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5/15/2025
<br />L/P Insurance Services LLC
<br />300 East 2nd Street
<br />Suite 1300
<br />Reno NV 89501
<br />Mary Hearron
<br />(775)996-6000 (775)473-9288
<br />mary.hearron@lpins.net
<br />Sierra Nevada Construction, Inc.
<br />SNC Leasing Company LLC
<br />P O Box 50760
<br />Sparks NV 89435
<br />Travelers Indemnity Co 25658
<br />Travelers Property Casualty Co of America25674
<br />Arch Insurance Co 11150
<br />Great American E&S Insurance 37532
<br />Axis Surplus Lines Co.16543
<br />Texas Insurance Co.26620
<br />CL2461304234
<br />A
<br />D
<br />X
<br />X
<br />X $100,000 BI/PD Deductible
<br />X Electronic Data Liab $1M
<br />X
<br />X Pollution/Professional
<br />VTC2KCO4R62982AIND24 7/1/2024 7/1/2025
<br />PCMF21045700 7/1/2024 7/1/2025
<br />1,000,000
<br />300,000
<br />5,000
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />See attached for policy limits 25,000 Ded
<br />B X
<br />X X
<br />VTJCAP5644B123TIL24 7/1/2024 7/1/2025
<br />1,000,000
<br />B
<br />E X
<br />X
<br />X 10,000
<br />CUP6W0974472325 (1st Layer)7/1/2024 7/1/2025
<br />JTI24XCAN0342901 (2nd Layer)7/1/2024 7/1/2025
<br />15,000,000
<br />15,000,000
<br />5,000,000
<br />C
<br />N ZAWCI9449804 10/1/2024 10/1/2025
<br />CA/NV/CO/ID/OR/UT
<br />X
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />F 3rd Layer Excess P0010003158103 7/1/2024 7/1/2025 Each Occurrence 5,000,000
<br />Contractors Equipment SEE ATTACHED
<br />RE: Job# 59044 City of Pleasanton – Annual Slurry Seal
<br />See Attached Additional Comments/Remarks page for information regarding additional coverage terms and
<br />Additional Insured status.
<br />City of Pleasanton
<br />P.O. Box 520
<br />Pleasanton, CA 94566
<br />(925)931-5595
<br />Mary Hearron/MARY
<br />The ACORD name and logo are registered marks of ACORD
<br />CERTIFICATE HOLDER
<br />©1988-2014 ACORD CORPORATION.All rights reserved.
<br />ACORD 25 (2014/01)
<br />AUTHORIZED REPRESENTATIVE
<br />CANCELLATION
<br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
<br />LOCJECTPRO-POLICY
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />OCCURCLAIMS-MADE
<br />COMMERCIAL GENERAL LIABILITY
<br />PREMISES (Ea occurrence)$DAMAGE TO RENTED
<br />EACH OCCURRENCE $
<br />MED EXP (Any one person)$
<br />PERSONAL &ADV INJURY $
<br />GENERAL AGGREGATE $
<br />PRODUCTS - COMP/OP AGG $
<br />$RETENTIONDED
<br />CLAIMS-MADE
<br />OCCUR
<br />$
<br />AGGREGATE $
<br />EACH OCCURRENCE $UMBRELLA LIAB
<br />EXCESS LIAB
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS
<br />PER
<br />STATUTE
<br />OTH-
<br />ER
<br />E.L.EACH ACCIDENT
<br />E.L. DISEASE - EA EMPLOYEE
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />$
<br />$
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />If yes,describe under
<br />DESCRIPTION OF OPERATIONS below
<br />(Mandatory in NH)
<br />OFFICER/MEMBER EXCLUDED?
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />HIRED AUTOS NON-OWNED
<br />AUTOS AUTOS
<br />AUTOS
<br />COMBINED SINGLE LIMIT
<br />BODILY INJURY (Per person)
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE $
<br />$
<br />$
<br />$
<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 />INSD
<br />ADDL
<br />WVD
<br />SUBR
<br />N / A
<br />$
<br />$
<br />(Ea accident)
<br />(Per accident)
<br />OTHER:
<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 />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
<br />INSURED
<br />PHONE(A/C, No, Ext):
<br />PRODUCER
<br />ADDRESS:
<br />E-MAIL
<br />FAX
<br />(A/C, No):
<br />CONTACTNAME:
<br />NAIC #
<br />INSURER A :
<br />INSURER B :
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />INSURER(S)AFFORDING COVERAGE
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />INS025 (201401)
<br />Docusign Envelope ID: F9AC9A1A-7D30-43C0-B525-C1635A73245B
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