|
MAININC-04 NVAZQUEZ
<br /> '4 OF`© CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYn
<br /> 9/21/2026
<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 Ella Chen
<br /> NAME:
<br /> HUB International Insurance Services Inc. PHONE FAX
<br /> 600 Corporate Pointe Suite 600 M (A/C,No,Ext):(877)825-2681 I(mc,n1.):(951)231-2572
<br /> Culver City,CA 90230 ADDREss:cal.cpu@hubinternational.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Federal Insurance Company 20281
<br /> INSURED INSURER B:Allmerica Financial Benefit Insurance Company 41840
<br /> Maintstar,Inc. INSURER c:Underwriters at Lloyd's London 15792
<br /> 1278 Glenneyre St.Ste.405 INSURER D:
<br /> Laguna Beach,CA 92651
<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 /> INSR TYPE OF INSURANCE ADDL'SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTIZ INSD_WVD (MM/DD/YYYY) (MMIDD/YYYY) _
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 2,000,000
<br /> CLAIMS-MADE X OCCURX X DAPRE35790788 8/15/2026 8/15/2027DAMAGE TOES(ERENTEDaoccurrence) $ 2,000,000
<br /> _
<br /> MED EXP(Any one person) $ 1 0,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 2,000,000
<br /> X POLICY PRO-
<br /> JECT
<br /> LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> —
<br /> OTHER: - $
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> __ (Ea accident) $
<br /> ANY AUTO X 73517904 8/15/2026 8/15/2027 BODILY INJURY(Per person) $ _
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) _ $
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE _ $ 2,000,000
<br /> EXCESS LIAB CLAIMS-MADE 5671-75-09 8/22/2026 8/22/2027 AGGREGATE $ 2,000,000
<br /> DED , RETENTION$ -$
<br /> B WORKERS COMPENSATION R
<br /> X STATUTE OTH-
<br /> ER
<br /> AND EMPLOYERS'LIABILITY
<br /> Y/N W23J165213 10/1/2026- 10/1/2027 1,000,000
<br /> ANYY IPROPRIET ER/PARTNER/ XECUTIVE N 1 A E.L.EACH ACCIDENT $
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $
<br /> C E&O I Ded:$2,500 ESO0140855067 6/26/2026 6/26/2027 Ea CIm/Agg 5,000,000
<br /> C Cyber:Ded:$2,500 ES00140855067 6/26/2026 6/26/2027 Limit 5,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> The City of Pleasanton is Additional Insured with regard to the General Liability policy,when required by written contract,per the attached endorsement form
<br /> 80-02-2367 05/07,Primary&Non-Contributory included.Waiver of Subrogation applies to the General Liability policy,when required by written contract,per
<br /> the attached endorsement form 80022000 04/01.Additional Insured applies with regard to the Auto Liability policy,when required by written contract,per the
<br /> attached endorsement form CA2048 10/13.
<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 /> The City of Pleasanton ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 520
<br /> Pleasanton,CA 94566-0802
<br /> AUTHORIZED REPRESENTATIVE
<br /> 1
<br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|