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<br /> ACORO�' OATS(MMID0IYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE , 08./22/2019
<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 /> •
<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 rightslto the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> PHOS'
<br /> Willie Towers Watson Insurance Services'Meat, Inc. Cita Willie
<br /> PHONE
<br /> Ineurence.Bervicea of California, Inc. - No1-877-945-7378 No); 1-888-467-2378
<br /> No.
<br /> c/o 26 Century Blvd • -- A SS: car tificatenferillie.cora •
<br /> P.O. Box 305191 ! INSURERO AFFORDING COVERAGE NALCO
<br /> Nashville, TN 372305191 USA INSURER A: Valley Forge'Iaeurance Company. ., ' 20508
<br /> INSURED i INSURERS: National Union,Fire•Inourance.Company of P ' 18445
<br /> Pump Repair Service Co. -
<br /> P.O. Bos 34327 INSURER C: Oak River Insurance Company 34630
<br /> I .
<br /> Ban Francisca. CA 94134 INSURERD: •
<br /> •
<br /> - • . INSURER E:
<br /> ...INSURER F: . . •
<br /> COVERAGES • .. CERTIFICATE NUMBER:1812364320 • • REVISION-NUMBER: : • , • .
<br /> THIS I8.TO CERTIFY.THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED.TO THE-INSURED NAMED ABOVE FOR THE POUCY,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 POUCIES 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 /> ILTR :ADDLSUBRIPOLICY EFF POLICY EXP -
<br /> TYPE OF
<br /> JN90 em, POLICY NUMBER (MWDDNYYY) IMMIUDIYYIM • •LIMITS
<br /> X COMMERCIAL GENERAL UABIUTY .I- •EACHOCCURRENCE . 5' 1,000,000
<br /> CLAIMS-MADE X OCCUR . • _ .. . DAMAGE TO(EsRENTED 100,000
<br /> � - PREMISES occurrence) 5
<br /> A X PD Ded. $1,000MED EXP(Any one person) 5 15,000
<br /> X• Per 0cc. y . 2053779521 08/21/2019 08/21/2020 PERSONAL&ADVINJURY 5-
<br /> 1;000,000
<br /> GEN'L AGGREGATE UMIT APPUES PER: GENERAL AGGREGATE .5 2,000,000
<br /> POLICY n LOC PRODUCTS-COMP/OPAGG S 2.000',000
<br /> • OTHER: -. , - - - _ - .$
<br /> AUTOMOBILELIABILnY COMBINED SINGLE LIMIT $ 1,000,000
<br /> .(Ea ecddellU .
<br /> X ANY AUTO ' BODILY INJURY(Per person) •5
<br /> A OWNED SCHEDULED .
<br /> 2053779535 - 08/21/2019 08/21/2020 BODILY INJURY(Peraccident)'5
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X- NON-OWNED . - PROPERTY DAMAGE --. 5: .
<br /> ._,_,AUTOS ONLY AUTOS ONLY - (Per-eclde l)
<br /> .. S .
<br /> •
<br /> aUMBRELIALUIB X OCCUR _- . . • -. • EACH OCCURRENCE $ 6,000,000
<br /> : X EXCE88 UAB • CLAIMS-MADE • 88019504292 • 08/21/2019 09/21/2020..AGGREGATE_ $ 6,000,000 •
<br /> DED X RETENTIONS 0 Prod/Comp opo . $ 6,000,000.
<br /> WORKERS COMPENSATION" ' . I •. X STATUTE ERS
<br /> AND EMPLOYERS'LIABILITY •
<br /> C ANYPROPRIETORIPARTNERIEXECUTNE YIN ` - EL.EACH ACCIDENT • 5 1,000,000
<br /> OFFICER/MEMBEREXCLUDED7 U NIA POWCO20493 04/01/2019 04/01/2020 1;000,000
<br /> (Mandatory In NH) , , - . - : E.L.DISEASE-EA EMPLOYEE S
<br /> 11 a,desalbeunder 1,000,000
<br /> DESCRIPTION OF OPERATIONS below . - - E.L.DISEASE-POLICY LIMIT 5' -
<br /> I
<br /> I ( .
<br /> -DESCRIPTION OF OPERATIONS ILOCATIONS/VEHICLES(ACORD.IOl,Additional Reinarlu Schedule,may be attached II more space II required)
<br /> •
<br /> City of.Pleaeanton is included an.Additional Insured as respects to General-Liability.
<br /> •
<br /> CERTIFICATE HOLDER I CANCELLATION .
<br /> SHOULD ANY OF THE ABOVE DESCRIBEDPOUCIES BE CANCELLED BEFORE
<br /> . THE --EXPIRATION.DATE •THEREOF, NOTICE SWILL. BE .DELIVERED 'IN
<br /> 1ACCORDANCE WITH THE POUCY PROVISIONS. -•
<br /> I
<br /> -... . •• .AUTHORQEDREPRESENTATIVE ' . ' - .- ' .
<br /> City of Pleasanton: -
<br /> P.O. Box 520 _ ... Is, . ..Pleasanton, CA 94566 " . . '
<br /> j . ©1988-2016•ACORD CORPORATION. All rights reserved. •
<br /> Th
<br /> ACORD 25(2016/03) ' i ACORD name and logo are registered marks of ACORD , -
<br /> BR IDS 18415674 BATCH, 1336756
<br /> i
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