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HomeMy WebLinkAboutG. Bortolotto & Company 06.25.2025 V2AC40R& CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYY 0625/2025 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 CONTACT NAME: CLIENT CONTACT CENTER P ONE FAX (AIC, No, Ext): 888-333-4949 IA/C, No): 507-446-4664 E-MAIL ADDRESS: CLIENTCONTACTCENTER@FEDINS.COM OWATON NA, MN 55060 INSURERS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED ntawrESTCH ESTER SURPLUS LINES INSURANCE 10172 INSURER C: G. BORTOLOTTO & COMPANY 582 BRAGATO RD SAN CARLOS, CA 94070-6227 INSURER D: INSURER E: CLAIMS -MADE OCCUR INSURER F: 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 LTRINSR TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES $100,000 (Ea occurrence) 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 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ jECT ❑ LOC PRODUCTS & COMP/OP ACC $210001000 OTHER: AUTOMOBILE LIABILITY CO (Ea acc deD)SINGLE LIMIT $1,000,000 BODILY INJURY (Per Person) X ANY AUTO BODILY INJURY (Per Accident) A OWNED AUTOS ONLY SCHEDULED AUTOS NON -OWNED HIRED AUTOS ONLY AUTOS ONLY Y N 1903446 08/13/2025 08/13/2026 PROPERTY DAMAGE (Per Accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $8,000,000 AGGREGATE $810003000 A EXCESS LIAR CLAIMS -MADE N N 1903447 08/13/2025 08113/2026 DED RETENTION WORKERS COMPENSATION PER STATUTE THER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER! EXECUTIVE E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? L (Mandatory in NH) NIA El DISEASE -EA EMPLOYEE E.L DISEASE POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below 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 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) SEE ATTACHED PAGE r%r_nT11=11%ATC Ur%1 nco CANCELLA110N TOWN OF LOS ALTOS HILLS 26379 W FREMONT RD LOS ALTOS HILLS, CA 94022-2624 63 0 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 A-' e e�,� © 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 HEDULE Page 1 of AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES G. BORTOLOTTO & COMPANY 582 BRAGATO RD INCLUDING PRIMARY SOURCE INSURANCE AGENCY SAN CA,RLOS, CA 94070-6227 POLICY NUMBER SEE CERTIFICATE # 63.0 - CARRIER NAIL CODE EFFECTIVE DATE: SEE CERTIFICATE ## 63.0 SEE CERTIFICATE ## 63.0 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE G BORTOLOTTO JOB #21-872 RE: 2021 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. ACORD 101 (2008/01) 4 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 CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE 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 insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". @Insurance Services Office, Inc., 2016 Page 1 of 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 tocoverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. VVHC>|8AN}NSUREDfmr"bodi|yinjury"ond"prupertydonmage"|iab|Kyiaonmendedtoimdude: Any person or organization other than o joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out ofoperation of covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from vvhorn you hire or borrow o 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 o member ofhis or her household. (3) Someone using acovered "auto" while he or she iaworking inabusiness of selling, servicing, repairing, parking urstoring "outmo"unless that business iayours. (4) Anyone other than your "employees", podmono (if you are a partnership), members (if you are o limited liability oornpony), or a lessee or borrower or any of their "enmp|oyeom", while moving property toorfrom ecovered "autu" (6) A partner (if you are o partnarmhip), or a member (if you are a limited liability company) for o 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 ofthe Coverage Part towhich this endorsement imattached. |naddition, 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 |irnUo of insurance applicable to such insurance mheU be the |eaeor of the limits required by the agreement between the parties, orthe limits provided bythis policy. D. Addihona\ exclusions. The insurance afforded to any person or organization am 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 eo|o 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. ��27 (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 - 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 THUS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. Y, INSURED OWNERS,LESSEES OR���MN8��� ~ CONTRACTORS � U�� WHEN �������u�n��mu�� STATUS REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section 11 - Who Is An Insured is amended to include as an additional insured any person or organization for whmnn you are performing operations when you and such 'person or organization have agreed in writing in o 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" caused, inwhole orinpart, by: D. Your acts or omissions; or 2. The acts oromissions of -those acting on your behalf; in the performance ofyour ongoing operations for the additional insured. Hovvever, -the-- insurance afforded tosuch 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 ponymn'a 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 the insurance afforded to these additional inouredm, the hd|ovvng additional exclusions apply: This insurance does not apply to: 1' "Bodily injury". "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional ornhiteotuns|, engineering or surveying aervioes, including: m. The prepehng, approvng, or failing to prepare orepprove.maps, shop drewinge. opinions, reports, mun/oym. �|d mrdena, change orders or drawings and specifications; or b. 8upervimory, inspection, architectural or engineering activities. This -exclusion applies oven if the claims against any insured allege negligence orother wrongdoing in the supervimion, hiring, emp|uynment, training or monitoring of others by that inaured. U the "occurrence" which caused the "bodily injury" or "property dommage", or the offense which caused the "personal and advertising injury".involved the rendering of or the ha\|una to render any professional architectural, engineering or surveying services. @ Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33i2 19 Policy Number: 1903446 Transaction Effective Date: 08M3/2025 2. "Bodily injury" or "property dernege" occurring after: a. All work, including rnateha|a, parts or equipment furnished in connection with such vvorh, on the project (other than aonice, maintenance or repairs) to be performed byoronbehalf nfthe 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 ordamnag*earises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional inauredm, the following is added to SectiorUNI-LimmiteOfUnsurance: The most we will pay on behalf of the additional insured iathe 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 is |oam. This endorsement shall not increase the applicable limits of insurance. Page -2 of 2 @ Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 1903446 Transaction Effective Date: 08/13/2025 1001AIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured Endorsement Number G Bortollofto & Company Policy Symbol Policy Niumber Policy Period Effective Date of Endorsement CPW G71661726 003 812312024 To 8123/2025 812312024 Issued By (Name of Insurance Company) Westchester SurplUs Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This -endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or 0[garfization: As required by written contract, priol, 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 -c omp le.ted operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms -and conditions -re. main -the--sarne.. ENV -3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page I of '11 I , 4:4 :P.-Sitcht. ter MOLUBLIMIT ENDORSE MENT - CONTRACTORS POLLUTION LIABILITY Named Insured, G Bortolotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G71661726 8/23/204 To 8/23/2025 8/93?'209 —4 003 Issued By (Name of Insurance Company) Westchestej- SurIfts Lines Insui-ance Company THIS ENDOMSEMENT CHANGES THE POLICY. PLEAS- E READ IT CAREFULLY. This endorsement modifies insurance pro,%ided miler the foil -owing; CONTRACTORS POLLUTION LIABILITY COVERAGE PART 1. �ubsection U. of the DEFINITTONS section of this Covorcage Part is hereby deleted in its entirety and replaced -vNdth ffie follovying: U. Pollution condition means the discharge, dispersal, release, escape, migration, or seepage of any solid, liquid, gaseous or thermal material, matter, irritant or co'ntaminant, including smoke, soot, vapors, fumes, acids,, alkalis, che - micals, hazardous substances, hazaa-dous -.1naterials, low- level radliologicalwaste,. mixed waste or -waste materials, including medfical, itifectious, or pathological wastes, on) in, into, or uj)on land and stractures thei-e-upon, the atmosphere, Surface water or groundwater, provided such conditions. are not naturally pr esent in the environment in the concentrations or amounts discovered. Poltntion condition also includes: :t. Electromagnetic fields, mold and bacteria, including legi(,)t?elt'a.p-,qezifizoph.;I(t, prmided that any such a. Conditions axe not naturally occurring in the en-vironnient in the amounts and concentrations discovered; and b. Bactet-*ta:i)isiic)ttlie-.restiltofconir-riti-tiicatioiior. tra:tismissi.oii.tl.--ti-c)t.iLYlihuniati,-to-hii-Iiiati., ITCHM T1 tO alliTllal Or M-liTTI'l to canirnial contact 11 r s Ne C1 Ci or cuo,ritact with any of t eir e, pecti r bodily fluids or discharges -5 ii) is required to "be. reported to any Federal, state, common -wealth, municipal or other local government agency or body mdth regWatory jurisdiction over the jobsite; and Iii.) becomes pathogenic as a direct result of your work. 2. The diseharge, dispersal, release of escape of silt, ol, se(Ii.m.entation. Pollution condition does not include anv such material, matter, irritant or contaminant that -is included, or involve n whole or in part. or was, contains or contained, -includes or s orinvolved i any ,drus, except for any virus that is ex-clusively contained w4hiri medical, infectious or Pathological wastes that have been previously characterized and prepared for disposal pursuant to governing regulations. E:. - 2l" ('04-20) Page I Of 2 tj N. (299447-4) ter -respect to coverage afforded -for p+-illution conditions involving mold or bacteria, including legioneffil pneinnophila, pursu-crint to Iteni 2), above, above, tl-ie f6IIo-"-4 Subliinits of Insurance and Deductible appl,n Liunits of Insurance: $2,000,000 Each Pollution Condition NI.c-.Ii-i..Agcyregat.e.[,i--niit (serve.*j to reduce the Genera] Aggregate I -It $e_.1000�000 Shown oti. the Deriarations, page) Deductible: $10,000 Each Pollutio n Condition FrIle Sublinnits of Ins-unnce and Deductible idemified above are gubject to the ternis and conditions ofti-.e I LIMITS OF INSURANCE sectioti of tl3e Coverage -Part niodified by this endorseinent. These-Sublimit's of -11 Insurance shall. be subject to, andpaytne tits inade pursuant to these Sublhuits of Insurance shall erode, the w Lhnits of Insurance identified on t1 -ie Declarations to this Policy. Al. other to rni.s wid conditions reinain t1ie saiue. AU-Morized Representative EST- }21`-;0.-20) (' Page 2 01122 (299447-4) 14,.�issfcliesl r A-DI)ITIONA-L INSURED ENDORSEMENT — ONGOING WO.OPE .A.TIO1' S Named InGUred G Bortolotto & Company Endorsement Number Policy Symbol Policy Niurriber Policy Period Effective Date of Endorsement CP W 671661726 003 8/23/2024 To 8/23/2-025 8/2312024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company hscn-t the rolicy nlln'.her. The remaindev of -the inflormation i� to be vuelp](4-ed milly When this enflorsement is issued subsequent to the p1 ep-11-1Ition ofthe lw-flie.y. THIS ENDO .LSE TMENT CHANICIES THE POLIC"Y. PLEASE RF-,,.'kD IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSUKkNCE PROVIDED UWDER THE FOLLOVY'ING: CONTIUCTORS POLL17HON LIABILITY C0117ERAGE PART SCHEDUILE,.- Name of Pe.rsqn(s) or Grga--nizzitio-n(s): 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 irvill be shown in the Declarations as applicable to this enclorsement.) A. SECTION II - 'AqIO IS AN INSURED. is amended to include as an addition -Ell insured the persons or organizations sho-vy-n in the Schedule, but only i�-ith respect to liability for fikjui73r or damage. to which this insurance applies, caused, in whole or in part, by: i. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; iii the T)erformance of your ongoing operations for the additioiial ffisureds. HoiA,,even :1. The insurance afforded to such additional insured only applies to the extent permitted -by hr�r; anck 2. If coverage provided to the additional insured is required by a contract or agreement. the insurance aff L o­ded to such additional insured �kill not be broader than that which you are required b- y- 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: Exclusions This insurance does not apply to injury or da-inage occurring after: a. Al work or operations, inchiding irtaterials, :parts orequ;,prnent, furnished. hi connection ivith such work- or o Ic rto c operations, on the proi ect (other than servi e, fnaintenance or repairs) -to be rinepe '.l by you or on. your behalf at the site of the covered operations has been completed; or periaussion Page I Of 2 (12. '18.' Includes copyrighted material of insurance SlerNices Office. inc. with its (221012.1) b. That portion of your work- out of which the injury or damage arises has been put to its intended use by any person or organ i7ation other than another contractor or subcontractor engaged in performing operations for the additional insured as a part of the same project. C.'With respect to the insurance affarded to these adchtional hisureds, the following is add -ed to SECTION III — LIMITS OF INS UTRANCE: if coverage pro-vided to the additional insured is requked byr a contract or agreement, the most we A�ill pay on behalf of the additional insured is the amount of insurance: :t. Required by the, cotitract or agreement; or 2. Available -tinder theapplicableLimits of Insurance shov�m in the Declarations; -whichever is less. This endorseirteiit shall aut increase the applicable Limits ofirtsura: -nee . shown in the Declarations. All other tennis and conditions of this policy reinain unchanged. hricludes copyrighted niateric-1 of insu--i-ance Senices Office. Inc. ,With Jlt!i permission Page z- Of 2 (.221012.