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,;.6.2.A. - Page 39 <br />AcoRv� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYYj <br />6/212014 <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 pollcy(ies) must be endorsed. If 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 />CONTACT <br />PRODUCER I NAME: Ann Martin-- <br />BB&T -Tanner Insurance Services I a"CONN _ Exn:925-598-2625 I (aic. Ne):888-77 _71945 <br />4480 Willow Road -�nAIL <br />Pleasanton CA 94588 ADDREss Martino0bbandt.com <br />INSURERS) AFFORDING COVERAGE NAIC q <br />INSURERA:Navia_ators SDecialty InSUranQe.CODID 36056. _..__. <br />INSURED 307CLASATRE INSURER0; <br />Classic RWC 1856, LP INSURER C : <br />Classic Communities, Inc. I INSURER D: <br />1068 East Meadow Circle - <br />Palo Alto CA 94303 INSURERE: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 1862338431 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 />ENSR 'ADDL SUER POLICY EFF POLICY EXP <br />LTR TYPE OF INSURANCE (NSR WVD POLICY NUMBER IMMIDDIYYYYI (MMIDDIYYYY) LIMITS <br />A GENERAL LIABILITY Y SF14CGL1337681C 5/22/2014 5/2212017 EACH OCCURRENCE $2,000,000 <br />X-" {{{ DAMAGE TO RENTED <br />COMMERCIAL GENERAL LIABILITY I PREMISES (Ea occurrence) $Excluded <br />CLAIMS -MADE I- 1 OCCUR II MED EXP (Any one person) $Excluded _ <br />X 25,000 LL PERSONAL & ADV INJURY $1,000,000 <br />GENERAL AGGREGATE $2,000,000 <br />GEN'LAGGREGATE LIMIT APPLIES PER: (PRODUCTS-COMPIOPAGG $2,000,000 <br />r <br />1 4X PRO- n $ <br />POLICY .IFCT LOC <br />AUTOMOBILE LIABILITY <br />CUMtiINkU 51NULe LIMI I <br />(£e accident) <br />$ <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED SCHEDULED <br />BODELY INJURY (Per accident) <br />$ <br />AUTOS AUTOS <br />NON -OWNED <br />ROP e'Iden6AMAGE <br />I PROPERTY <br />$ <br />HIRED AUTOS AUTOS <br />A UMBRELLA LIABSF14FXS8145301C <br />OCCUR <br />$12212014 5122/2017 EACH OCCURRENCE <br />$5,000,000 <br />X EXCESS�LIAB CLAIMS -MADE <br />$5,000,000 <br />,. <br />_AGGREGATE <br />...__. <br />DED_.1j�R"E--'r'ENTION$ <br />$ <br />WO 2KERS COMPENSATION <br />II WC STATU- OTH- <br />JORY LIM1T5 ER <br />AND EMPLOYERS' LIABILITY YIN <br />_ . - <br />ANY PROPRIETORIPARTNERIEXECUTIVEC� <br />E.L. EACH ACCIDENT <br />OFFICERIMEMBER EXCLUDED? L NIA <br />' <br />(Mandatary in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />$ __ <br />it yes, descnbe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />RE: Building Permit I Location: 755 Brewster Avenue and 313-321 Fuller Street, Redwood City, CA 94063 <br />The City of Redwood City, its council members, officers, boards, commissions, employees and Agents are named as additional primary <br />insureds per the attached forms CG 20 10 07 04 & CG 20 01 04 13. <br />*The attached forms apply as required per written contract or written agreement between the listed parties and the insured, which are subject <br />See Attached... <br />CERTIFICATE HOLDER CANCELLATION <br />City of Redwood City <br />Engineering & Construction <br />Post Office Box 391 <br />Redwood City CA 94064 <br />ACORD 25 (2010105) <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 />AUTHORIZED REPRESENTATIVE <br />,t <br />O 1986-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />