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® DATE(MM/DDIYI'YY}
<br /> AC®R® CERTIFICATE OF LIABILITY INSURANCE 08/03/2016
<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 be endorsed. 11 SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT NAME:
<br /> Marsh Sponsored Programs PHONE 800-338-1391 FAX No): 888-621-3173
<br /> a division of Marsh USA Inc . E-MAIL
<br /> IL Ext}: ( )
<br /> E MAIL acecc1ientreauest @marsh . com
<br /> PO Box 14404 ADDRESS:
<br /> Des Moines IA 50306 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> _ _ __ ____f INSURER A : Hartford Accident & Indemnity_Co 22357 __ _
<br /> INSURED ^ __ INSURERB : Hartford Insurance Co . of the Midwest 37478
<br /> MacLeod And Associates , Inc .
<br /> INSURER C :
<br /> 965 Center Street INSURER D :
<br /> San Carlos CA 94070
<br /> INSURERE_ _____________—_______ ------ ___________
<br /> INSURER F :
<br /> COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE IN SUBR POLICY NUMBER (MMI EXP LIMITS
<br /> A GENERAL LIABILITY Y 84SBWEF7332 11/01/2015 11/01 /2016 EACH OCCURRENCE $1 , 000 , 000
<br /> Prof . Liab . Excl . DAMAGE TO RENTED
<br /> X 1 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $1, 000 , 000
<br /> CLAIMS-MADE X OCCUR MED EXP (Any one person) $10 , 000
<br /> X Cross Liability PERSONAL S,ADV INJURY $1, 000 , 000
<br /> X Contractual GENERAL AGGREGATE $2, 000 , 000
<br /> GE 'L. AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $2 , 000 , 000
<br /> PRO-
<br /> POLICY X JECT LOC $
<br /> A AUTOMOBILELIABILITY Y 84UEGRZ4830 11/01/2015 11/01/2016 COMBINED SINGLE LIMIT
<br /> (Ea accident) $1 , 000 , 000
<br /> X ANY AUTO BODILY INJURY (Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
<br /> AUTOS NON OWNED PROPERTY DAMAGE $
<br /> HIRED AUTOS AUTOS , (Per accident)
<br /> I
<br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION Y 84WBGNC0117 11/01/2015 11/01/2016 WITS TORY LIMITS ER
<br /> AND EMPLOYERS' LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y I . NIA E.L. EACH ACCIDENT $1, 000 , 000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory In NH) E,L. DISEASE - EA EMPLOYEE $1, 000 , 000
<br /> If yes, describe under
<br /> DESCRIPTION OF OPERATIONS below E,L. DISEASE - POLICY LIMIT $11000 , 000
<br /> .. .
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br /> RE: Consulting surveying services, On-going surveying services at various City locations.
<br /> The City of Redwood City, its Council members, commissions, committees, boards, officers, employees , and agents are
<br /> included as additional insured when required by written contract . Primary/Non Contributory applies to GL and Auto
<br /> when required by written contract. Waiver of Subrogation is included when required by written contract.
<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 /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Redwood City; Engineering Division
<br /> AUTHORIZED REPRESENTATIVE
<br /> P . O . Box 391 . V1lvj
<br /> Redwood City, CA 94062 , ,
<br /> © 1888-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25 (2010!05) The ACORD name and logo are registered marks of ACORD
<br />
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