Agmt21 Bayside Stripe & Seal, Inc.

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A� Rte® CERTIFICATE OF LIABILITY INSURANCE oATg/2O/2021 �l 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 endomement(s). PRODUCER Don Ramatici Insurance, Inc. 731A Southpoint Boulevard CONTACT NAME: Naomi Milano PH CNNo EXIII 707-782-9200 x143 AIc No): 707-782-9300 Petaluma CA 94954 A REss: naomi@ramat!Clins.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: Toklo Marine Specialty Insuran 23850 License#: 0449871 INSURED BAYSSTR-01 Bayside Stripe &Seal, Inc. PO Box 703 INSURER B: State Compensation Insurance F 35076 INSURER C: Landmark American Insurance Co 33138 INSURER D: GuideOne National Insurance Co 14167 Petaluma CA 94953 INSURER E: GuideOne Mutual Insurance Com 15032 INSURER F: Westchester Surplus Lines lnsid 10172 COVERAGES CERTIFICATE NUMBER: 594615154 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 AODLSUSR INSO INVID POLICY NUMBER POLICY EFF MMODfYYYY) POLICY EXP (MMIDDIY`vlD1 LIMITS D X COMMERCIAL GENERAL LIABILITY Y 70K10033700 5/4/2021 5/4/2022 EACH OCCURRENCE $1,000,000 CLAIMSMADE EXI OCCUR PREMISES Eaoxunence$100,000 MED EXP (Any one person) $ 5,000 X $5,000 PD Ded per Occurrence PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYIA JE� El LOC GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Lmted Pollution $100,000 OTHER: E AUTOMOBILE LIABILITY 70K10033800 5/4/2021 5/4/2022 COMBINED SINGLE LIMIT $1,000,000 Ea accident XANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS JURY Per accident) ( ) BODILY IN $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident) A X UMBRELLA LIAB X OCCUR PUB766918 5/4/2021 5/4/2022 EACH OCCURRENCE $3,000,000 AGGREGATE $3,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN V 92535172021 5/4/2021 5/4/2022 X STATUTE ER E.L. EACH ACCIDENT $1,000,000 ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUDED] ❑ N/A E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below C F 2nd Layer Excess Pollution Liability LHA251590 G28317918001 5/4/2021 5/4/2021 5/4/2022 5/4/2022 Excess Limit 1,000,000 Each Condition/Aggr 2,000,000 Pollution Ded 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS )VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) itis agreed that the City of Redwood City and its officers, officials, employees and agents are named as additional insured with primary wording performs CG2010 1 2/1 9 and CG2037 12/19. Waiver of subrogation applies to the workers compensation perform 1021704/18. Job: Vera Avenue Bicycle Boulevard Project CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Redwood City ACCORDANCE WITH THE POLICY PROVISIONS. c/o Engineering Division AUTHORIZED REPRESENTATIVE 1017 Middlefield Rd Redwood City CA 94063 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD