|
bV I VKU I -U1
<br />EDURHAM
<br />DATE (MM/DD/YYYY)
<br />ACOR
<br />�.,.- CERTIFICATE OF LIABILITY INSURANCE
<br />SUBR
<br />5/30/2025
<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(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # 0757776
<br />HUB International Insurance Services Inc.
<br />548 W Cromwell Avenue
<br />Suite 101
<br />Fresno, CA 93711
<br />NAMEACT LISA Glynn
<br />PHONE
<br />(A/C, No, Ext): FAX
<br />AoDRE : lisa.glynn@hubinternational.com
<br />SCGL005000208900
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURER A:SUmmitSpecially Insurance Com any 16889
<br />EACH OCCURRENCE $ 1,000,000
<br />INSURED
<br />INSURER B: Arch Insurance Company 11150
<br />INSURER C:
<br />SVT Gruppe, Inc.
<br />2775 Napa Valley Corporate Drive
<br />Napa, CA 94558
<br />INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />G1JVIzHA1iI-S CFRTIFir`ATF NI IMriCD•
<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 />IITR NSR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />X
<br />SCGL005000208900
<br />6/1/2025
<br />6/1/2026
<br />EACH OCCURRENCE $ 1,000,000
<br />DAMAGE To RENT ante $ 100,000
<br />PREMMED
<br />EXP (Any oneperson) $ 5,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO- Y LOC
<br />JECT
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />AUTOS ONLY AUOTOS ONL�
<br />ZACAT1209700
<br />6/1/2025
<br />1/1/2026
<br />COMBINED SINGLE LIMIT 1,000,000
<br />Ea accident $
<br />BODILY INJURY Per person)$
<br />BODILY INJURY Per accident $
<br />�
<br />PPe�a.dent AMAGE $
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />SXCS005000082100
<br />6/1/2025
<br />6/1/2026
<br />EACH OCCURRENCE $ 5,000,000
<br />AGGREGATE $ 5,000,000
<br />DED I I RETENTION $
<br />$
<br />B
<br />WORKERSN
<br />ND EMPLOYERS' COMPENSATION
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
<br />N/A
<br />X
<br />ZAWC11053300
<br />6/1/2025
<br />1/1/2026
<br />X STATUTE ORH
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE $ 1'000'000
<br />(aFICER/MEMBEREXCLUDED?
<br />(Mandatory in NH)
<br />If es, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Pleasanton, its officers, employees and agents are additional insured.
<br />Endorsements attached: CG20100413, WC endorsement to follow from carrier
<br />City of Pleasanton
<br />City Manager
<br />123 Main Street, P.O. Box 520
<br />Pleasanton, CA 94566
<br />ArnOn 9G Nn4crn41
<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 />AUTHORIZED REPRESENTATIVE
<br />IJ 19$8-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|