Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2024_PS-2400501 thru PS-2401000_ - PS-2400872

Home Browse Search

AC"I?Vr CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/01/2023 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 have ADDITIONAL INSURED provisions or 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 1-612-333-3323 CONTNAME: Dawn Heinemann or Sara McWethy Brown & Brown Inc. PHONE FAX A/C No Ext: 612-333-3323 A/C No: 612-373-7270 E-MAIL dawn.heinemann@bbrown.com ADDRESS: 80 South 8th Street INSURER(S) AFFORDING COVERAGE NAIC# Suite 700 INSURERA:GENERAL CAS CO OF WI 24414 Minneapolis, MN 55402 INSURED INSURER B . INSURANCE CO OF THE WEST 27847 TAK Communications CA, Inc. INSURER C : $ 500,000 INSURER D: $ 10,000 4125 Northgate Blvd. INSURER E: INSURER F Sacramento, CA 95834 COVERAGES CERTIFICATE NUMBER: 68883037 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CGA1392212 05/21/23 05/21/24 EACH OCCURRENCE $ 1,000,000 _7CLAIMS-MADE � OCCUR DAMAGE TO PREM SES (Ea occurrRENTEence) $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FX'-] PRO- ❑LOC JECT PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY CBA1392212 05/21/23 05/21/24 COMBINED SINGLE LIMIT Ea accident $ 11000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR CCU1392212 05/21/23 05/21/24 EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 10,000 $ B WORKERS EMPLOYCOMPENSATION ILII AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IN I (Mandatory in NH) N/A WMN506569401 05/21/23 05/21/24 X PER STATUTE EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) ddebuhr 68883037 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE San Joaquin County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1810 East Hazelton Ave AUTHORIZED REPRESENTATIVE Stockton, CA 95205 USA ACORD 25 (2016/03) ddebuhr 68883037 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD