HomeMy WebLinkAboutSKMBT_C35109091413450ACORD _ CERTIFICATE OF LIABI
2009YR)
LITY INSURANCE Dat 8
8
/
/
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HEFFERNAN PROFESSIONAL PRACTICES
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License Number: 0564249
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1855 W. Katella Avenue, Suite 255
Orange, CA 92867
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A.
Travelers Property Cc of Am
36161
ALTA PLANNING AND DESIGN, INC.
INSURER B:
Travelers Indemnity Company
25656
711 SE GRAND AVENUE
INSURER C:
Travelers Casualty Ins Co. of America
19046
PORTLAND
OR 97214
INSURER D:
Continental Casualty Company
20443
,
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 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
ADWL
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRO
TYPE OF INSURANCE
POLICY NUMBER
DATE MIDOTY
DATE MMIDD,YY
LIMITS
A
GENERAL LIABILITY
68021751918
06/01/2009
06/01/2010
EACH OCCURRENCE
$1,000,000
B
X
COMMERCIAL GENERAL LIABILITY
6806997M998
06/01/2009
06/01/2010
DAMAGE TO RENTED
$1
000
000
EM I SE9 Ed Oaunenae)
PR _
,
,
CLAIMS MADE X OCCUR
MED EXP IANY ONE PERSON)
$10,000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,006,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS-COMPIOP AGG)
$2,606,600
PRO-
X
POLICY
JECT _GC
A
AUT
OMOBILE LIABILITY
680217SL918
66/01/2609
06/01/2010
G
IMI
COMBINED SIN
LE L
T
$1,000
000
B
ANY AUTO
6806997M998
06/01/2009
06/01/2010
(Ea....dem)
,
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per Person)
X
HIRED AUTOS
BODILY INJURY
$
X
NON OWNED AUTOS
(Per aceiaent)
PROPERTY DAMAGE
$
(Per ACeff
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHERTHAN EA AGO
$
AUTO ONLY AGG
$
A
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 1,000,006
X OCCUR β CLAIMS MADE
CUP1459T864
06/01/09
06/01/10
AGGREGATE
$ 1,000,000
$
DEDUCTIBLE
$
RETENTION $10 GG0
$
WORK
ERS COMPENSATION AND
UB7125Y672
6916112669
09/61/2616
we sTATU OTH
X
EMPLO
YERS' LIABILITY
TORY LIMITS ER
C
ANY PROPIETORPARTNEREXECUTIVE
EL EACH ACCIDENT
$1,000,000
OFFIOERMEMBER EXCLUDEUI
EL DISEASE POLICY LIMIT
$1,000,000
If yes, describe under
EL DISEASE EA EMPLOYEE
$1
006
000
SPECIAL PROVISIONS below
,
,
OTHER
D
ProlaSsort2l Liabiflty
MCH114135257
10/17/2008
10/1712009
$2,000,000 Per Claim
$2,000,000 Aggregate
DESCRIPTION OF OPERATIONS/LOCATIONS/VE HICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
All operations including but not limited to Share the Path Program. City of Tiburon is named as additional insured on general liability policy-see attached
endorsement.
CERTIFICATE HOLDER CANCELLATION *10 Day Notice for Non-Payment of Premium
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDBAVOI MAIL 90' DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ',.RAββ I
Cit
f Tib
uron
y o
Attn: Diane Crane lacopi
1505 Tiburon Blvd.
Tiburon, CA 94920
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) PACORD CORPORATION 1988