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TO:
Town of Tihuron
and their officers, agents and employees
F~: 1-415-435-2438
Atin:Attn: Di~ne Crane Iacopi
FROM:
Roman Catholic Archbishop of San Francisco
Phone:
Arthur J. Gallagher & Co.
Agency: Insurance Brokers of California, Inc., License #0726293
Phone:
1-415-546-9300
Subjecl:Rornan Catholic Archbishop of San Francisco - Town of Tihuron and their officers, agents and
This document was brought to you by CertificatesNow and Arthur J. G~llagher & Co. Insurance
Brokers of California, Inc. in San Francisco, CA.
If you have questions regarding the content of this document, please contact
the Producer/Agent listed on the certificate of insurance.
The data included in this notice and in the attached document is confidential to
ConfirmNet and Arthur J. Gallagher << Co. Insurance Brokers of California, Inc.
cc: St. Hilary Church
(FAX), Winnie
(EMAIL)
The data included in this notice and in the attached document is confidential to ConfirmNet and the
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYVVV)
08/06/08
PRODUCER 0726293 1-415-546-9300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Arthur J. Gallagher &: CO. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Brokers of California, Inc. , License #0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
One Market Plaza, Spear Tower ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 200
San Francisco, CA 94105
INS URERS AFFORDING COVE RAG E NAIC#
INSURED INSURERA: ORDINARY HUT RRG CORP 10171
Roman Ca tho lic Archbishop of San Francisco
INSURERB: Farmington Cas Co 41483
One Peter Yorke Way INSURER C:
San Francisco, CA 94109 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED. 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR IADO'l PJ>l-{~~';~~6g~~IE Pg~fJ,~:b~~~N
LTR NSRrl TVPE OF INSURANCE POLICV NUMBER LIMIlS
A GENERAL LIABILITV CGAL0022008 07/01/08 07/01/09 EACH OCCURRENCE $1,000,000
I-- ~~~~~~~ YE~~~~r~ncel
X COMMERCIAL GENE RAL L1AB JLlTY $1,000,000
I-- o CLAIMS MADE 0 OCCUR
I--- MED EXP (Any oos psrsoo) $5,000
I-- PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREAE LIMIT APPLI ES PER: PRODUCTS - COMP/OP AGG $2,000,000
Xl POLICY ~fc9i n LOC Liquor Liabili ty 1,000,000
A AUTOMOBILE LIABILITY CGAL0022008 07/01/08 07/01/09 COMBINED SINGLE LIMIT
- $1,000,000
X ANY AUTO (Ea accident)
-
X ALL OWNED AUTOS BODILY INJURY
- $
X SCHEDULED AUTOS (Per person)
I--
X HIRED AUTOS
I--- BODILY INJURY $
X NON-OWNED AUTOS (Per accid enl)
-
- PROPERTY DAMAGE $
(Peraccidenl)
GARAGE LIABILITV AUTO ONLY .EAACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY. AGG $
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAJMSMADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
B TFUB419J84150B 01/01/08 01/01/09 X IT~~$I1UNs I 10TH.
WORKERS COMPENSATION AND ER
EM PLOVERS' L1ABIUTV E.L. EACH ACCIDENT $1,000,000
ANY PROPRIETORIPARTNERlEXECUTIVE
OFFICERIMEMBER EXCLUDED? E L. DISEASE. EA EMPLOYEE $1,000,000
~~~~I~t~~~~r~~NS below E.L. DISEASE - POLICY LIMIT $1,000,000
OTHER
A Counselors E&O Liability CGAL0022008 07/01/08 07/01/09 Per Claim 1,000,000
Claims-Made Form !Aggregate 3,000,000
DESCRIPTION OF OPERATIONS} LOCATIONS} VEHICLES} EXCLUSIONS ADOEDBV ENDORSEMENT} SPECIAL PROVISIONS
RE: St. Hilary Church, 761 Hilary Dr., Tiburon, CA 94920.
As respects to CYO Flag Football Practice &: Games from September, 2008 through November, 2008 and CYO Girls Soccer
Practice & Games from March, 2009 through May, 2009.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TlON
Town of Tiburon DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAVS WRllTEN
and their officers, agents and employees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Diane Crane Iacopi IMPOSE NO OBLIGATION OR LIABILITV OF ANV KINO UPON THE INSURER, ITS AGENTS OR
1505 Tiburon Blvd.
REPRESENT A liVES.
Tiburon, CA 94920 AUTHORIZED REPRESENTATIVE '~\I 7,/ ,. { /
USA /J;~7'''''''''''' r/ () ju..."......
(/ . (/
ACORD 25 (2001/08) rahuBan
9501167
@ACORD CORPORATION 1988