HomeMy WebLinkAboutSmitty Built insuranceG=HTTFIGATE Gf L|A3IUT? IHSI'TAHCE urrElKffinrrrl
THIS CERNFEATE tS ISSUED AS A IATTER OF INFORT'\TION ONLY AIID GONFErc NO R|SHTS I'F(}TI THE CERNFEATE HOLDER T}F
CERNF|GATE DOES NOT AFFIRf,ATN'ELY OR }'EGATII'ELY ANEND, EXIE}ID OR ALTER THE G(n|ERAGE AFFORDED BY THE POLIGIES
EEL{W. Tt{tS GERnHGATE OF tHSltRA}acE I,OES t{t}T SOI|STITUIE A GOI{TRACT #TTYEEN THE ISS[rf,{G IIISURER{S}, AT THOREED
REPRESE}TTATN'E {'R PRODUGER" AIID THE GEFNHCATE HOLI}ER
IilPORTAIIT: lf Ere certificate holdor in an ADDITIONAL INSURED, Ors pdffil€sl mrrst hilalDDITPllAL IIISURED pno&ions orbe endorted.
lf SUBROGATIOT{ lS IIAn|EQ subject to the terms and conditions of the policy, cerbin @€ may rcgulm an endotlBerEnl A shbmslil on
this certifrcate does not confer rights to the cer,tificate holder ln lieu of such endorsemen{=}.
?MEER
T'IADITI E GEilTRY AGEITICY
76{18 El Ganrinc Real #t0
Abgcaderc. C*9tr{;E
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silITH, GI|R|STOPI|ER
IIB* Sf,ITTY B{trLT GOTSTRI'GTK)I{ @
255 PaciftAvenue
Pa-coRahles- CAg3l{f
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GOVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSUMNCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTTH 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,
E(CLUSIOGs AflD GOTiIDMOF{S OF SI'CH PC'IJGIES, LIITfTS SHOWbI MAY HAVE BEEN REDUCED BY PAID CLAIMS.
PERIOD
F'IIE ll'IER uxTaNFLrn?t?E*tHrn llcE
EAC|{ OOCITRRE}ICE {-900-001tn
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MED EXP {Amon€ o€rEml $5.000
r _oo0.000$PERSOML&AI'V INJURY
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AUTMEI.ELI,ASUTY
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AUTSONLY
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AUIOS'ONI-Y
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A@REGATE s
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$DED RETENTIONI
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EL DISEASE-FOUCYLIMIT $
ITORXERS COTPETIEAT|OT
AND EIPL]OYERS' LTAAruIY
AI{Y PROPruETOR'PARINER/EXEGUTIVE
OFFICER'MEMBER EXCLUDEIT?
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DEBCRIPTPT{ OF OPERATPIIS , LOCATIOflS, VEHICLE9 {ACORD 1(}1, Addltlon i Roriltr Sclrodub. mry b. edred f mola .Fca b lrgul'rd)
lddltHl lr[lrrdgengtA
{IW OF SA}I LUIE OBFPq A IUTEIPAL OORFORANOT
PUEIJC TORI(S T'EFARTTEI'IT
9t9PA|.XSIREET
aAfl LUla OBTSPO OASa0{
SHOUT.D ANY OFIIGSOVE DESCRIBED FOLICIES BE GAI{CELLED EEFORE
THE EXPIRATIfl DITE THEREOF, NOTICE TYITL BE DELIVERED I'{
ACCORDAT{CE wlllll- POLICY PROVI$OilS.
crrv oF sAN LUts oBlsPo, A tuiltctPAl-
CORFORATTOX PUBLIC TORI(s DEPARTIET{T
r]*,Il'lrcgTEFESEIiT*TfiI€glq PALI'.$TREET
sAN LU|S OBTSPO CA 934tX
@,t988-20t5A$(nrl
Ths AGORD name and logo att rcglstered marks af AGOSAGORD 25 e0r6r03l
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rcUCY NUi{FEff : offiffirtr-scffiE-lgffi-sff
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THIS ENDORSEMEHT CHAHGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONALINSURED -
STATE OR POLITICAL SUBDIVISIONS_ FERHTTS
This endorsement modilies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SEf€*EE
{lf no entry appears above, information required to complete this endorsement will be shown in the Declarations
a* am#ts S&e esrdossrerel
$edftrr [ - ths k An htslfiEd i.s amended to
include as an insured any state or political subdM-
sion shown in the Schedule, subiect to the following
provisions:
t. Thls insurance 4plies nnly with rASerJ lo qper-
dirms per{orTltd by yul or o{t ysrrr beha$ fu
wlrich fusta* or pdiricd $rbdivisbri hre issred
apermil
e Thls frrysumnce ds6 not apply to:
a. "Bodily iniury," "property damage" or "person-
al and advertising iniury" arising out of opera-
tions performed for the state or municipality;
'or
h. "Eodily iniuqf ar "prapety damagd'incltded
vrffiin ilre "pro*rce-cunptemA operdions
hazardn.
$tate Or FaliEcal Subdivisiwr:
CITY OF SAN LUIS OBISPO. A MUNICIPAL CORPORATION PUBLIC WORKS DEPARTMENT
919 PALM STREET
SAN LUIS OBISPO CA 93401
ffiErtfrs Copryrigtrt"'tnsurane Ssrvices Office, te-- lgST rucl dr tr
F*s,ne I orfikr€ $enEem | flJftetmtleffi
Conlmctofs Limnse Detail for License # S5{512
1$l$rEl-tffintsAloensesnahsdledrpovides isormdisrt&mframft* 6ELB license database. Befiom rclying on
*ris informatiolr, you should be awart af &e foltowing limitaticns.
CSLB wndaintdfi#ure b rstoicled hy larr {BAP 7114.6} lf fris endtyisst&ipdmpn$fccomplaiktdBture#tur
link that wifi apar bebw for nrore lnhrrnation. Click here for a ddr*$bn; d diffi aciiilns.
Only consbuction r*ted civil iudgments reportd to CSLB ale discftm$ {BEF 7&711..117, }"
Arbitrations are not listed unless the mntractor fails to comply with the terms.
Due to workload, there may be relevant information that has not yet kn entered into the hrds fimnse database-
$aiitFTY EUILT ftFiSTRUCTifiF{ Cg
ft*@T' VAHDERLI P COURT, 28
HISO ROBLES. CA 93446
Business Phone Number:(80s) 61 0-9072
Entity Sole Ownership
lssue Date 11{1O12O10
Expire Date 1113012824
: ti i r,.i: l'''i ', ; ...'
This license is current and active.
All information below should be reviewed.
B - GENERAL BUILDING
,t,,
Contractor's Bond
This license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY
Bond Number: 100653202
Bond Amount: $25,000
Effective Date: 01 lA1 12023
Contractor's Bond History
An employee service group hdds ffre wotkers mmpensalion insurance.
Policy Number:C55527635
Effective Date: OT 101 12023
Expire Date: 07 lD1 12024
Workers' Cornpensation History