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Client#: 2013261
<br />OCEANBARI
<br />ACORD.CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />10/9/2024
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />USI Insurance Services NWa/c°
<br />CONTACT Lori Andrews
<br />NAME:
<br />No Ext , 503 224-8390 FAx
<br />(A/C No):610 362-8130
<br />825 NE Multnomah, Suite 1500
<br />Portland, OR 97232
<br />503 224-8390
<br />E-MAIL
<br />ADDRESS: Lori.Andrews@usi.com
<br />INSURER(S) AFFORDING COVERAGE NAIC#
<br />INSURER A: Security National Insurance Company 19879
<br />INSURER B: Wesco Insurance Company 25011
<br />INSURED
<br />Ocean Bar RWC LLC
<br />30248 Santucci Ct
<br />Sequoia Insurance Company 22985
<br />INSURER C : q P Y
<br />07/07/2025
<br />Hayward, CA 94544
<br />INSURER D:
<br />INSURER E:
<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 CONTRACTOR 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />X
<br />X
<br />SPP1813352
<br />7/07/2024
<br />07/07/2025
<br />EACH OCCURRENCE $110009000
<br />CLAIMS -MADE F OCCUR
<br />PREMISES Ea occur ence $100,000
<br />X
<br />MED EXP (Any one person) $5,000
<br />BI/PD
<br />PERSONAL &ADV INJURY $1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $2,000,000
<br />X POLICY ❑ J COT LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />B
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />WUM2010096
<br />7/07/2024
<br />07/07/2025
<br />EACH OCCURRENCE s4,000,000
<br />AGGREGATE s4,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $10000
<br />$
<br />`+
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />OFFICER/MEMBER EXCLUDED?
<br />N / A
<br />X OWC1336795
<br />12/07/2023
<br />12/07/202
<br />X sPTA TE ER
<br />E.L. EACH ACCIDENT $11,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: location at 2107 Broadway, Redwood City, CA 94063
<br />City and its Council, officers, officials, agents, employees and volunteers shall be additional insured
<br />including completed operations, primary noncontributory, waiver of rights/recovery in favor of City, its
<br />Council, officers, agents, employees, and volunteers.
<br />CERTIFICATE HOLDER CANCELLATION
<br />The City of Redwood City
<br />1017 Middlefield Road
<br />Redwood City, CA 94061
<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 />v _ B.4
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S45831120/M45831066 LZAJT
<br />ATTY/AGR.2024.213/Ocean Oyster (2107 Broadway) (Page 19 of 27)
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