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72/7/2025
<br />E (MM/DD/YYYY)
<br />ACOR" CERTIFICATE OF LIABILITY INSURANCE
<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 rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER CONTACT
<br />NAME: Sierra Kies
<br />(HD) Heffernan Insurance Brokers PHONE FAX
<br />1350 Carlback Avenue A/c No Etl: 925-934-8500 (AIC,
<br />AIc No): 925-934-8278
<br />Walnut Creek CA 94596 ADDRESS: sierrak@heffins.com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />License* 0564249 INSURERA: Accelerant National Insurance Company 10220
<br />INSURED PIZZCAR-01 INSURER B: Republic Underwriters Insurance Company 24538
<br />Pizzeria Cardamomo, LLC
<br />2053A Broadway INSURER C:
<br />Redwood City CA 94063 INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 588171184 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DDIY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />N0091PK005565
<br />7/1/2024
<br />7/1/2025
<br />EACH OCCURRENCE $2,000,000
<br />CLAIMS -MADE Fx] OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $ 250,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $
<br />POLICY PRO ❑ LOC
<br />JECT
<br />F—I$
<br />PRODUCTS - COMP/OP AGG $ 6,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />N0091PK005565
<br />7/1/2024
<br />7/1/2025
<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) $ 1,000,000
<br />PROPERTY DAMAGE $
<br />Per accident
<br />X
<br />HIRED�( NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />UMBRELLA LIAB
<br />HCLAIMS-MADE
<br />OCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />EXCESS LIAB
<br />DED I I RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATIONY
<br />AND EMPLOYERS' LIABILITY Y / N
<br />25776901
<br />1/24/2025
<br />1/24/2026
<br />X PER OTH-
<br />STATUTE ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />OFFICER/MEMBEREXCLUDED. ❑
<br />NIA
<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 />A
<br />Property Coverage
<br />N0091PK005565
<br />7/1/2024
<br />7/1/2025
<br />225,000
<br />usiness Income Actual Loss Sust.
<br />[BPP
<br />enant Improvements 10,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City and its Council, officers, officials, agents, employees, and volunteers shall be additional insured including
<br />completed operations, primary noncontributory, waiver of rights/recovery; and Worker's Comp Waiver of
<br />Subrogation endorsement in favor of City, its Council, officers, agents, employees, and volunteers
<br />CFRTIFICATF Hnl I)FR CANCFI I OTION
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />ATTY/AGR.2025.061/Pizzeria Cardamomo, LLC (2053A Broadway) (Page 18 of 31)
<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 />The City of Redwood City
<br />1017 Middlefield Road
<br />AUTHORIZED REPRESENTATIVE
<br />Redwood City CA 94061
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />ATTY/AGR.2025.061/Pizzeria Cardamomo, LLC (2053A Broadway) (Page 18 of 31)
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