-1) R 7. e.sithester- ADD ITIONAL INSURE, D ENDORSEMENT — PRODUCTS -COMPLETED OPERATIONS HAZARD Named Insured G Bortalotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G71661726 003 8/23/2024 To 8/23/2025 8/Z3/2024 Issued By (Name of Insurance Company*% - Westchester Surplus Lines Insurance Company inset the -policy number, ahe remainaer of the information is to be coinple-tec only when this eniiorseanent is issued subse-quent to the preparation of tile policy. THIS ENDORSEMENT CHANIG'ES'THE POLICY, PLEASE RF,,kD rr C.MtEKILLY. THIS EN-DORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:, C0 NTRACTORS P01,IXTION LIABILITY ", )ATERAGE, PART SCHEDlLJLE Name. of Person or Orga--nizatiou- As required by written contract, prior to a loss to wh.ich this insurance applies ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- (If no entty appeais above., ird'orniation re(jaired to complete this endorsement -will be sbown. in. the Declarations as applicable to this endorsement.) A. SECTION 11 —'X,'v7H0 IS AN INSITRED is ainended to include as an ac"'.1ditiona'I ins -tired the person(s) or organization(s) shown in the Schedule, but only with respect to liability for injuiry or danitLge, to which this insurance applies, caused by or resulting from yotw Nvork performed for that additional insured and included in the prod-ticts-complete.d operations Iiazard, and only to the extent that sudh injury or damage is caused, in whole or in part, by your negligence or the negligence of those acting onyourbehalf. I-Jowever: it. The insurance afforded to such additional insured only applies to the extent permitted. by 1-crv%r; and If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to Ba ch insu- ed will not be broader than thatwhich. 41 you are required by the contract or agreement to provide for such additional insured. R. NVith respect to the. insurance afforded to these additional insureds. the fbllo-%,,ingr is added to SECTION TH - LIMITS OF INSURANCE: If coverage provided to the cadditional insured is required by a contract or agreement, the most -we will pla.)7 on. behalf of the ad ffitional insured is the amount of insurwice' :t, Required by the contract or agreement; or 2. Alrailable under the aj).plicable Litnits of Insurance shown in the Declarations; Nvhichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy rernain unchanged. EN7V-,)J 2 1 11,13) hictudescop.5 1 / yi-ighted materMl of Insurance Sen ices Office. ly.m. with ibs pezm, fission Page.1 of -t (221012.2) ter PRUYLARYAND NONCONTRIBUrOR17 — OTHER INSURAN CE CONDITION Named Insured G Bortolotto & Company Endorsement Number Policy Symbo.1 -------- Policy Number Policy Period Effective Date of Endorsement CPW 671661726 003 8/2312024 To 8/23/2025 8/23/2024 Issued By (Name, of Insurance Company) Westchester Surplus Lines Insurance Company j, j�, j . _() J)V. (,.0Mjfl ndonsernent is V9811ed NUbsequem In me. prepm-21LIOR M U)P I)MICV, I n'sed the. pollf:y nurriber.1be remillinfler (11' the irtforM411. i , nj 5r vvh en Lhizi e THIS ENDORSEMENT CHANGES THE POLIM PLEASE READ IT CAREFULLY. 4 r -rREFOLLMNINIG. rHIS END01USEMENI'MODIFIES IN'SURANCE PROVIDED UNDER CONTRACTOW S POLLUTION LIABILITY CONTRA 3E PART The follovvdng is added to the Other Insurance Condition wid stipersed.es anyprovisionto the contrary,; Primary and Noncontributory Ins-ttrance This policy is prin-l-wir to, and -vd1l not seek- contribution from,. any other insurance avaiWble to an additional itisured un "-or this pohqy, proNdded that: a. The additional insured. is a named insured under such other insurance; and b. Jbe named insured has -agreed in a written contract or agreennient that this insurance vvould: (t) act as. primary insurance; and (2) would not seek contribution from aiKv other insurance available to the additional insured.. AU otlier terms and coaditionS of :his policy rem-ain un changed. Z3 '%-3`3 2D 5 (124-18) Inchides copy -righted iina-Lcrivd af. 1--asuraince Servkts (9fice, Inc. Nvi-Ch its permission (266�162.2_) 443-843-8 63 #BWNDHBS BP001-06 - 0022 #XWxW0021 XXXXXXx5# TOWN OF LOS ALTOS HILLS 26379 W Fremont Rd Los Altos Hills, CA 94022-2624