Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2013_PS-1301001 thru PS-1301500_ - PS-1301336 (2)

Home Browse Search

�w ® DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 01/02/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LIC #0726293 1-415-391-1500 CONTACT NAME: Gallagher Construction Services/ PHONE FAX Arthur J. Gallagher & Co. Insurance Brokers of CA Inc. C No Ext): A/C No): 1 Market St., Spear Tower #200 ADDRESS: San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC# INSURER A: OLD REPUBLIC GEN INS CORP 24139 INSURED INSURER B: STARR IND & LIAB CO 38318 PRESTON PIPELINES, INC. INSURER CWESTCHESTER FIRE INS CO 21121 133 Bothelo Avenue INSURER D: Milpitas, CA 95035 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 31295740 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLTYPE OF INSURANCE INSR SUER POLICY NUMBER POLICY WVD /DD/YYYY EFF POLICY LTR/DD/YYYY LIMITS A GENERAL LIABILITY X X AICG99291302 01/01/1 01/01/14 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ CLAIMS-MADE Fi-I OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PE OT LOC $ X A AUTOMOBILE LIABILITY X X AICA99291302 01/01/13 01/01/14 COMBINED SINGLE LIMIT Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ X Ded $1000 Coll/Comp Ded $ $1000 B X UMBRELLA LIAB X OCCUR SISCCCLO1974913 01/01/1 01/01/14 EACH OCCURRENCE $ 10,000,000 C EXCESS LIAB CLAIMS-MADE G24352286001 01/01/1 01/01/14 AGGREGATE $ 10,000,000 DED RETENTION$ 2nd Laye $ 15MXSof10M A WORKERS COMPENSATION X A1DW99291302 WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N O1/Ol/1 01/01/14 XTORY ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Evidence Only CERTIFICATE HOLDER CANCELLATION RE: Evidence Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE *Evidence Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ankurgsc 31295740