HomeMy WebLinkAboutINS CERT 2008-12-31
29-Dec-2008
CERTIFICATE OF COVERAGE
Alliant Insurance Services, Jnc.
600 Montgomery Street
9th Floor
San Francisco, CA94111
,
THIS CERTIFICATE IS lSSUEDAS A MATTER OF EVIDENCE ONLY AND CONFERS 1
NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT I
AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES :
BELOW
I PRODUCER
(415) 403-1400
I INSURED Sanitary District NO.5 of Marin County
Member of CSRMA
P.O. Box 227
Tiburon, CA 94920-
1721
MEMORANDUM OF COVERAGE NUMBER
CSL SO 5 0809 1
PROGRAM AFFORDING COVERAGE
California Sanitation Risk Management Authority (C.S.R.M.A.)
'COVERAG"S
THIS IS TO CERTIFY THAT THE COVERAGE IS AFFORDED TO THE ABOVE NAMED MEMBER, AS PROVIDED BY THE MEMORANDUM{S) OF COVERAGE, FOR THE
COVERAGE PERIOD SHOWN BELOW, NOTHWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE PROGRAM DESCRIBED HEREIN IS SUBJECT TO All THE
TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM(S) OF COVERAGE. THE FOLLOWING COVERAGE IS IN EFFECT
PUBLIC ENTITY LIABILITY IS DEFINED IN THE MEMORANDUM{S) OF COVERAGE ON FILE WITH THE ENTITY, AND COPIES ARE AVAILABLE ON REQUEST.
Type Of Coverage:
,Public Entio/_~i~~i_llty_~'!c.ludi_ng:
,
EffectiveDate
ExpirationDate
S.I.R.
Deductible
Liability Limit Per
Occurrence
;General.l,.ii,-bj1Ltv-'C_Qyer<Lq~l__
General liability
Products/Completed Operations
,__GQQ!~~c;tLJal liability
iAutomobile Liabilitv ICoveraqe)
i Owned Automobiles
I Non-Owned Automobiles
Hired and Non-Owned Auto
1------
-----o:1-0ec-200Bl31-0ec-2009
. --
-T
$10,000
$15,000,000
- T31-0eC-200B
31-0eC~2L--
$10,000
$15,000,000
1
,
-----1
RECEIVED
JAN - 2 2009
TOWN MANAGERS OFFICE
TOWN OF TlBURON
1
-I
I
- -
DESCRIPTION OF OPERA TIONSfLOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTS/SPECIAL PROVISIONS
'THE HOLDER IS NAMED AS AN ADDITIONAL COVERED PARTY PER THE MEMORANDUM OF COVERAGE WITH RESPECTS TO THE USE OF
PREMISES DURING THE POLICY TERM.
COPIES OF THE MEMORANDUM OF COVERAGE ARE AVAILABLE UPON REQUEST.
I
I
'CERTIFICATE HOLDER
--~.,-,-~_..-.--.--._~-~ .
TIBURON TOWN CLERK
15366 - 382
CANCELLATION
..,......."".~-~.,~"-~~~.. ----.-."" ~_..,",',",'- +~----_..
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
INRITTEN 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 COMPANY,
ITS AGENTS OR REPRESENTATIVES.
1505 TIBURON BOULEVARD
TIBURON, CA 94920
I AUTHORIZED REPRESENTATlVE iJ..vJ A. - #. !? ,J
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