Loading...
HomeMy WebLinkAbout2010-11 CorstoneACQ ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/5/2010 PRODUCER (415) 978-3800 FAX: (415) 978-3825 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Calender-Robinson Company, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FB0267063 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 300 Montgomery St., Suite 888 San Francisco CA 94104 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Great American Insurance CorStone INSURER B: Midwest General Insurance 33 Buchanan Drive INSURER C: ! INSURER D: Sausalito CA 94965 INSURER E: nOVFRAnFA 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 TER MS, EXCLUSIONS AND CONDIT IONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD. - - DATE I'M OLICY EFFECTIVE POLICY EXPIRAY ON POLICY NUMBER PDATE (MM/DDNYYYI LIMITS GENERAL LIABILITY _ EACH OCCURRENCE $ 1 000 000 L 1 X COMMERCIAL GENERAL LIABILITY - - DAMAGE TO RENTED $ PREMISES - - - _ 100,000 A CLAIMS MADE IX OCCUR PAC 7575606 04 3/19/2010 3/19/2011 _ - MED EXP (Any one peeso) $ 5, 000 X Professional Lia @ PERSONAL & ADV INJURY $ - 1, 000, 000 $1M / $2M GENERAL AGGREGATE $ 2, 000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ - 2,_000, 000 - X POLICY PRO- r LOC 7 i AUTOMOBILE LIABILITY ~ COMBINED SINGLE LIMIT $ ~ ANY AUTO (Ea accident) 1,000,000 A ALL OWNED AUTOS 'PAC 7575606 04 3/19/2010 3/19/2011 BODILY INJURY SCHEDULED AUTOS - Per $ ( person) _ _ X HIRED AUTOS ~ I BODILY INJURY X NON-OWNED AUTOS $ (Per accident) IE 8 PROPERTY DAMAGE $ P id ( er acc ent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ I ANY AUTO APR - 7 010 , - - - OTHER THAN EA-ACC $ - - - AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY TOWN CLE K EACH OCCURRENCE $ OCCUR r CLAIMS MADE TOWN OF TIB RON AGGREGATE $ - DEDUCTIBLE I I $ - ~ - - - _ . RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I WC STATU 0TH- ! TORY LIM]TS L Eft ~ ANY PROPRIETOR/PARTNER/EXECUTIVE i l / N , _ . E. L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) WCMSTR0533705 3/20/2010 3/20/2011 - - E.L. DISEASE - EA EMPLOYE $ , 11000L000 If yes, describe under - - - - SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER I j I i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is included as additional insured as per the attached endorsement - NOTE: 10 days notice of cancellation for non-payment of premium VtK I IhICA I t HULUtK Town of Tiburon & its agents Attn: Diane Lacopi 1505 Tiburon Blvd. Tiburon, CA 94920 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REP SENTATIVES. n dUtkQRIZED REPRESENTATIVE n ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are re 'stered marks of ACORD Named Insured: Corstone Policy: PAC 7575606 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, and for which a certificate of insurance naming such person or organization as additional insured has been issued, but only with respect to their liability arising out of their requirements for certain performance placed upon you, as a nonprofit organization, in consider- ation for funding or financial contributions you receive from them. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organi- zation. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your on-going operations; or B. In connection with your premises owned by or rented to you CG 2026 (07/04)