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HomeMy WebLinkAboutG. Bortolotto & Company 06.25.2025AC40REP CERTIFICATE OF LIABILITY INSURANCE DATE�M DNYYY) 06/25/2025 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(les) 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 FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES INCLUDING PRIMARY SOURCE INSURANCE AGENCY 121 E. PARK SQUARE OWATON NA, MN 55060 ACT NAME: CLIENT CONTACT CENTER PHONE FAX [(AIC, No, Ext): 888-333-4949 (A1C, No): 507-446-4664 E-MAIL ADDRESS: CLI ENTCONTACTCENTER@FEDI NS,COM INSURERS AFFORDING COVERAGE NAIL # INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED G. BORTOLOTTO & COMPANY 582 BRAGATO RD SAN CARLOS, CA 94070-6227 MvPW WESTCHESTER SURPLUS LINES INSURANCE 10172 INSURER C: INSURER D: INSURER E: INSURER F: r+rZ\/GDar'.GC CFRTIFICAI E NUMBITH' /H mrvio1V11 IYVIVIVGn■ V 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 ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $110001000 (Ea occurren }ELATED PREMISES $100,000 CLAIMS -MADE OCCUR MED EXP (Any one person) EXCLUDED A Y N 1903446 08/13/2025 08/13/2026 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS & COMP/OP ACC $210001000 X POLICY ❑PR ❑ LOC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $110001000 (Ea accident) BODILY INJURY (Per Person) X ANYAUTO BODILY INJURY.(Per Accident) A OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY Y N 1903446 08/13/2025 08/13/2026 PROPERTY DAMAGE (Per Accident) X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $8,000,000 AGGREGATE $810001000 A EXCESS LIAB CLAIMS -MADE N N 1903447 08/13/2025 08/13/2026 DED RETENTION WORKERS COMPENSATION PER STATUTE THER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE E.L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? (Mandatory in NH) /A E.L DISEASE -EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E,L DISEASE POLICY LIMIT ONTRACTORS POLLUTION LIABILITY Y Y G71661726 003 08/23/2024 08/23/2025 EACH -LIMIT -$2,000,000 AGGREGATE $2,000,000 B DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) SEE ATTACHED PAGE r%CD-r1C1r+n-rr. unI nFQ CANCELLATION TOWN OF LOS ALTOS HILLS 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 780 1 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 , AJJ4.*,L ;e O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD J AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES G. BORTOLOTTO & COMPANY 582 BRAGATO RD INCLUDING PRIMARY SOURCE INSURANCE AGENCY SAN CARLOS, CA 94070-6227 POLICY NUMBER SEE.CERTIFICATE # 78.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE ## 78.0 SEE CERTIFICATE ## 78.0 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE G BORTOLOTTO JOB #19-803 RE: 2019 PAVEMENT REHABILITATION AND DRAINAGE IMPROVEMENT PROJECT ADDITIONAL INSURED INCLUDES: TOWN OF LOS ALTOS HILLS, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF. THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. INSURANCE PROVIDED BY THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE.CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. GENERAL LIABILITY COVERAGE CONTAINS CG 25 03 DESIGNATED CONSTRUCTION GENERAL AGGREGATE LIMIT ENDORSEMENT APPLICABLE TO EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. FOR REASONS OTHER THAN'NON- PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED ENDORSEMENT:FOR CONTRACTORS POLLUTION LIABILITY. THE CONTRACTORS POLLUTION LIABILITY COVERAGE CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER SUBJECT TO THE CONDITIONS OF THE WAIVER OF SUBROGATION. INSURANCE PROVIDED BY THE CONTRACTORS POLLUTION LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. MOLD COVERAGE IS INCLUDED UNDER CONTRACTORS POLLUTION LIABILITY. a. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered (marks of ACORD COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT ES THE POLICY. PLEASE READ IT CAREFULLY. Y. PRIMARYAND NONCONTRIBUTORY OTHER N CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other. Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other inuunanoo available to on�naured"under your policy providodthat: 1. Such "insured" is a Named Insured under such other insurance; and 2' You have agreed in writing in u contract or agreement that this insurance would be primary and would not seek contribution from any other inmuranco available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision tothe contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary toand will not seek contribution from any other insurance available to an "insured" under your policy provided that: U. