GEORGE BANCHI CONSTRUCTION, INC. (#2025045)

ACODR& CERTIFICATE OF LIABILITY INSURANCE III Y) DATE 10/10/202(MMI/2024 THIS CERTIFICATE IS ISSUED ASA 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 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 Leavitt Pacific Insurance Brokers, Inc. License #OD79674 1570 The Alameda, Suite 101 San Jose CA 95126 co' Jana Hinkle NAME: PHONN EYt (408)288-6262 (A/C, No: (409)299-7635 E-MAIL ADDRESS: ana-hinkle@leavitt.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA-Landmark American Insurance Company 33138 INSURERB:West American Insurance Company 44393 INSURED George Bianchi Construction, Inc. 775-A Mabury Road San Jose CA 95133 INSURERC:RSUI Indemnity Company 22314 INSURER D: Insurance Company of the West 27847 INSURER E: Westchester Surplus Lines 10172 INSURER F:StarStone Specialty Insurance Company 44776 COVERAGES CERTIFICATE NUMBER:24/25 Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 MMIDDIYYYY POLICY EXP MM/ODIYYYv LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE �X OCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occu«enre S MED EXP (Any one person) $ NONE X LHA114830 10/4/2024 10/4/2025 PERSONAL 8 ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 PROPOLICY � iEC F LOC .iEC7 I PRODUCTS -COMP/OP AGG S 2,000,000 S OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea acc:don!'_ BODILY INJURY (Per person) S B X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BAW56320903 10/4%2024 10/4/2025 BODILY INJURY (Per accident) S X NON -OWNED HIREDAUTOS X AUTOS PROPERTY DAMAGE Per accident) S Uninsured motorist combined single S 1,000,000 X $500 Comp Ded X $500 Coll Ded UMBRELLALIAB X OCCUR EACH OCCURRENCE S 51000,000 AGGREGATE S 5.000.000 C X EXCESS LAB CLAIMS -MADE DED I RETENTION $ $ NRA602725 10/4/2024 10/4/2025 WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY YIN OTH- X STATUTE ER E L. EACH ACCIDENT S 11000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 71N (MandatoryinNH) /A WFL506754002 10/4/2024 10/4/2025 E.L. DISEASE - EA EMPLOYEE S 1,000.000 If yes, describe under E.L. DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below E Pollution Insurance 674352029003 11/9/2024 11/9/2025 $2,500 Deductible $1M Occ/$2M Agg F Excess Liabilty 85092A244ALI (2nd Layer) 10/4/2024 10/4/2025 $4M Occ/$4M Agg DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Pleasanton, its officers, employees and agents are named as additional insured per attached GL endorsement. CERTIFICATE HOLDER CANCELLATION City of Pleasanton P.O. Box 520 Pleasanton , CA 94566 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 ,red Stafford/MIDATO ? r 'i`y A/ "` 01 1988-2014 ACORn CORPORATION All rininte rPSPrvarl ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS0251201401)