Loading...
HomeMy WebLinkAbout2011-02-01 (Diving Services)John Sutak Risk Services INSURANCE PROGRAM MANAGERS & BROKERS Dear Certificate Holder: Attached you will find certificate of insurance for: o- C Vim' V'( fl '4x V C~ This certificate is being sent to you at the request of our client. If for any reason this is not correct please let us know and we will remove you from the list of holders. We want to update our information to include an email address and fax number to send out future certificates. Please provide this information at your earliest opportunity. You can email me directly with the information - pam.wayne@johnsutakrisk.com Or fax to: Pam Wayne at 415-394-8839 Certificate Holder Name: Contact Name: Email Address: Fax Number: Thank you and please do not hesitate to contact me should you have any questions. Thank you, Pamela Wayne John Sutak Risk Services One Embarcadero Center, Suite 1040 San Francisco, CA 94111 email: pam.wayne@johnsutakrisk.com Phone direct: 415-901-2553 Fax: 415-394-8839 ONE EMBARCADERO CENTER, SUITE 1040 SAN FRANCISCO, CALIFORNIA 94111 TEL 415-394-0700 LICENSE # 0743936 FAX 415-394-8839 CoRn® CERTIFICATE OF LIABILITY OP ID 03 DATE (MM/DD/YYYY) INSURANCE PARKS-3 01/27/11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John Sutak Risk Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR One Embarcadero Center, Suite ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Francisco CA 94111 Phone: 415-394-0700 Fax: 415-394-8839 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: CNA Insurance Companies INSURER B American Home Assurance Co Redwood Shore Diving, Inc. DBA: Parker Diving Service INSURER C IMU - One Beacon P. O. Box 1 648 / Sausalito CA 94966 INSURERD , Quality Id. SpeClcaG i 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 ANY CONTRACT OR OTHE R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE D HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOD'L - POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD i TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYYYY) DATE (MM/DD/YYYY) LIMIT S GENERAL LIABILITY , EACH OCCURRENCE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY ML872626 I ~ 02/01/11 1 02/01/12 DAMAGE TO RENTED PREMISES (Eaoccnrence) - _ $ 50,000 I _ CLAIMS MADE X OCCUR MED EXP (An e Y on person) $ 5,000. I X Sh lprepalrers INCL SUDDEN c ACCIDENTAL I - PERSONAL & ADV INJURY - $ 1,000,000. 1 , Legal Liability POLLUTION GENERAL AGGREGATE •s-2,000,000. GEN'LAGGREGATF LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1,000,000. POLICY O LOC AUTOMOBILE LIABILITY 1 - ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTO S BODILY INJURY 1 $ SCHEDULED AUTOS (Per person) , HIREDAUTOS ' BODILY INJURY (Per accident) $ NON-OWNED AUTOS - - - PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT - $ ANY AUTO _.I EA ACC $ OTHER THAN _ AUTO ONLY AGO $ EXCESS/ UMBRELLA LIABILITY 1 EACH OCCURRENCE $ 4,000,000 B 'X OCCUR CLAIMS MADE 051764894 02/01/11 02/01/12 AGGREGATE $ DEDUCTIBLE - RETENTION $ , $ WORKERSCOMPENSATION WC STATU- OTH- ACID EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVE E L EACH ACCIDENT OFFICERMEMBER EXCLUDED? ❑ . . y (Mandatory in NH) If yes describe under 1i E.L. DISEASE - EA EMPLOYEE $ - - , SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT ' $ 1 OTHER C H&M/P&I/Jones Act N5JR7I234 -ALLIED HARINZR 03/04/10 03/04/11 H&M 165,000 D Pollution 43-26364 POLLUTION 03/04/10 03/04/11 P&I Poll 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES / EXCLUSIONS ADD ED BY ENDORSEMENT /SPECIAL PROVISIONS Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYTIB 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 City of Tiburon REPRESENTATIVES. 1155 Tiburon Blvd. Tiburon CA 94920 ♦%,urw zu tzuuyiu 1) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD