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HomeMy WebLinkAboutJoe A. Gonsalves and Sons Inc. 03.02.20264/1/2026 7:38:31 PM PST (GMT -8) FROM: fax -TO: 16509413160 Page: 2 of 3 ACC>R" . CERTIFICATE OF LIABILITY INSURANCE DATE (MM /YYYY) 3/2/2026 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 McGee & Thielen Insurance Brokers, Inc. 3840 Rosin Court, Suite 245 CONTACT NAME: Shanon Pham MIONE FAx 1,AJC. No Extl: 9l b-b4b-1 J1 J A/C No): 91 b-bob-UUUS ADDRESS: shanon@mcgeethielen.com Sacramento, CA 95834 INSURERS) AFFORDING COVERAGE MAIC # 6/17/2026 INSURERA : Travelers Indemnity Company of CT 25682 www.mcgeethielen.com 0633187 INSURED Joe A��//Gonsalves and Sons Inc. INSURER B : Hartford Accident and Indemnity Company 22357 1 GENERAL AGGREGATE $4,000,000 1201 K Street INSURER C: INSURERD : Suite 1850 Sacramento CA 95814 INSURERE : INSURER F 6/17/2025 COVERAGES CERTIFICATE NUMBER: 89534894 REVISION NUMBER: 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE F✓ OCCUR GEN'LAGGREGATE LIMIT APPLIES PER: POLICY 1:1PRO LOC JECT OTHER: ✓ 16609794P909 -TCT -25 6/17/2025 6/17/2026 EACH OCCURRENCE $ 2 000,000 DAMAGEO RERTEU- PREMISES Ea occurrence $1001000 MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ Excluded GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY 16609794P909 -TCT -25 6/17/2025 6/17/2026 CEOMBIINdEeDtSINGLE LIMIT $1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ✓ DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? Li (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 57WECZ15671 4/1/2026 4/1/2027 TH f SPER I TATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1_000,000 E.L. DISEASE - POLICY LIMIT $1_,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Town of Los Altos Hills is named as addtional insured with respects to general liability per the attached endorsement form CG D1 05. CERTIFICATE HOLDER CANCELLATION Town of Los Altos Hills 26379 Fremont Road SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills CA 94022 AUTHORIZED REPRESENTATIVE Charlotte Brown ACORD 25 (2016103) © 1998-2015 ACORD CORPORATION. All rights reserved. The ACORD name and log® are registered marks of ACORD 89534894 1 w2026/27Master GL/AL/WC I Charlotte Brown 1 3/2/2026 1:48:16 PM (PST) I Page 1 of 2 w1���38-31�PST (GMT -8) FROM* fax -TO -1650941o160 Page- aof3 COMMERCIAL GENERAL LIABILITY BLANKET ADDITIONAL INSURED �OWNERS, LESSEES... OR CONTRACTORS This endorsement modifies insurance provided under the : COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1' WHO |SANINSURED 11) is amended toinclude aaeninsured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in a written oontraot, executed prior to loss to name as additional |noured, but only with respect to UauUYy arising out of "your work" or your ongoing operations for that addi- tional insured performed byyou orfor you 2' With respect to the insurance afforded to Addi- tional Insureds the following conditions ddi-tiona||nmunodsthefoUow|nQcondNons apply, a. Limits of Insurance — The following limits of liability apply: 1. The Urn|ta which you agreed to provide; or 2. The limits shown onthe declarations, whichever is less. b. This insurance is excess over any valid and collectible insurance unless you have agreed in e written contract for this insurance to apply onmprimary orcontributory base 3, This insurance does not apply: a' on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy, b' to "bodily injury," "property damage," "per- sonal pe� sona| injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, in- cluding: 1. The pnsparimA, approving or failing to prepare or approve maps, dnnm/inWs' opiniona, reports, surveys, change or- ders, designs orspecifications, and 2' Supervisory, inspection or engineering een/|cea CG D1 050494 Copyright, The Travelers Indemnity Company, 1984. Includes Copyrighted Material from Insurance Services Office, Inc. 89534894 1 *2026/27M=reroL/AL/WC / Charlotte Brown 1 3/2m026 z.^u.z^ vu 'PST) / Page of 2 Page 1 of 1 4/1/2026 7:38:31 PM PST (GMT -8) FROM: fax -TO: 16509413160 Page: 1 of 3 ::From: McGee & Thielen Insurance Brokers, Inc. 3840 Rosin Court, Suite 245 Sacramento, CA 95834 916-646-1919 0633187 www.mcgeethielen.com ............................:.,:.....:..........:.......:.............................:.........................: From. �'o; Subject: Attn: Deborah Padovan Town of Los Altos Hills Date: 26379 Fremont Road Los Altos Hills CA 94022' Delivery Via: No. of Pages: FAX DOCUMENT Certificate of Insurance Delivery by ecertsonline T"I Charlotte Brown Cert No. 89534894 - Certificate of Liability Insurance: Joe A Gonsalves and Sons Inc. - 3/2/2026 FAX 16509413160 3 THIS MESSAGE IS INTENDED FORTH E USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by eoerteonlineTM Insurance Visions, Inc. All rights reserved.