HomeMy WebLinkAboutDarling Family Corporation dba J&M Termite Control, Inc. 07.24.2025LCERITIFICATE". 0`f L19.1"L
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ODIC
CERTIFICATE DOES NOT AFFIRMATIVELY OR 'NEGATIVELY AMEND,
BELOW. THIS CERTIFICATE OF INSURANCEDOES NOT coNSTITU
REPRESENTATIVE OR PRODIJICERA AND THE CERTIFICATE HOLDER.
IMPORTANTA: if the certificate holder Is an ADDITIONAL INSUR
ED, the
If SUBROGATION IS WAIVED, subject to the terms,and. conditions 0 tl
this ce0ificate does, not. confer rightsto the certificate holder In lieu o -f s
PRODUCER
EdPartners Ins. Center
inewood
. 677 White Rook Rd. Suite 300
Llc#OB29370
Rancho Cordova CA 95670
INSURED JMTERM
Darling Family Corporation DBA
J & M Termite Control, Inc.
159 N Whisman Rd
Mountain. View CA 94043
ML a DATE (MM1001MY)
MILITY" IONOUKANtwi=
7024/2025
........ .. .. ..... ... .... ......
(AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
rE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
)oflcy(les) must have ADDITIONAL INSURED provisions or be endorsed.,
I e policy,, certain policies may requirean endorsement. A statement, on
x h. enddrsemlent
TACT ESPPI 8
N A m F.,, ervice Team
PH x
LAIC Nq),,
A
ADDRESS—: ES,Pl$erviceTeem,.Oepicbrokejs..00m
INUI AFFORDING COVERAGE
NAIC #
IN$UR9,F,1-A-, PreferredEmployers Incur ange cmpany
0900
INSURER, a Accelprant 8 eel nsurance Comp
16890
wsutisri c United Financial Casualty Company
11770
INSURER
BODILY INJURY (Per person)
INSURER E:
BODILY INJUPY (Per acoldent)
$
RO P 1' 13TY �AMAGE
I I
OOVERAGES CERTIFICATE NUMBER so 208,6087767 REVISION NUMBER,,
M who
THIS IS TO CERTIFY THAT THE POLICIE.8 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CON.D.ITION OF AN� CONTRACT OR OTHER
CERTIFIOATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE
EXCLUSIONS AND CONDITIONS OF SUCH: POLICIES. Ll MITS SHOWN MAY HAVE KEN REDUCED BY PAID CLAIMS.
L:IRI
DOCUMENT WITH RESPECiT To L WHICH THIS
HER, 'Ii IS SUBJECT TO ALL THE TERM$,
L10TS
.... r, w r4Pr�.A,,.,� � �rF 9,"I.. � .�MOA1 �M .tm4y
TYPE OF INSURANCS
j 0
W D
POLICY NUMBER
8X
COMMERCIALGENERAL LIABILITY
y
y
LtP000770PK00054700 318/2025 3/8/2026
$2,000,000
CLAIMS -MADE E-] OCCUR
'I .
---------- 1 ED SING[E"LfMif
Molf I
............ ....
$1,000,000
BODILY INJURY (Per person)
X
BODILY INJUPY (Per acoldent)
$
RO P 1' 13TY �AMAGE
$
X
GEN'L AGGREGATE. LIMIT APPLI ES PER:
AGGREGATE
- POLICY LOO
El. EACH ACCIDENT
_2 1, I� �, 000
E.L. DISEASE - EA EMPLOYEE
............. -
.
....... 1-1W .,._..0_Y_11_
od)
... .......... . ..... ------- -- ... .........
C
AUTOMOSILELIASILITY
y
y
'994241405 31812025 9/0/2025
ANY AUTO
OWNED X SCHEDULED
AUTO$, ON LY A'T
HIRED 0 N?RW N E D
AUTC )$. ONLY AUTOS ONLY
UMBRELLA LII OCCUR
EXCESS LIAO CLAIMS -MADE
=0EE) RETENTION-$-
WORKERSCO300750386 1A MPENATION Y PG10//2,024 10/1/1025
ANDEMPLOYERS! LIABILITY YIN
.ANYPriOPR,IETOR/PAnTNER/C-XECUTIVE [
OFFICERIM EMS ES EXCLUDED? NIA
(Mandatory In N14)
If ya% desoribe under
DESCRIPTION OF OPERATION81LOCATIONS / VEHICLES (ACORD 10-1, Additional Remarks, Schedule, may ttoohad If more speoe Is requi,
Work performed by Named InSUred as per written contract.
