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TRI-VALLEY HAVEN - SECOND AMENDMENT (#2023606)
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TRI-VALLEY HAVEN - SECOND AMENDMENT (#2023606)
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Last modified
11/18/2025 10:06:43 AM
Creation date
11/18/2025 10:04:36 AM
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CONTRACTS
Description Type
Professional Services
Contract Type
Amendment
NAME
TRI-VALLEY HAVEN (SECOND AMENDMENT)
Contract Record Series
704-05
Munis Contract #
2023606
Contract Expiration
6/30/2026
NOTES
ALLOCATION OF HOUSING & HUMAN SERVICES GRANT (HHSG) FUNDS FOR FISCAL YR 23/24
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09/10/2025 BY <br />(AUTHORIZED REPRESENTATIVE) <br />NOTICE: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code <br />Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is <br />not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims <br />in the event the risk pool becomes insolvent. <br />NIA- DEC GL <br />MEMBER ID: 0003720 POLICY NO: 01-CP-0003720-01-22 END: 016 <br />NAMED INSURED AND MAILING ADDRESS PRODUCER AND MAILING ADDRESS 1662 <br />Tri-Valley Haven for Women <br />3663 Pacific Ave <br />Livermore, CA 94550 <br />Jeffrey Stephens Insurance Services, LLC <br />9 Laurel Ave <br />San Anselmo, CA 94960 <br />POLICY PERIOD: FROM 04/01/2025 TO 04/01/2026 AT 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS <br />SHOWN ABOVE. <br />ENDORSEMENT EFFECTIVE: 04/01/2025 <br />TRANSACTION REASON:The following additional insured(s) is/are hereby added to read City of Pleasanton, its <br />officers, officials, employees, or volunteers <br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE <br />WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />TERRORISM PREMIUM:$0 <br />Modified <br />TOTAL TRANSACTION PREMIUM:$0 <br />Modified <br /> <br />THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE <br />COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND ENDORSEMENTS, IF ANY, ARE ISSUED TO FORM A <br />PART THEREOF, AND COMPLETE THE ABOVE NUMBERED POLICY. <br />COMMERCIAL GENERAL LIABILITY COVERAGE DECLARATION <br />Docusign Envelope ID: BAF64511-C271-4FC1-BBE9-5AF1BC605D95
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