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Home My WebLink AboutINS CERT 2008-07-01 (2) ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 12/15/08 PRODUCER 0726293 1-415-546-9300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. ONL Y 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 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A ORDINARY MUT RRG CORP 10171 Roman Catholic Archbishop of San Francisco INSURER B HARTFORD FIRE IN CO 19682 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY NUMBER P~.k+~~~~f8g~~:: P8i!f:I~~~~tgN LTR NSRC TYPE LIMITS A GENERAL LIABILITY CGAL0022008 07/01/08 07/01/09 EACH OCCURRENCE $1,000,000 ~ DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $1,000,000 I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $5,000 ! PERSONAL & ADV INJURY $1,000,000 r--- GENERAL AGGREGATE $ 2,000,000 I--- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 r--x-l POLICY n j~c?T nLOC Liquor Liability 1,000,000 A AUTOMOBILE LIABILITY CGAL0022008 07/01/08 07/01/09 f-- COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) r--- X ALL OWNED AUTOS BODIL Y INJURY r- S X SCHEDULED AUTOS (Per person) I--- _. X HIRED AUTOS r- BODIL Y INJURY $ X NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (per accident) GARAGE LIABILITY AUTO ONL Y - EA ACCIDENT $ =1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY \ EACH OCCURRENCE $ o OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ B 57WEFX4185 01/01/09 01/01/10 I WC STATU- I IOTH-' WORKERS COMPENSATION AND X TORY LIMITS ER EMPLOYERS' LIABILITY $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYFE $1,000,000 If yes, describe under -- SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $1,000,000 OTHER A Counselors E&O Liability CGAL0022008 07/01/08 07/01/09 ~er Claim 1,000,000 ClaimS-Made Form ggregate 3,000,000 I DESCRIPTION OF OPERATIONS / LOCA TIONS / VEHICLES / EXCLUSIONS ADDED BY 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 eyo Girls Soccer Practice & Games from March, 2009 through May, 2009. CERTIFICA TE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Tiburon DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN 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 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1505 Tiburon Blvd. REPRESENT A TIVES. Tiburon, CA 94920 AUTHORIZED REPRESENTATIVE USA 4~/V~~.;-' 7:7-,,\ - l. ACORD 25 (2001/08) shwethasan 10547831 @ ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08)