|
•
<br /> • ....-1;--"="1. o2v (S I 6 '"' "" ` 71° HF&HCON-01 SGONZALEZ
<br /> '4C—®`R® •CERTIFICATE OF LIABILITY INSURANCE DATE(MMmDmrvn
<br /> 4......---- 08/2812017
<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 CQNTACT Alvaro Sapiz
<br /> HUB International Insurance Services I 2 PHONE
<br /> Eel:(925)415-1104 I FAX No):(951)231-2572
<br /> P.O.Box 5076 a�/ i5 cal c u hub intemational.com
<br /> San Ramon,CA 94583 "x ; p
<br /> INSURER(SI AFFORDING COVERAGE NAIC IS
<br /> SEP 05 2017 INSURER A:Sentinel Insurance Company,Ltd. X11000
<br /> INSURED INSURER B:Hartford Casualty Insurance Company 129424
<br /> HF&H Consultants,LLCINSURER c:Houston Casualty Company 42374
<br /> 201 North Civic Drive,Suive1T)Y CLERK OFFICE INSURER D:
<br /> Walnut Creek,CA 94596 - 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 I HE 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 /> ILLTRR TYPE OF INSURANCE I DD ISyyyp POLICY NUMBER PODGY EFF I PODGY 111( I LIMITS
<br /> IMMIDDlYYYYI•IMM/DDlYYYY)
<br /> A X 'COMMERCIAL GENERAL( LIABILITY 1 I I EACH OCCURRENCE I S 2,000,000
<br /> I i CLAIMS-MADE ILJOCCUR DAMAGE TO RENTED 1,000,000I ' X X 57SBABH9155 09!08!2017 09106/2016 PREMISES(Ea oeamerwe) S
<br /> h _ I MED EXP Any one Person) $ 10,000
<br /> U ! PERSONAL&ADV INJURY S 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000
<br /> X I POLICY I INf I I LOC PRODUCTS-COMP/OP AGG S 4,000,000
<br /> I OTHER $
<br /> A AUTOMOBILE LIABILITY !COMBINEDISINGLE LIMIT S 2,000,000
<br /> ANY Hato 1 57SBABH9155 09!0612017 09/06/20181 BODILY INJURY(Per person) $
<br /> fl OWNED ^SCHEDULED -
<br /> 1
<br /> TO
<br /> AUTOSr���ONLY ! AUTOS
<br /> yyr,)Ep I I BODILY INJURY(Per accident) 5
<br /> AUTOS ONLY X AUTOS ONLY II (ParrPROPacci
<br /> dent)
<br /> DAMAGE S
<br /> II (
<br /> A X i UMBRELLA UAB X OCCUR 1 EACH OCCURRENCE S 3,000,000
<br /> EXCESS(JAB I CLAIMS MADE I 57SBABH9155 09/06!2017 09/06/2018 AGGREGATE S 3.000,000
<br /> DED X RETENTIONS 10,000 I 5
<br /> B WORKERS COMPENSATION I X STATUTE I ER I
<br /> AND EMPLOYERS LIABILITY Y!N
<br /> 57WECZR5765 09!06/2017 09/06/2018 I$ 1,000,000
<br /> I A�pFICERRAIEMTBOER(EXCLUDED'ARTNER/EXECUTIVE iT1 N I A EL EACH ACCIDENT
<br /> lowandat°ry in NH) 1, I E.L.DISEASE-EA EMPLOYEE]S 1,000,000
<br /> I If
<br /> under .
<br /> DeSGRiP descrNOF OPERATIONS below1 •
<br /> I EL DISEASE-POLICY LIMIT•$ 1'000'000
<br /> C (Professional Liab H717110248 09/06/2017 09/06/2018 Occurrence/Aggregate 2,000,000
<br /> C ;Retro Date:8/1/1989I H717110248 09106/2017 09/06/2018 IRetention: . 10,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached If more space is required)
<br /> City Manager,City of Pleasanton.City,its officers,employees and agents are Additional Insured with respect to General UKtaprppuiteelJs\amMtaem
<br /> contract per attached endorsement SS0008 04/05,Primary&Non-Contributory included and Waiver of Subrogation inclu Y 1J rI.CF1�77i�Y
<br /> SEP 112011
<br /> CITY ATTORNEY
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE ,City Manager ACCORDANCE WITH THE POLITCYREOFPROVISIONSCE WILL BE DELIVERED IN
<br /> City of Pleasanton
<br /> P.O.Box 520
<br /> Pleasanton,CA 94566 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|