|
DocuSign Envelope ID:9D75147C-A6EF-4E54-94F5-57200035C54F
<br /> ACC 02/08/2024® CERTIFICATE OF LIABILITY INSURANCE DATE( / I)
<br /> ��
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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. BONN Extl: (415)978-3800 FAQ No (415)978-3825
<br /> 0267063 E-MAIL jennmondares@calrob.com
<br /> ADDRESS:
<br /> 233 Sansome St.Ste 508 INSURER(S)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 AUUL 5UHH POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> UAMAUE I U HEN I E151,000,000
<br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y 57SBANK7611 10/01/2023 10/01/2024 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY E PRO 4,000,000
<br /> JECT 7 LOC PRODUCTS-COMP/OPAGG $
<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 /> IX
<br /> HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> i
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> AEXCESS LIAB CLAIMS-MADE 57SBANK7611 10/01/2023 10/01/2024 AGGREGATE $ 1,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> RKERS COMPENSATION X SPER ER
<br /> EMPLOYERS'LIABILITY Y I N
<br /> PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> B ICER/MEMBER EXCLUDED? Fy� NIA 168749-18 04/01/2023 04/0112024
<br /> (Mandatory in NH) E .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 I LOCATIONS I 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 /> r I/ Ji�CIQI.iS
<br /> @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|