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Home My WebLink AboutINS CERT 2008-09-01 ACORD.. CERTIFICATE OF LIABILITY INSURANCE CSR BL I DATE (MMIDDNYYY) CALIF-6 n~1A , PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIDN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bollinger, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 101 JFK Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Short Hills NJ D7078-5000 , Phone: 800-526-1379 Fax:973-921-2876 INSURERS AFFORDING COVERAGE NAIC# . INSURED INSURER A PhIladelphIa Insurance Company 23850 INSURER B Markel Insurance Company California Youth Soccer INSURER C Association{ Inc.- North -~--- 1040 Se~en ine L6 Suite 201 INSURER 0 Pleasanton CA 945 6 --- INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NQTWITHST ANDING 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 REOUCED BY PAID CLAIMS POLICY NUMBER PD~~~(~MrJoC~E PDATE'!~~h~~~N LIMITS . - LTR NSR TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $1,000,000 - PHPK249107 09/01/08 09/01/09 IJ"RENTEU" A X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) '1,000,000 I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) .5,000 -- - ~ Inc. Part. Lia PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $5,000,000 - .2,000,000 GEN'L AGGREGATE LIMIT APAS PER PRODUCTS. COMP/OP AGG ""I ,nPRO. -. . j---'-- POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - .1,000,000 ANY AUTO (Ea accldenl) l- I-- ALL OWNED AUTOS BOOIL Y INJURY (Per person) . SCHEDULED AUTOS I- PHPK249107 09/01/08 09/01/09 A ~ HIRED AUTOS BODILY INJURY . A ~ NON.OWNED AUTOS PHPK249107 09/01/08 09/01/09 (Peraccidenl) I- PROPERTY DAMAGE . (Per accident) RRAGE LIABILITY AUTO ONL Y . fA ACCIDENT . ANY AUTO R.. 1(' ::-, J ::f") ~ OTHER THAN EA ACC . AUTO ONLY AGG . EXCESS/UMBRELLA LIABILITY II ( IV-, , 'II " EACH OCCURRENCE . =:J OCCUR D CLAIMS MADE - r -- AUr; 2 2008 AGGREGATE . . =i DEDUCTIBLE (l i ., Fi I . RETENTION . T.. . WORKERS COMPENSATION AND ..'..'" I" ,. , .;~\UK WN I To'R/LII~:~S I IUd~ EMPLOYERS' LIABILITY ~._. ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT . OFFICER/MEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE . If yes, describe under EL DJSEASE - POLICY LIMIT . SPECIAL PROVISIONS below OTHER A Accident Coverage 4102AH024934 09/01/08 09/01/09 Med. Max: $300,000 Full Excess Ded: $250/Claim DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL OPERATIONS OF CYSA-NO. ITS YOUTH MEMBER TEAMS & LEAGUES. THE CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED WITH RESPECTES TO THE LIABILITY COVERAGE. (MILL V ALLEY YOUTH SOCCER LEAGUE) CERTIFICATE HOLDER CANCELLATION CITY OF TIBURON AND BELVEDERE 1155 TlBURON BLVD. TIBURON , CA. 94920 COTB2DDBI2DD9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRE @ ACORD CORPORATION 1988 ACORD 25 (2001/08)