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HomeMy WebLinkAbout2011-07-01 Reed Union School District1/25/2011 4:15:15 PM PST (GMT-8) FROM: insurancevisions.com-TO: 141541,524,118 From: Page: 1 of 4 FAX DOCUMENT Certificate of Insurance Delivery by ecertson line TM To: Town of Tiburon, its agents & employees Attn: Diane Crane lacopi 1505 Tiburon Boulevard Tiburon CA 94920 This document was created by eCertsONLINE From: Rose Meisenheimer Subject: Certificate of Coverage: Reed Union School District Date: 1/25/2011 Delivery Via: FAX 14154352438 No. of Pages: 4 The attached or linked document(s) contain certification of insurance coverage for the insured named in the subject above. Your company is listed as the organization requesting receipt of these documents. If this document is se! it via e-mail, you must click on the link below. The linked document is in a pdf format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe Reader for free, visit www.Adobe.com. If you have any questions regarding the content of this message, you should contact the Producer/Agency listed on the attached/linked documents. ~n 711 THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THEME SSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BY7ELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US ATTHE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. © 2002 Certificate of Insurance Delivered by ecertsonline TM Insurance Visions, Inc. All rights reserved. `~zw" 7 112512011 4:15:16 PM PSI' (GMT-8) FROM: insurancevisions.com-TO: 1415435248 Pace: 2 of 4 Northern Califomia ReLiEF CERTIFICATE OF COVERAGE Issue Date 1/25/2011 ADMINISTRATOR: LICENSE # 0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Keenan & Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1111 Broadway, Suite 2000 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Oakland, CA 94607 AFFORDED BY THE COVERAGE DOCUMENTS BELOW. ENTITIES AFFORDING COVERAGE: 510-986-6750 www.keenan.com ENTITrA: Northern California ReLiEF COVERED PARTY: ENTITY B, Reed Union School District Marin Schools Insurance Authority ENTITY C: 277-A Karen Way ENTITY D. Tiburon CA 94920 ENTITY E. I THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY I REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. MEMBER ENT TYPE OF COVERAGE COVERAGE EFFECTIVE/ RETAINED LIMIT LTR DOCUMENTS EXPIRATION DATE / DEDUCTIBLE LIMITS A GENERAL LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE I GENERAL LIABILITY 1 jCLAIM MADE (-JOCCURRENCE NCR 00601-19 7/1/2010 $ 25,000 $ 1,000,000 GOVERNMENT CODES 7/11/2011 1 ERRORS & OMISSIONS I ] A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE ANY AUTO I NCR 00601-19 7/1/2010 $ 25 000 $ 1,000,000 J I HIRED AUTO I NON-OWNED AUTO 7/1/2011 , 1 GARAGE LIABILITY 1 ,4AUTO PHYSICAL DAMAGE A PROPERTY NCR 00601-19 7/1/2010 $ 25,000 $ 250,000,000 1 ALL RISK 7/1/2011 EACH OCCURRENCE I EXCLUDES EARTHQUAKE & FLOOD I ] BUILDER'S RISK A STUDENT PROFESSIONAL LIABILITY NCR 00601-19 7/1/2010 S 25,000 Ilicluded 7/1/2011 EACH OCCURRENCE WORKERS COMPENSATION I J WC STATUTORY LIMITS OTHER I ] ] EMPLOYERS' LIABILITY $ E.L. EACHACCIDENT EXCESS WORKERS COMPENSATION $ 1 j EMPLOYERS' LIABILITY $ E.L. DISEASE -EACH EMPLOYEE E.L. DISEASE - POLICY LIMITS OTHER $ S UCQt,Mw-, JUN Ur UrtKAI1UN51LUGAIIUN5/VEHIGLESIRESTRICTIONS/SPECIAL PROVISIONS: Use of Town Council Chamber facilities at the Tiburon Town Hall by Reed Union School District for their Strategic Planning Meeting on 213/2011 through 2/4/2011. CERTIFICATE HOLDER: Town of Tiburon, its agents & employees Attn: Diane Crane lac;opi 1505 Tiburon Boulevard Tiburon CA 94920 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING ENTITY/JPA WILL ENDEAVOR TO MAIL _3_0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE ENTITY/JPA, ITS AGENTS OR REPRESENTATIVES. Graham Grice AUTHORIZED REPRESENTATIVE w ww.eCm s Online. mrn CERT NO.: 9403374 CLIENT CODE: P.EEDUNI$ RoSe Meisenheimer 1/25/2011 0:13:51 PM PaQe 1 pf 3 1/25/2011 4:15:15 PM PST (GMT-8) FROM: insurancevisions.com-TO: 14154352438 Page: 3 of 4 DISCLAIMER The Certificate of Coverage on the reverse side of this form does not constitute a contract between the issuing entity(ies), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the coverage documents listed thereon. eCat sOnfin a com CERT NO.: 9403374 CLIENT CODE: P.EEDVNIS Rose MeiSenhelmer 1/25/2011 4:13:51 P1 Page 2 of 3 112512011 4:15:16 PM PSP (GMT-8) FROM: insurancevisions.com-TO: 14154352438 Page: 4 of 4 ENDORSEMENT ADDrrjONAL COQ/EKED PANTY COVERED PARTY COVERAGE DOCUMENT ADMINISTRATOR Reed Union School District NCR 00601-19 Keenan & Associates Marin Schools Insurance Authority Subject to all its terms, conditions, exclusions, and endorsements, such additional covered party as is afforded by the coverage document shall also apply to the following entity but only as respects to liability arising directly from the actions and activities of the covered party described under "as respects" below. Town of Tiburon, its agents & employees Attn: Diane Crane lacopi 1505 Tiburon Boulevard Tiburon CA 94920 Use of Town C3uncil Chamber facilities at the Tiburon Town Hall by Reed Union School District for their Strategic Plann,ng Meeting on 2/3/2011 through 2/4/2011. The Town of Tiburon, its agents and employees are included as an Additional Covered Party but only as respects to the sole negligence of Reed Union School District. Authorized Representative Issue Date: 1/25/2011 CEP.T NO.: 9483374 CLIENT CODE: P.EEDUNIS Rose Mei5enheLmer 1/25/2011 4:13:51 PM Page 9 Of 3