TE HOLDER CANCELLIA7n
NOW 114", . I EA0
D NAMED ABOVE FOR THE POLICY PER1.0,I)
DOCUMENT WITH RESPECiT To L WHICH THIS
HER, 'Ii IS SUBJECT TO ALL THE TERM$,
L10TS
EACH OCCURRENCE
DA
100,000
MED EXP (Any one enon)
PERSONAL & ADV INJURY
s 1,D00,000
GENERAL AGGREGATE
$2,000.,000
PR0D'U0T,8-00MP/0PACqG
$2,000,000
'I .
---------- 1 ED SING[E"LfMif
Molf I
............ ....
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJUPY (Per acoldent)
$
RO P 1' 13TY �AMAGE
$
TPr1M�hY� U,.f
EACH OC-CURRENCE
AGGREGATE
El. EACH ACCIDENT
_2 1, I� �, 000
E.L. DISEASE - EA EMPLOYEE
$ 1 lon,000
El. DISEASE.- POLICY LIMIT
.11110,0,0 , 0
od)
... .......... . ..... ------- -- ... .........
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED SEPORE
THE EXPIRATION DATE. THEREOF, NOTICE WILL E. DELIVERED IN
Town of Los Altos Hills Building Inspection Dept. ACCORDANCE WIND THE POLICY VISI NSM
26379'W Fremont Rd M
Los Altos Hills CA 94022 AUTHORIZE.0 "REPRESENTATIVE
USA
......... ............ ........ ... ....... .... ....... ... ...........
0 19882015 D CORPORATION., All rights reserve
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
294: 2 " of 7
PROGRESSIVE
PO BOX 94739
CLEVELAND, OH 44101
Darling Family Corporation
DBA Name,, AM Termite Control, Inc.
169 N Whisman Rd
Mountain View, CA 94043
The attached endorsements listed to applies to pollicy number: 994241405
Form 2366 (02/11) Blanket Additional insured Endorsement
Form 23,67 (06/10) Blanket Waiver of Subrogation Endorsement
Endorsement effective: March 8, 2025
I laton dateFeeS W"Irl b;e waived on your curent
Endorsements flistedabove are effective until policy cancli. r
e 'I
po,licy term,
294: 3 ;' of 7
Form 2366 (02/11) IVISL
#M=
This endorsement modifies insurance provided by the Commercial Auto Policy, Motor Truck Cargo Legal'
Liab ilityCove rage Endorsement, and/or Commercial General Liability Coverage Endorsement, as appear
on the declarations page, All terms and conditions of the pollIcy apply unless �modiffed by this
endorsement.
If YOU pay the fee for this Blanket Addlitional Insured Endorsement, we agree with you that any person
or organization with whom: you have executeda written agreement prior to any loss Isadded as an
additional insured with respe:ct to such liability coverage as Is afforded bly the poticy, but this Insurance
0
appliesto such additional insured only as a person or organization liablefor your operations and then
only to the extent of that liability. This endorsement does not apply to: acts, ornisstions, products, work,
or operations of the additional Insured.
Regardless of the provisions oilf paragraph a, and b. of the "Other Insurance" clause of this policy, If the
person or organization with whom you have executed a written agreement has other insurance. under
which It is the first named insured and that insurance also applies, then this 'insurance is primary to and
non-contributory with that ter insurance when the written contract oragreement between you and
that X�
_persori or organtza-tion, signed and executed Wry or t ge
_by you before the bodily iq.j
proper y dama
occurs and In effect during the policy period, requires this insurance to be primary and non-
contributory.
