Loading...
HomeMy WebLinkAboutEmily Michiko Smith Michiko-Smith Dressage LLC 01.30.2026SMITEM2 nP In- AH CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)01/3012026 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 800-752-2472 Equisure, Inc. 13790 E Rice PI Ste 100 CONTACT E NAME: q uisure Inc PHONE 800-752-2472 FAX 303-614-6967 (A/C, No, Ext): (A/C, No): Aurora, CO 80015 Amy Hull ADDRESS: info@equisure-inc.com X INSURERS AFFORDING COVERAGE NAIC # INSURER A: Lloyds, London 112200 08/25/2026 INSURED Emil/ Michiko Smith Michiko -Smith Dressage LLC 2971 Bluffs Drive INSURER B: INSURER C: Marina, CA 93933 INSURER D: INSURER E: INSURER F: COVERAGES ('FRTIFIC:ATF NI IMRFR- P1=X1lclnly nil ImnRl=P- 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 DDL IVSD UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR X B123062096C25-SMITEM2 08/25/2025 08/25/2026 EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 51000 PERSONAL & ADV INJURY $ 110001000 GENERAL AGGREGATE $ 2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYF] JERT 7 LOC PRODUCTS - COMP/OP AGG $ 2,0003000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ USOSOL ONLY AUTOY acen DAMAGE (Per acid $ $ UMBRELLALIAB OCCUR - -_EACH _OCCURRENCE AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY Y / N ANY PROP RIETOR/PARTNER/EXECUTIVEF7N/A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab B123062096C25-SMITEM2 08/25/2025 08/25/2026 Included Included DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate holder is additional insured as to the general liability exposure of Emily Michiko Smith but only with respects to the occurrences related to the named insured only. (Interest Added 12/5125) (Interest Deleted 1/23/26) YOUR INTEREST IN THIS POLICY HAS BEEN DELETED EFFECTIVE 1/23/26 FIFICATE HOLDER The Town of Los Altos Hills Landowner 26379 Fremont Road Los Altos Hills, CA 94022 ON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD