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" � ' ' � DATE(MM/DD/YYYY)
<br /> ACOR� CERTIFICATE OF LIABILITY INSURANCE
<br /> 9/17/2013
<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 ADDITIONAI INSURED,the policy(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 /> PRODUCER N C
<br /> NAME:
<br /> Michael J Hall &Company PH�N EX,: - 7 �a,�ic No:360- - 70
<br /> A/E insurance Services E-MAIL
<br /> 19660 10th Ave NE ADDRESS: I�fl t h Ilan m an . om
<br /> Poulsbo WA 98370 INSURER S)AFFORDING COVERAGE NAIC#
<br /> iNSURERa TRAVELERS_IND�_��T._._____ _____ �2___ _
<br /> INSURED 748 INSURER B:Tf vel r Pr ert s It f A 74
<br /> The Crosby Group Engineers/Architects �NSUReRC:HART RD FIRE IN 2
<br /> DBA The Crosby Group INSURER D:TRAVE ERS A & R TY O F AMER 11 4
<br /> 999 Baker Way, Suite 410
<br /> San Mateo CA 94404 INSURERE:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:509787392 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 CIAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR INSR WVD POLICY NUMBER MM/DDIYWY MM(DDlYYYY LIMITS
<br /> A GENEanLLIABIUrv 809362L604 /18/2013 /18/2014 EACHOCCURRENCE $1,000,000
<br /> X DAMAGE TO RENTED
<br /> COMMERCIAL GENEFtAL LIABILITY PREMISES Ea occurrence $300,000
<br /> CLAIMS-MADE � OCCUR MED EXP(Any one person) $5,000
<br /> X OCP/XCUBFPD PERSONAL&ADVINJURY $1,000,000
<br /> X Separation Insds GENERALAGGREGATE $2,000,000
<br /> GEN'L I�GGREGATE LIMIT APPLIES PER�. PRODUCTS-COMP/OP AGG $2,000,000
<br /> POLICY X PRO- LOC �
<br /> A AUTOMOBILE UABILITY 6809362L604 (18(2013 /18/2014 Ea accident ��� � 1,000,000
<br /> ANV AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> NON-OWNED PROPERTY DAMAGE $
<br /> X HIRED AUTOS X AUTOS Per accident
<br /> $
<br /> B X UMBRELLA LIAB X OCCUR � CUP8854Y461 /18/2013 /18(2014 EACH OCCURRENCE $2,000,000
<br /> EXCESS LIAB �� CLAIMS-MADE AGGREGATE $2,000,000
<br /> DED X RETENTION$0 $
<br /> C WORKERS COMPENSATION 52WECLP3587 /18/2013 /18/2014 X WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY O Y I -
<br /> ANY PROPRIETORlPARTNEW'EXECUTIVE Y�N EL EACH ACCIDENT $1,000,000
<br /> OFFIGER/hJ1EMBER EXCLUDED? � N�A`
<br /> (Mandatory in NH) E1.DISEA5E-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000
<br /> � Professional Liab;Claims Made 105407917 (24/2013 /24/2014 $1,000,000 Per Claim
<br /> $2,000,000 Aggregate
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD'107,Additional Remarks Schedule,if more space is required)
<br /> Project: Marshall Street Garage Elevator Cab Modifications; 750 Marshall Street, Redwood City, CA 94063; Upgrade of two (2)elevator
<br /> interior surfaces.
<br /> The City of Redwood City, its council members, officers, boards, commisions, employees and agents are named as an Additional Insured on
<br /> the Commercial General Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the
<br /> Named Insured. The Commercial General Liability insurance is primary insurance and any other insurance maintained by the Additional
<br /> Insured shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the Commercial General Liability,
<br /> Auto Liability, Umbrella/Excess Liability and Workers Compensation/Employers Liability in favor of the Additional Insured.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Redwood QCCORDANCE WITH THE POLICY PROVISIONS.
<br /> Community Development Department
<br /> PO Box 391 AUTHORIZED REPRESENTATIVE
<br /> Redwood City CA 94064 ����'" �• ��'�'�
<br /> O 1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010I05) The ACORD name and logo are registered marks of ACORD
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