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Docusign Envelope ID: A868345E-ODA9-4AO8-8C65-AB1D9DOA71380
<br />,ac -
<br />i 12/09/2024 Y)
<br />CERTIFICATE OF LIABILITY INSURANCE DATE /024
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER LIC #OL72977 1-888-845-2248 ICONTACT
<br />NAME:
<br />McSherry & Hudson, An Alera Group Company PHONE FAX
<br />1901 S. Bascom Avenue
<br />Suite 1190
<br />Campbell, CA 95008 USA
<br />Charles Griswold
<br />INSURED
<br />Brannon Corporation
<br />10492 Dougherty Avenue
<br />Monrgan Hill, CA 95037 USA
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: CRUM & FORSTER SPECIALTY INS CO
<br />44520
<br />INSURERB: OHIO CAS INS CO
<br />24074
<br />INSURERC: STATE COMPENSATION INS FUND
<br />35076
<br />INSURERD:
<br />INSURERE:
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 751549176 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />OF INSURANCE
<br />ADDLTYPE
<br />INSR
<br />WVDSUBI
<br />POLICY NUMBER
<br />MM DPOLID YCY EYYY
<br />MM/DDFF Y EXP
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X
<br />X
<br />EPK-147311
<br />04/01/2
<br />04/01/2-9
<br />EACH OCCURRENCE
<br />$1,000,000
<br />OMMERCIAL GENERAL LIABILITY
<br />-MADE �OCCUR
<br />4XD.ductible:
<br />DAMAGE TORENTED
<br />PREMISES Ea occurrence
<br />100,000
<br />$CLAIMS
<br />MED EXP (Any one person)
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />$5,000
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 2 , 000 , 000
<br />POLICY X PRO- LOC
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BA062860866
<br />04/01/2
<br />04/01/25
<br />OMBINED SINGLE LIMIT(Ea accident)
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />Per accidenPROPERTY t DAMAGE
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EFX-124989
<br />04/01/2
<br />04/01/25
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />X
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $ N/A
<br />AUTO XS LIMIT ONLY
<br />$ 5,000,000
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? Y❑
<br />(Mandatoryin NH)
<br />N / A
<br />X
<br />9356789-2024
<br />04/01/2
<br />04/01/25
<br />X WCSLIMIT ER
<br />T RY LIMIT ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />Rented/LeasedRented/Leased Equipment
<br />BMO
<br />Limit 500,00
<br />A
<br />Contractor's Pollution
<br />EPK-147311
<br />04/01/2
<br />04/01/25
<br />Limit 1,000,000
<br />A
<br />Errors & Omissions Liab.
<br />EPK-147311
<br />04/01/2
<br />04/01/25
<br />Limit 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: 2024 Geotechnical Hazard Abatement District (GRAD) Maintenance
<br />Brannon Project #: 024-1016
<br />Additional Insured: City of Pleasanton
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Pleasanton
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />123 Main Street
<br />AUTHORIZED REPRESENTATIVE
<br />Pleasanton, CA 94566
<br />USA
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />maggil2
<br />751549176
<br />
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