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HomeMy WebLinkAbout2010-11 Leukemia/Lymphoma SocietyDATE(MM/DD/YYYY) kft°!~O® CERTIFICATE OF LIABILITY INSURANCE 04/01/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Aon Risk services Northeast, Inc. Parsippany NJ office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 10 Lani dex center west CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE P.O. Box 608 COVERAGE AFFORDED BY THE POLICIES BELOW. Parsippany N3 07054-0608 USA LL PHONE-(866) 283-7122 FAX-(847) 953-5390 INSURERS AFFORDING COVERAGE NAIC # U INSURED INSURER A: Phi 1 adel phi a Indemnity Ins Co 18058 The Leukemia & Lymphoma Society, Inc. 1311 Mamaroneck Avenue, Suite 310 INSURER B: white Plains NY 10605 USA INSURER C: INSURER D: INSURER E: rnVF.RA( F.C 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. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YYY DATE(MM/DD/YYYY) A PHPK548261 03/30/2010 03/30/2011 EACH OCCURRENCE $1 000 000 ENERAL LIABILITY , , X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 PREMISES (Ea occurrence) CLAIMS MADE M OCCUR MED EXP (Any one person) $20,000 PERSONAL & ADV INJURY $1 000,000 , ❑ GENERAL AGGREGATE $3,000,07 ' GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $3,00 0, 000 POLICY ❑ PRO- ❑ LOC ❑X JECT 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS li n D nn~~ IUl , ~J BODILY INJURY SCHEDULED AUTOS e H v ( Per person) HIRED AUTOS PR 1 3 2010 BODILY INJURY r ac ident) (P NON OWNED AUTOS A e c PROPERTY DAMAGE id t P TOWN CLERK TIBURON en ) er acc ( GARAGE LIABILITY AUTO ONLY - EA ACCIDENT H ANY AUTO OTHER THAN EA ACC AUTO ONLY : AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION WC STATU- OTH- WORKERS COMPENSATION AND TORY LIMIT ER EMPLOYERS' LIABILITY Y/N E.L. EACH ACCIDENT ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandator in NH E.L. DISEASE-EA EMPLOYEE y E.L. DISEASE-POLICY LIMIT If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Regarding Event: Team Training. Town of Tiburon and its agents are included as Additional Insured as respect General Liability policy. tr w a it Q b O x t\ Ln N M 00 M O O n Ln O z O .Vr 4r Fr U CERTIFICATE HOLDER CANCELLATION Town of Tiburon and its Agents SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn : Diane crane Iacopi DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1805 Tiburon Blvd. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Tiburon CA 94920 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE cs o~9Z~l~f~c/stiraedc/~e~uc~i/~~ ~N- ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved= The ACORD name and logo are registered marks of ACORD INSURED The Leukemia & Lymphoma Society, Inc. 1311 Mamaroneck Avenue, suite 310 white Plains NY 10605 USA CG2026 - Additional Insured Endorsement POLICY NUMBER: PHPK548261 POLICY DATES: 03/30/10 to 03/30/11 PHILADELPHIA INDEMNITY INSURANCE COMPANY COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED--DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) See CERTIFICATE DESCRIPTION. WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 Insurance services office, Inc., Certificate No : 570038324576 Aon Risk Services Northeast, Inc March 31, 2010 To Whom It May Concern: Ref: The Leukemia & Lymphoma Society - Certificate of Insurance Dear Sir or Madam: Sherry Porter Sr. Client Specialist The enclosed certificate represents a renewal of coverages for The Leukemia & Lymphoma Society, spanning a period from March 30, 2010 to March 30, 2011. You are receiving this certificate as you had previously requested / been issued a certificate evidencing these coverages, as a Certificate Holder. Please update your files with this renewal certificate. Please note that this certificate is valid for any/all events / operations The Leukemia & Lymphoma Society may host or participate in, for the entire term of the policy(ies) represented. In saving your organization time and resource, it is therefore not necessary to request a certificate of insurance for each and/or every event this single document will suffice. If you received this certificate in error, no longer require a certificate, or require changes to this certificate, please contact Aon Risk Services directly, for the necessary changes. Our contact details are provided below. Thank you. Aon Risk Services, Client Services Dept. Tel: (866) 283-7122 Fax: (800) 363-0105 E-Mail: ACS Chicauo@at-s.aon.coin Aon Risk Services Northeast, Inc. 01'e nt Servlices Depiment 1000 Milwaukee Avenue Glenview, IL 6002510