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Agmt04 San Mateo, County of
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Agmt04 San Mateo, County of
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Entry Properties
Last modified
5/12/2008 1:35:12 PM
Creation date
5/17/2005 10:26:30 AM
Metadata
Fields
Template:
Agreement
Contractor Name
San Mateo, County of - Dept of Public Works
PROJECT NAME
Garfield School playing fields
RMP File Number
304.5
Date
7/14/2004
Box
6585
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<br />SOp-C9-04 04:39pm <br />CERTIFICATE NO <br /> <br />Frcm- <br /> <br />T-B66 <br /> <br />P . 04/04 <br /> <br />F-62B <br /> <br />CPEIA-WC-361 I CERTIFICATE OF COVERAGE 1 08/27/04 <br /> THIS CERTJF¡CA TE IS ISSUED AS A 1M TIER OF INFDRMA TION 01'11.'( AND CONFERS NO RlGt1TS <br />CSAC Excess UPON THE CERTIFICATE HOlpeR. THIS CERTIFICATE DOES NOT AMEND. EXrc.:ND OR AI. TER <br /> THE COVERAGE AFFORDED BELOW. <br />Insurance Authority <br />c/o DRIVER ALUANT INSURANCE SERVICES, INC. <br />P.o. BOX 6450 CovERAGE CSAC Excess Insurance AuthoritY <br />NI:WPORT BEACH, CA 92558-8450 AFFORDED BY A - <br />LICENSE JOC~6a61 COvERAGE <br />PHONE (949) 755-0271 I FAX. (949} 756.2713 AFFORDED BY'- B - <br />CPE1A MEMB¡:~: COVERAGE <br />LOCAL AGENCY wORKERS' COMPENSATION AFFORDED BY: C - <br />EXCESS JPA (LAWCX) AND MEMBER AGENCIES COvERAGE <br />ClO BICKMORE RISK. SERVICES ATTN: MARY <br />- - AU/ISO - -- - - AFfQRPEQ.6Y: - R . - --. -- - . - .-- - - - -. <br />. - <br />1020 19TH STREET. SUITE 200 COvERAGE <br />SACRAMENTO, CA 95814 AFFORDED By E: - <br />Co~ras?:TO CERTIFY TMAT THE MEMO~NDuMS OF COvERAGE--L.ISTED BELOII\I HA\1E-SEErinssLieDTO THE MEMBER NAMED ABOVE <br /> FOR Ttti= PERIOD INDICATED. NO1WITt1STANDING ANY" R~QuIREME'NT. TERM OR CONDITION OF ANY' CONTRACT OR OTnER <br /> DOCUME\IT WITH RESPECT TO Wt1ICn TnlS CERTIFICATE MA 'f BE I~SuED OR w.. 'Y PERTAIN 1'tiE covERAGE AFFORDED .ar THE <br /> MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLLlSIONS. AND CONDITIONS OF SUCH MEMORANDUMS <br />co TYPE OF COVERAGE MEMORANDUM COVERAGE EFFEC'TIVE C:OVEAAGE E¡l;PIf{A.TlON LIA61un LIMITS <br />LTR NUMBER DA. TE (MMlDDIYY) I DATE (MMfDD/Y'Y) <br /> OTHER <br />A EXCESS W.C 8. CPEIA-D4-EWC-32 07¡O1J20D4 07/0112005 W.C.: $95,000,000. <br /> EMPLOYERS' EXCESS OF <br /> LlABIUTY $2,000,000 <br />- -- -- --- -- - --- -- -_.- - - .-- ----- - - Ei.. -'$5.0~Oa-- - <br /> EXCESS OF <br /> $2.000,000 <br />SUaLIMIT' ~ZQ NlILLION pe~ QCCJANNUAI- AGG. AS RESPECTS TERRORIST ACTIVITY EXCLUDING NBCR EXCESS OF 5'~ MILl-ION <br />. I-I~ITS APPLY PER OCCURRENCE FOR ALl- PROGRAM MEMSERS COMSINED. <br />AS RESPECTS EVIDENCE OF' COVERAGE ONI- Y <br />THE CITY OF REDWOOD CITY IS A MEMBER OF LAWCX THROUGH BCJPIA. <br />Certificate Holder Canc:ellation <br /> SMDuLD A/If\" DF TME ABOvE DESCRIBED M¡:~O~NDUMS BE CANt:E~~ED BEFORE Tt1£ <br />CITY OF REDWOOD CITY e¡c;PIAATION D'ITE Tt'lEREOF, T"E ISSUING COMPANY WI~~ ENDEAvOlt TO MAI~ '30 Ol<\"S wRrn'EN <br /> ,..OTlce TO Tt'lE c.:RTiFICATE "O~DER oIAIoŒD TO iME ~EFT, BUT FAI~uR£ TO MAI~ 5uCti NOTice <br />ATTN' ARACILI FIERRO St1AI.~ IMPOSE NI;) OEII-IGATION OR LII'EII~fTY OF ANY ¡C:ND uPON TME COIUIP,IIN'f. ITS II!>ENTS DR <br />1017 MIDDLEFIELD ROAD REPRESENTATIllES <br />REDWOOD erN. CA 94063 AuT~RiZEC REPRESENTATIVE <br /> ~~~- <br /> <==- -=:> <br /> CSAC, EXCESS INSuRANCE AuTriDRIT'r <br /> <br />.---- -. ... . <br /> <br />--- -- ---- <br /> <br />. """'-"'-"."""-.""'---"-.".."-"- -."'..- <br />
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