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or mnent that this insurance would be primary and vvou|dnot seek contribution from any other insurance available to such "insured". @\nsunanceServices Office, |nc..2O18 Page 1 o 1 CA 04 49 11 16 Policy Number: 1903446 Transaction Effective Date: 08/13/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a. limited liability company) for a covered "auto" owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any- insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss" which occurs prior to the date of your contract with such person or organization; 2. To -"loss" arising out of the sole negligence of any person or organization that- would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto" or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA -F-127 (03-03) Policy Number: 1903446 Transaction Effective Date: 08/13/2025 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY M . OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. @ Insurance Services office, Inc., 2018 CG 20 01 12 19 Policy Number: 1903446 Page 1 of 1 Transaction Effective Date: 08/13/2025 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 877 CAREFULLY. ADDITIONAL INSURED = OWNERS, LESSEES OR CONTRACTORS ~ AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided underthefollowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section U! - 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 on additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury". "property damage" or "personal and advertising injury" oaUoed. in whole orin p�ft. by: 1. Your acts oromissions; ur 2. The acts or omissions of those acting on your behalf; in the performance ofyour ongoing operations for the additional insured. However, the- insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to thainaurance afforded to these additional inaureda, the following additional exclusions apply: This insurance does not apply to: 1- "Bodily ipjury". "property damage" or "personal and advertising injury" arising out of the rendering of, orthe failure to render, any professional architectural, engineering or surveying services, including: m. The pnaparing, epprovng, or failing to prepare orapprove, maps, shop drawings, opiniwno, reports, nurveyo. field on±eny, change orders or drawings and specifications; or b. 8uporvioory, inmpootion, architectural or engineering activities. This exclusion applies even if theo!oinmo against any insured allege negligence orother wrongdoing in the muperviaion, hiring, mmpiuymment, training or monitoring of others by that inmured, if the "occurrence" which caused the "bodily injury" o/ "property damage". or the offense which caused the "personal and advertising injury"` involved the rendering of or the failure to render any professional anohiteotura|, engineering or surveying services. @ Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 1903446 Page 1 of 2 Transaction Effective Date: 08/13/2025 2. "'Bodily injury" or "property damage" occurring after: a. All vvmrh including rnoteha|m, parts or equipnment furnished in connection with such work, on the project (other than eerv1oe, maintenance or repairs) to be perfornmedbymronbehe|f.o[the additional insured(s) at the location of the covered operations has been completed; or b- That portion of "your work" out of which the injury urdamage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for aprincipal oaapart ofthe same project. C. With respect to the insurance afforded to these additional insureda, the following is added to Section I.0-Limcits Of Insurance: Tha most we will pay on behalf mfthe additional insured iothe amount ofinsurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available'under the applicable limits of insurance; whichever |aless. This endorsement shall not inonaaaa the applicable limits of insurance. Page 2 of 2 @ Insurance Services Office, fmz.2O1@ CG 20 3312 19 Policy Number: 1903446 Transaction Effective Date: 08/13/2025 - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US IT Named Insured Endorsement Number G Bortolotto & Company Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW 671661726 003 812312024 To 812312025 812312024 Issued By (Name of insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This -endorsement modifies i risurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or OE - ganization: As required by written contract, prior to a loss to which this insurance applies (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations -or your work done under a contract with that person or organization and included in the products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All otherteres-andconditions remain the_same.______ ENV -3143 (03-05) 1 ne-ludes copyrighted material of Insurance Services Office, Inc. with its perrnission Page 1 of 'I ' -S.Icho ter MOLD. SUBLIMIT ENDORSEMENT — CONTRACTORS POLLUTION LIABILITY Named Insured G BoftolotLo & company Endorsement Number Policy Symbol Policy Number Policy Peri©d Effective Date of Endorsement CP W G7:i661-726 8/2903/2024 To 8/23/202512 9 — 024 8/31' .003 Issued By (Name of Insurance Company) We.stchestej- Surplus L.hies Imsm-ance Company THIS E NDOMSEMENT CHANGES THE POLICY. PLEAS -E RIKAD IT C.AREFLTLLY. TI -As endorsement modifies insurance pro-%ided mider the follo-oving: . CONTRACTORS- POLLUTION L11ABILITY COVERAGE PART . 1. Subsection V. of t1e DEFINITIONS section of this Coverage Part is hereby deleted in its entirely and replaced -vNdth !be following: U. Poll-ution, condition means the discharge, dispersal, release, escape, migration, or seepage of any solid, liquid, gaseous orthermal material, matter, irritant or contaminant, including smoke, sootn .1 1 vapors, ftime-s , acids,, 4117calis, che- iicals, hazardous substances, hazafflous - naterials, low- level radiological- waste, mixed waste or 'waste materials, including, ine-dical, fectiou, or pathological wastes, an, in., m -to, or ul.-ton land and structures there -upon, the atmosphere, surface water or ground -water, pro-vided such conditions. are not natur4lly present in the environment in the concentrations or amounts discovered. Pott tion. condition also inchides.- :1. Electromagnetic field"Is, mold and bacteria, including legioi7elt'a,p-,qeziF7i.oph.;I(i., pro,6ded that any such: a. Conditions are not naturally occurring in the environment in the amounts and - concentrations discovered; and b. Bacteria: i) is not the result of come-ruinication or tratismissIon t1--Xrc-ugJ3 hirman-to-hu-Inan, hurnan to af]41181 Or ' 3-liTTKII tib aTliTM-11 C!0311tact, or co-11tact with any of C Ci ' any' their respeethre bodily fluids or discharges; ii) is required to "be. reported to any Federal, state, commonwealth, municipal or other local government agency or body with regulatory jurisdiction over the job 'site; and Iii.) becomes pathogenic as a direct result of your work. C 2. The discharge, dispersal, release or escapeafsilt- or se limentatiOR. Pollution condition does not include any such material, natter, irritant or contamina,--it that is or was, contains or contained, -includes or included, or involves or involved, in whole or in part, any virus, e.-&-cept for any virus* that is exclusively contained within medical, - infectious or pathological wastes that have been preidiously characterized and prepared for disposal pursuant to governing regulations. j21n EWNT-p 4.1 %. I (' 04-20) Page 1 Of 2 (299447-4) RtstdwNter 11. 'Wftli respect to coverage afforded -for pollution conditions involAng mold or bacteria, hi -chiding legioneffil pnewnophila, pursacitnt to Iteni 2), above, above, the following Sublimits of Insurance and Deductible apply: Limits of Insurance:$2_3.000,000 Each Pollution Condition $000;000 TvIcId (serr ti to educe the GAggregate general Aregate 1-111xit 2, nown on the Declarations page) Deductible: $10,000 Each Pollution Condition 'r e ib n he terns and conditions of flae .11 St' Ii- ifts of Insurance and Deductible identified above are wbjer.t to t LIMUS OF IMSURANCEseetioti of the Coverage. -part niodified by tbds endorseinent. These. SidDlimits of -11 Insurance shall. be subject to, an.d.Payine tits made pursuant. to these Sublimits of Insurance shall erode, the Limits of Instirance identified on the Declarations to this Policy. Al. other te mis and conditions reinain the same. Au-thorized Rep resentati-Ve EST- ('04-20) Page 2 041,2) (299447-4) Ter ADDITIONAL INSURED ENDORSEMENT — ONGOING WORK OR OPE PLAXIONS Named InGLIred- G Bortolott® & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G71661726 003 8/23/2024 To 8123/2025 8/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company -1 7 "Sement is i'�4qned Subsequent to the preprinntion of tr e pollicy. Insert fhe policy -P -je ffic -0 j .11ml —emninder of the infit M71han alis end!)] ,St ENDORSETMENT CJUNI (.Y'ES THE POLICY.'PLEASE RE,'kD IT CAREFULLY. THIS EN.DORSE'I%IENT MODIFIES INSUKANNE PROVIDED UNDER THE FOLLO"WING: COINIRACTORS POLLI-MON LIABILITYC017E RAGE PART SCHEDUJLE.a Name of Person(s) M., Organizatio-a6s): As required by written contract,, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown '111 the Declarations as ap plicable to Ibis endorsement.) A. SECTION 11 - NA110 IS AN INSURED is amended to include as an additional insured the persons or organizations but oily -tvith respect to liability for iikiury or damage, to i4hich this ganizations shown in the Schedule, . y insurance applies, caused, in -whole or in part, by: :t. Your acts or omissions; or 0> -behalf- The acts or omissions of those acting on your 14 in the performance of your ongoing operations for the additional insureds. HmA,,even - :t. The insurance afforded to such additional insured only applies to the extent pen-nitted,'by huv\r; anG"' 2. If coverage provided to the additional insured is recluired by a contract or agreement, the insurance afforded to such additional insured will not. be broader than that Which you are required by the contract or agreement to proAde for such additional insured. B. With respect to the insurance afforded to these additional insureds, the follolAing exclusion is added: I In Exclusions This insurance does not apply to injury or dainage occurring after: a. All work or operations, including mcatericals, :parts or eqtjparent furnished. in connection iviffi such ivork- or operations, on the project (other than service, maintenance or repairs) -to be perforniec".. by you or on. your behalf at the site of the cov, erect operations h as been conipleted; or EN, V - - ;o jor (i2ASI h ncludes cripyTighted in-ain terial of surance SeriiOffi ces c'e, hic. with itus permission Page I Of 2 -, (221012.1') Hvhtcliester b. That portion