubrogation claims, against any person or organization with whom a written waiver
agreement �has been executed by the named insured,, as required by written contract, prior to
the occurre'nee of any loss.
468: 5 * of 7
(Ed - 04-19)
�NLWWM-1HL0 011",J
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -1 BLANKET
,* CAL[FORNIA
We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our
right against the person or organization for which you perform work under a written contract that: requires you to: obtain this
agreement from us.
The premium charge for this endorsement shall be 3% of the Worker's Compensation premium, subject to a minimum
premium charge of $500.
This endorsement changes the policy to which itis attached and is effective on the dateissuedunless otherwise stated.
(The Information below Is required only when this endoront Is Issued subsequent to preparation of the policy.)
Endorsement Effective 10/01/2025 Policy No. PEG300756386 Endorsement
Insured Darling Family Corporation Premium $12,425
Insurance Company Preferred Employers Insurance Company
Countersigned by ...... I
Authorized Representative
WC 99 07 00 A I Of 1
(Ed - 04-19) 468: 6 * of 7
POLICY'NUMBER: LIP0007OPK000547i*00 COMMERCIAL GENE RALLIABILITY
S GL 0070 00060 12 22
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED (INCLUDING COMPLETED OPERATIONS)
AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN -AG, REEMENT WITH YOU
I IN
"S Ma I$ OF 01100HIMPOTIN *1% SATC-1
Of 0 MIIN 314 n*
,
, $I,* 1,fM
INK 1WA& LOU M 0 4 10 - 421
The incurance provided by this endorsement shall not serve to 'increase our limits of insurance as described in SECTION III -LI IIS OF
INSURANCE.
A. SECTION 11 — WHO IS AN INSURED is amended to Include as an additiona 1 4 nSUred any per -son 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 proliCy. Such parson or organization is an additional insured only with
respect to liability for:
1. '.Bodily injury',, "prop ertydamage" or "personal and advertislilg.'Injury'caused, "In whole or In part, by:
a. Your acts or omission. or
b. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for thatadditional
insured; and
2. "bodily injury", "property damage included in the "products -completed operations hazard with respect to '�our work"
performed for that additional insured .
B. Only with respect to the insurance afforded. to any additional Insureds- 'by this andorstement, paragraph 4,, Other Insurance,
subparagraph a. Primary Insurance- of SECTION IV — COMMERCIAL-GENERAL-LIILITY CONDITIONS is -amended to read as
folloftv 0.
This inUirance shall be considered primary "if any other valid and Collerctible insurance is available to any person or
organization included as an additional insured under this endorsement and such other insurance shall lbe excess of and 01
not contribute to the inSUrance afforded by this endorsement.
C. Only with respect to the insurance afforded to any additional insureds by this endorsement . graph 8. Tran%fer 0
p era - f Rig hts of
Recovery Against Others To Us of SECTION IV COMMERCIAL. GENERAL LIABILITY CONDITIONS is replacedbythe
following:
We will waive any right of recovM we may have against any person or organization added as an additional incur ed.under the
terms of this endorsement against whom you have agreed to waive such right of recovery in a written contract or agreement
because of payments we make for 'IboLdll,y injury;) or "property damage" arising out of your ongoing operations or "your worW
included within. the products completed operations hazard done under a contract or agreement with that person or organization."
8 GL 0070 00050 12 22
Page I of I
468: 7 " of 7
Edgewood Partners I res. Center
10877 White Dock Road Ste 300
L.ic#1370
Rancho Cordova, CA 95670
!,o68 0
INSPECTIONIII 11111111111111111111111111111 '111 Jill 1111111111111111111 111111111
TOWN OF LOS ALTOS HILLS BUILDING ' .
w W FREMONT RD
LOS ALTOS HILLS, CA 94022-2624 ,,.
465: 1 * of 7