|
BRENINC-02 CMALLAPUR
<br /> ACO1217` DATE(MM/DD/YYYY)
<br /> ih...--- CERTIFICATE OF LIABILITY INSURANCE 3/16/2026
<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 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 CONTACT Michelle Vargas
<br /> HUB International Insurance Services Inc. PHONE 916 770-2918 I ac,No 951 231-2572
<br /> 6101 Bollinger Canyon Rd (A/C,No,Ext):( ) ( )( )
<br /> Suite 150 E-MAILADDRESS:cal.cpu@hubinternational.com
<br /> San Ramon,CA 94583-5108 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Champlain Specialty Insurance Company 16834
<br /> INSURED INSURER B:Navigators Specialty Insurance Company 36056
<br /> James Breneman dba JB Infrastructure INSURER C:Landmark American Insurance Company 33138
<br /> PO Box 1055 INSURER D:State Compensation Insurance Fund of California 35076
<br /> Concord,CA 94522
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 /> ADDL SUER POLICY EFF POLICY EXP
<br /> ILTR TYPE OF INSURANCE _INSD mato. POLICY NUMBER _1MMIDDIYWYI (MWDDIYY1L11. LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X CSAR-CGL-0000638-04 6/24/2025 6/24/2026 DAMAGEES(ToEa RENTEDoccurrence) $ 100,000
<br /> PREMIS
<br /> X Ded:$5,000MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT PRO-APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY I X I LOC _PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> JECT
<br /> OTHER: _ -$
<br /> INED
<br /> B AUTOMOBILE LIABILITY ,_(_EaCOMacciden SINGLE LIMIT $ 1,000,000
<br /> ANY AUTO GA25BAP02338800 5/29/2025 5/29/2026 BODILY INJURY(Per person) $
<br /> OWNED
<br /> AUTOS ONLYAUTOS X SACHEDULED BODILY INJURY(Per accident),$
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY (Per accident) $
<br /> $
<br /> C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAB CLAIMS-MADE LHA607396 6/24/2025 6/24/2026 AGGREGATE $ 5,000,000
<br /> DED RETENTION$ $
<br /> D WORKERS COMPENSATION X PERTUTE PEOETH
<br /> AND EMPLOYERS'LIABILITY Y/N 9324661-25 9/2012025 9/20/2026 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVEY I N/A E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? I 1,000,000
<br /> (Mandatory in NH) _E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Revised 03-16-2026:This certificate rescinds and supersedes any and all prior certifcates issued on behalf of the Named Insured.
<br /> RE:Gingerbread Preschool Project.
<br /> City of Pleasanton,its officers,employees and agents are Additional Insured with regard to the General Liability policy,when required by written contract,per
<br /> the attached endorsement form CG2010 04/13.Waiver of Subrogation applies to the General Liability policy,when required by written contract,per the
<br /> attached endorsement form CG2404 05/09.Excess Liability policy follows form of the underlying General,Auto and Employers Liability coverages,per policy
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Pleasanton ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 400 Old Bernal
<br /> Pleasanton,CA 94566
<br /> AUTHORIZED REPRESENTATIVE
<br /> fa 1_.,
<br /> 1
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|