HomeMy WebLinkAboutINS CERT 2006-12-06
PRODUCER
952-830-3000
DATE (MM/DDIYY)
12/07/06
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
__________ __QQ~EANIE~t_.EfORDING COVERAGE ____
A CORaM
CERTIFICATE OF LIABILITY INSURANCE
Acardia
4300 MarketPointe Dr #600
Bloomington, MN 55435
COMPANY
A
8urlington Insurance Co.
INSURED
Astra Events of America
Astra Events of the North Bay
47 Paul Dr., #9
San Rafael CA 94903
COMPANY
B
C/o CRC-IL
COMPANY
C
COMPANY
o
COVERAGES
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 RfDUCfD BY PAID CLAIMS,
-r--- -- --- - -, - I
, f'OLlCY NUMBER POLICY fCFFFCTIV[ ; POliCY FXPIRA liON I
DAl E: (MM/DD/YY) : DA!E (MMIDD/YYj i
CO
I Tf<
TYf'E' OF INSURANCE
LIMITS
I
A I GENEI<AL l.IABILllY
HGL0013884
9/15/06
9/15/07
_GEN~~_,=-A~~~~ATE_ _ ~____ !2.9..2.Q.QSJ.Q.__
X COMMERCIAL GENERAL LIABILITY See Attachment
CLAIMS MADE 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
PRODUCTS. COMP/OP AGG
PERSONAL & ADV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
2000000
1000000
1000000
50000
Excluded
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
-~ ---
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
I PROPER ry DAMAGE
I
i $
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE
AGGREGATE
OTHER THAN UMBRELLA FORM
._-----
OTH.
ER
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
EL DISEASE - POLICY LIMIT $
_..~__ __~-.-__ __________n__
I EL DISEASE - EA EMPLOYEE
DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS
Event Date: All Year Long
The City of Tiburon, its officials, officers, employees, agents and
volunteers are added as Additional Insured as respects General
Liability as their interests may ap ear
CERTIFICATE HOLDER
( !)Di"W r[ )"
ItA ,A ( A (jti E f
CANCELLA TION
City of Tiburon
Attn: Diane
1505 Tiburon Blvd.
Tiburon, CA 94920
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT FAilURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR L1ABII.ITY
ACORD 25-S (1/95)
72- 52
RATION 1988
Astro Events of North Bay
Certificate Attachment
NOTICE
1. The insurance policy that you are applying to purchase is being
issued by an insurer that is not licensed by the State of
California. These companies are called "Non-Admitted" or "Surplus
Lines" insurers.
2. The insurer is not subject to the financial solvency regulation and
enforcement which applies to California licensed insurers.
3. The insurer does not participate in any of the insurance guarantee
funds created by California law. Therefore, these funds will not
pay your claims or protect your assets if the insurer becomes
insolvent and is unable to make payments as promised.
4. California maintains a list of eligible surplus lines insurers
approved by the insurance commissioner. Ask your agent or broker if
the insurer is on that list.
5. For additional information about the insurer you should ask
questions of your insurance agent, broker, or "surplus line" broker
or contact the California Department of Insurance at the following
toll-free telephone number: 1-800-927-4357.