in no way does this endorsement walvethe "Other Insurance" clause of the policy, nor make, this- policy
tne insured or on the *nsured'sbe half
primary to third parties hired by the insured to perform work fo I 1 0
294: 4 * of 7 j
go No
Form 20"'67 (06./1 . CL
This endorsement modifies Insurance provided by the Commercial Auto PoRcy, Motor Truok Cargo Legal
Liability Coverage Endorsement, and/or Commerol"al General, Liability Coverage Endorsement,
as appears on the declarations I. All terms and conditions of the policy appl'y unless modified by
this endorsement.
t
If you paythe fee Ifor this Bla,nket Waiver of SLUbrogation Endorsement, we agiree to waive any
and all subrogati"on claims against any person or orqanization� with whom a written waiver
agreement has been executed by the named insured, as required by, written, contract, prior to
the occurrence of any, loss.
L
294: 6 * of 7
ry LICY NUMBERI.-1 LIP0007OPK000547"00 COMMERCIAL GENERAL LIABILITY
S GL 0070 00060 12 22
THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ IT CAREFULLYN
ADDITIONAL INSURED (INCLUDING C01VIPLETED OPE, RATIONS)
AUTOMATIC STATUS WHER REQUIRED IN WRITTEN AGREEMENT WITH YOU
I EMM
0 r 211
0 ZL TAIN-ru
0
AN
-4 ILL i
The insurance provided by this endorsement shall not serve to increase our limits of insurance as described in SECTION 111,LIMITS OF
INSURANCE,
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 1.9 an additional insured only with
respect to liability for:
1. "Bodily injury", "property damage" or"personal and advertising injury',caused, in whole orin part, by:
.bI . The sets or omissions of those acting on your behalf in the performance of your ongoing operations for that additional
insured, and
2. "bodily injury", "property damage" included in the "prod ucts-completed operations hazard" with respect to "your work"
performed for that additional insured
B. Only with respect to the 'insurance afforded to any additional insureds by this endorsement, paragraph 4. Other Insurance,
sub paragra P h a.. Primary Insurance of 85CTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS Is amended to read as
follows'k,
This insurance shall be considered primary, 'if any other valid and collectible insurance is available to any person or
organization included as an additional Insured Linder this endorsement and suoh other insuranoe, shall be excess of and will
not contribute to the inSUrance afforded by thi's endorsement.
C. Only with respect, to the insurance afforded to any additional insureds bythis endorsement, paragraph 8, Transfer Of 1119fits of
Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the
following*
We will waive any right of recovery we may have against any person or organization added as an additional insured under the
terms of this endorsement against whom you have agreed to weive such right of recovery in a writtenoont' ract or agreement
because of payments we make for "bodily Injury" or ""property damage" you
arising out of r ongoing operations or "your workP
included within the products completed operations hazard done under a contract or agreement with that person or organization,"
8 GL 0070 00060 12 22
Page I of I
294: 6 " of 7
f"Merred
Fre
I N S U R A N C E C 0 M P A N Y
WC 99 07 00
WAIVER OF'OUR, RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— BLANKET
VT'e have the right to recover our payments from anyone liable for an injury covered by thi s. policy, We will not
enforce our right against the person or organjZation for wh,ich you perform work under a written contract that
requi,res you to obtain this agreeme- nt torn us.
:n I
The premium charge for this, endorsement shall be 3% of the Worker's Compensation premium, subject to a
miG
i
nmum charge of $500.00
This endorsement changes the policyto which it Is affached effective on the date issued unless otherwise statad,.
(The information bellow Is required only when, this endorsement is Issued subsequent to preparation of the policy.)
Endorsement Effective 10101/24 Policy No. PEG300756386 Endorsement No. 2
Insured DARLING FAMILY CORPORATION DBA J & M TERMITE CONTROL INC.
Insurance Company PREFERRED EMPLOYERS I-NSURANCE COMPANY
Countersigned By
294: 7 * of 7
Edgewood Partners Ins. Center
10877 White Rock Road Ste 300
L6OB70
Rancho Cordova, CA 95670
294 2 SP 1.900
111111111111111 111111 Jill 111111111111111111
TOWN OF LOS ALTOS HILLS BUILDING INSPECTION DEPT
26379 W FREMONT RD
LOS ALTOS A 94022-2624 29A
ir
294, 1 " of 7