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DocuSign Envelope ID:9D75147C-A6EF-4E54-94F5-57200035C54F
<br /> ® DATE / Y)
<br /> CERTIFICATE OF LIABILITY INSURANCE oz/08/o8/2024zo2a
<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 CONTACT Jennylyn Mondares
<br /> NAME:
<br /> Calender-Robinson Company,Inc. A/oNN Ext (415)978-3800 FAc,No]I: (415)978-3825
<br /> 0267063 E-MAIL jennmondares@calrob.com
<br /> ADDRESS:
<br /> 233 Sansome St.Ste 508 INSURERS)AFFORDING COVERAGE NAIC#
<br /> San Francisco CA 94104 INSURER A: Sentinel Insurance Co.,LTD 11000
<br /> INSURED INSURER B: Republic Indemnity Co ofAmerica
<br /> Jones Hall,A Professional Law Corporation INSURER C:
<br /> INSURER D
<br /> 475 Sansome St.,Ste 1700 INSURER E:
<br /> San Francisco CA 94111 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: CL2391336564 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 AIJULbUbH TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MMIDD/YYYY MM/DDIYWY
<br /> X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 2,000,000
<br /> AMAISES Ea occurrence 1,000,000
<br /> CLAIMS-MADE X OCCUR PREM $
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y 57SBANK7611 10/01/2023 10/01/2024 PERSONAL&ADV INJURY S 2,000,000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY PRO LOC PRODUCTS-COMP/OP AGG $ 4,000,000
<br /> JECT
<br /> OTHER $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> AOWNED SCHEDULED 57SBANK7611 10/01/2023 10/01/2024 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> IX AUTOS ONLY X AUTOS ONLY Per accident
<br /> X UMBRELLA LIAB I-.,el OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A EXCESS LAB CLAIMS-MADE 57SBANK7611 10/01/2023 10/01/2024 AGGREGATE $ 1,000,000
<br /> DED I X1 RETENTION$ 10,000 �/ $
<br /> WORKERS COMPENSATION /� STATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> B OFFICER/MEMBER EXCLUDED? NIA 168749-18 04/01/2023 04/01/2024
<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 /> EMPLOYEE BENEFIT
<br /> A 57SBANK7611 10/01/2023 10/01/2024 Each Claim: $2,000,000
<br /> Aggregate: $4,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Pleasanton,its officers,its officials,employees,volunteers,and agents are included as additional insureds subject to the policy terms,conditions and
<br /> exclusions.
<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 /> P.O.Box 520
<br /> AUTHORIZED REPRESENTATIVE
<br /> Pleasanton CA 94566
<br /> J
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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