HomeMy WebLinkAboutINS CERT 2008-11-13
MiARSH
CE R TIF1CAl'EOF IN.StJRANC E
CERTIFICATE NUMBER
SEA-001260079-01
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
PRODUCER
MARSH RISK & INSURANCE SERVICES
1 CALIFORNIA STREET
CALIFORNIA LICENSE NO. 0437153
(415) 743-8000
SAN FRANCISCO, CA 94111
Attn: Greg Wessel 415-743-8235
016368--UMB-08/09
COMPANY
A N/A
COMPANIES AFFORDING COVERAGE
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INSURED
GOLDEN GATE BRIDGE, HIGHWAY &
TRANSPORTATION DISTRICT
BOX 9000 PRESIDIO STATION
SAN FRANCISCO, CA 94129
COMPANY
B N/A
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TOWN OF TIBUkON
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THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COMPANY
C
COMPANY
D
L.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DDIYY)
GENERAL LIABILITY
-
X
I .
COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE [8] OCCUR LIMITS ARE EXCESS OF AND
OWNER'S & CONTRACTOR'S PROT SUBJECT TO $3,000,000
SELF-INSURED RETENTION
07/01/08
07/01/09
LIMITS
GENERAL AGGREGATE $
PRODUCTS-COM~OPAGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
e-
AUTOMOBILE LIABILITY
f--
I-- ANY AUTO
ALL OWNED AUTOS
I--
_ SCHEDULED AUTOS
_ HIRED AUTOS
-
NON-OWNED AUTOS
-
GARAGE LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
RINCL
EXCL
AUTO ONLY - EA ACCIDENT ~
OTHER THAN AUTO ONLY: ~
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
$
$
I T"6~~I~JNs I I Ul~ 1;;<. ,F"'';ji.. 'Ui
EL EACH ACCIDENT $
$
AGGREGATE
-
_ ANY AUTO
-
EXCESS LIABILITY
R UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS'L1ABILlTY
EL DISEASE-POLICY LIMIT
EL DISEASE-EACH EMPLOYEE $
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
The City of Belvedere 1 Town of Tiburon is included as additional insured as respects to the Community Workshop in Town Council Chambers on November
13, 2008.
CERTIFICATE HOLDER
CANCELLATION
CITY OF BELVEDERE 1 TOWN OF TIBURON
TIBURON TOWN CLERK
1505 TIBURON BOULEVARD
TIBURON, CA 94920
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL ----3..0 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services <2I\"n i'll ~.-u '1AJ. ~
BY: Gregory Wessel /'-' ""'r ... if
MM1(3/02)
VALID AS OF:10/28/08