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HomeMy WebLinkAboutJ. Johnson & Company, Inc. 10.09.2024InNNr.n1 np in. Ar. CERTIFICATE O LIABILITY INSURANCE D/YYYY) 1 DATE E (M (MM/DM/D 024 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 831-475-4314 UVIS Donald R Hardy Agency P.O. Box 308 Capitola, CA 95010 CONTACT Charmane Phillips, CSR PHONEFAX (A/C, No, Ext); 831-475-4314 (A/C, No):831-475-9524 ADDRESS: charmanep@hardyins.com David J. Martini, AAI INSURERS AFFORDING COVERAGE NAIC # INSURERA:Gemini Insurance Company 10833 EACH OCCURRENCE $ 110005000 INSURED J. Johnson & Company, Inc. 600 Calabasas Road INSURER B: United Financial Casualty 11770 State Compensation -Ins Fund 35076 INSURER C: p INSURER D: RLI Insurance Company 13056 Watsonville, CA 95076 INSURER•E : INSURER F: AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY NON-OWNED ONLY 7 7 CnVFPAnFS r`FRTIFIr'ATF NI IMRFR• REVISION NUMBER: .., �::._.,�_.. ! : . �� ! I TFIl. R �e Bim_ N ! . ,O. �: _ I I n n. Q .AVE FOR: I -LF P� 00 PERI D �-;,S ;S T�, CER'";FY TW AT ?'.`-1E..OLI .1 ,. Os .,.v..,P�..l`�.�� �.�, �.� �,ELO�! � ,.:VE ��_.! .� SJED �... T�I,E I.l���. __ .�� .�p�,!�..E..�...�3..�� Y O 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ®OCCUR X Los Altos Hills, CA 94002 VIGP026018 02/05/2024 02/05/2025 EACH OCCURRENCE $ 110005000 PREM SES (EAMAGE TO a olccurrrence TED $ 1005000 MED EXP (Any oneperson) $ 5'000 PERSONAL & ADV INJURY $ 150005000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY® R� LOC OTHER: GENERAL AGGREGATE $ 250009000 PRODUCTS - COMP/OP AGG $ 250005000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY NON-OWNED ONLY 7 7 X 986236852 09/02/2024 03/03/2025 COMBINED SINGLE LIMIT 150005000 Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ 1 A UMBRELLA LIAB X EXCESS LIAB X OCCUR CLAIMS -MADE VIFX002661 02/05/2024 02/05/2025 EACH OCCURRENCE $ 25000,000 AGGREGATE $ 250005000 DED RETENTION $ C D WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EX ECUTIVE Y / N OFFICER/MEMBER EXCLUDED. H (Mandatory in NH) If yes, describe under DES RLPTION OF -OPERATIONS below ..<.u.s.y,-..�....:.,....._ ...�.__� ..�....R..��4�.,,.....�.,.�,� Equipment Floater N / A _ _ _ PSIC0701456101 _ .. ._ . ,,.....,-...,��,..,�..�.P,�..�....r.,.,.,_.�.,...r.�_„�,..,..., _.G. ,.. ILM0718683 ' 08/09/2024 . ,.. , �..�..�.�,:..,..-w.�,.�...,,...�....,.,_.._..,.-.-.. .10/02/2024 08/09/2025 - 10/02/2025 PER X TSTATUTE EOR H E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 15000,000 E.L.E1 000 000 DISEASE POLICY LIMIT �� .., �4.'; DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Town of Los Altos Hills is named as Additional Insured pper attached CG20100704 and CG20370704 as regard General Liabilit and as regards g Y Commercial Auto. TOWN LG2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94002 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rignts reserves. The ACORD name and logo are registered marks of ACORD