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CAUSEY CONSULTING, SOLE PROPRIETOR
City of Pleasanton
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CAUSEY CONSULTING, SOLE PROPRIETOR
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Last modified
12/13/2024 2:08:36 PM
Creation date
2/16/2024 10:56:45 AM
Metadata
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CONTRACTS
Description Type
Professional Services
Contract Type
Amendment
NAME
CAUSEY CONSULTING, SOLE PROPRIETOR
Contract Record Series
704-05
Munis Contract #
2022515
Contract Expiration
6/30/2024
NOTES
MAINTENANCE PROGRAM FOR CITY'S SANITARY SEWER SYSTEM
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The ACORD name and logo are registered marks of ACORD <br />CERTIFICATE HOLDER <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECTPRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES (Ea occurrence)$DAMAGE TO RENTED <br />EACH OCCURRENCE $ <br />MED EXP (Any one person) $ <br />PERSONAL & ADV INJURY $ <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGG $ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE $ <br />EACH OCCURRENCE $ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS <br />PERSTATUTE OTH-ER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />HIRED AUTOS NON-OWNED <br />AUTOS AUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <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 />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Ea accident) <br />(Per accident) <br />OTHER: <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: <br />INSURED <br />PHONE(A/C, No, Ext): <br />PRODUCER <br />ADDRESS:E-MAIL <br />FAX(A/C, No): <br />CONTACTNAME: <br />NAIC # <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S) AFFORDING COVERAGE <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 />1/17/2024 <br />R.C.Fischer &Co. <br />P.O.Box 8101 <br />Walnut Creek CA 94596 <br />925-932-7823 925-932-0962 <br />cmehan@rcfischer.com <br />License#:0142335 Sentinel Insurance Company,Ltd 11000 <br />CAUSCON-01 <br />Causey Consulting Paul H Causey <br />733 Cree Court <br />Walnut Creek CA 94598 <br />1352173533 <br />A X 2,000,000 <br />X 1,000,000 <br />10,000 <br />2,000,000 <br />4,000,000 <br />X <br />Y Y 57SBABN9726 11/1/2023 11/1/2024 <br />4,000,000 <br />A 2,000,000 <br />XX <br />57SBABN9726 11/1/2023 11/1/2024 <br />A Data Breach Defense &Liab Cov.57SBABN9726 11/1/2023 11/1/2024 Limit $50,000 <br />City of Pleasanton is included as additional insured,w/waiver of subrogation,when required by written contract per policy form attached. <br />City of Pleasanton <br />PO Box 520 <br />Pleasanton CA 94566 <br />DocuSign Envelope ID: 1655CBDA-10FD-4F50-BAA1-0DA47C56D177
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