ofyourwork- out of which the injury or damage arises has been put to its intended i-igaged in use by any person or organization zation other than another contractor or subcontractor el performing operations for the additional insured as a part of the same project. C.Witb respect t.the ins-orance afforcled to these additional itisureds, the follolving is added to SECTION ') III — MMUS OF INSITRANCE" If coverage provided to the -additional insured is required by a contract or agreement, the most we A-Vill pay on behalf of the additional insured is the amoLtnt of insurance: :t. Requit-ed b.v the coaract or agreement; or 2. Available under the applicable Limits of Insurance shu"M in the Declarations: -whiche-ver is less. D a This endorsement shall not increase the applicable Limits ofinsurance ho r i the ' eclax tions. All other terms and condltion.,.-N of whey reinain tinchanged. OfT % 2 ENV'--12,�30 (12/18.) Includes copyrighted inaterial -In-surance Senices Offic.e. hic— with its perillission Page z, of hes er* ADDMON-AL INSURE D ENDORSEMENT — PRODUCIS-COMPLETED OPERATIONS HAZARD Named Insured G Bortolotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CP W 671661726 003 812312024 To 8/23/2025 18/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Inseat f—he, policy nunaber. The remainder of the information is to be completer'. only when this endorse -anent. is issued subsequent to the preparation of policy. I y THIS ENDORSEMENT CHANGESTHE POLICY.PLE_4JS_E REkD rr CMtEFULLY. 4. THIS EN-DO&SEMENT MODIFIES INS113-R-ANCE PROVIDED UNDER THE FOLLOWING0 C ONTRACTORS POIAXTION 1,TABILIrnr CONT RAGE, PART SCHEDULE Name of Persmn gr Organization: As required by written contraft, prior to a loss to whtich this insurance applies ----------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- I J no entry appears above., information re(jaired to co niplete this endlorsement -will be sho-wa in the Declarations as applicable to this endorse-nient.) A. SECTION 11 — NIU10 IS AN INSITRED is amended to include as an ac"Ilditionail insured the person(s) or orgranization(s) shown in the Schedule, bit only i-vith respect to 'liability for injuiry or damAge, to ivhich this insurance applies, caused by or resulting from yotw -work perfornied for that additional insured and : nT included in m the prod-ttets-co operations hazard, and only to the extent that such inju . or damage is caused, in vArhole or in part, ky your negligence or the negligence of those acting on.your behalf llowe-ver: i. The insurance afforded to such additional insured only applies to the extent permitted 'bar hcrvv; and ()S,rided to the additional hisured is rec L ,3 fired b - If coverage -pr y a contract or agreemelt, the insurance ea ured by the contract or afforded to such additional insured -will nc)t be broader than that whii.ch you are I - K agreement to proVide for such additional insured. B. NVith respect to the insurance affilorded to these additional insureds. the follo-vving is added to SECTION III - LIMITS OF INSURANCE: Tf ("(werage provided to the additional insured is required by a contrail or agreerrient, the most -we will p,ay on behalf of the additional insured is the anlo-ant of insurance: :t, ReqiAred bv the contract or agreement; or 2. Available -ander the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. E, N-V-3;Z5:L (.1L' 1-18) hic-fudes co!py r Pee Sen ices Office. with ibs pmmis,�;ion righae(l material of 1-nsu a. Page I of -t PR-111VLARY,kND NONCONITRIBILTFORY — OTHER INSURANCE CONDITION Named Insured G Bortolotto & Company Endorsement Number Policy Symbol -------- -- Policy Number Policy Period Effective Date of Endorsement CPW G71661726 003 8/2312024 To 8/23/2025 8/23/2024 Issued By (Name Of Insurance Company) Westchester Surplus Lines Insurance Company Insect Lhe P611 :y nttm1)er.Thv, r(-mal-ndevol'ibe. in formaLi(n is is) Ile, compli-Led' umly-when Lhi.i endorsement is issued %ijhsequt-nL Lo Lhe-prepiraLlon (It THIS ENDORSEMENT CHANGES THE POLIM PLEASE READ IT CAREFULLY. rr -rHEFOLLO-VVING.- THIS ENDOIUSEMENI'MODIFIES IN'SURANCE PROVIDED I-JNIYER CONTTRACTOW 8 POLL13TION LIABILITY CONT AGE PART The follmving is added to the Other Insurance. Condition and stipersed.es anyprovision to the contrary; Primary and is oncontributoryy Ins-titrance This policy is primar.y- to, and -"ill not seek contribution from. any other insurance available to ail additional ifisured un(ler this -policy-, provided that: a. The additional insured. is a nained- insured tinder such other insurance; and bo ribe nanied insured has agreed In a written contract or ag-'reement that this insurance would: W act a,-.% primary insurance; and. (2) would not seek contribution from any other insurance available to the additional insured. All other terms- and. conditions of this policy rernaiii vinchanged. E,Nyl-3-253 (121-18) Inch,,dcs copyrighted --a-1-atcried fif hasur-3--act. Wficc., Inc. -wifn its pf-m-mission Pa 'n -1 of. i (-,--,66�-)62. ?-) 443-843-8 78 #BWN D H BS BP001-06 - 0029 #xwxw0021 XXXXXXX5 TOWN OF LOS ALTOS HILLS 26379 W Fremont Rd Los Altos Hills, CA 94022-2624