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HomeMy WebLinkAbout2011-12 (St. Hilary/Archiodecese of SF)10/7/2011 2:44 Remote ID Imprint ID Fax Town of Tiburon TO : Fax: 1-415-435-2438 Attn: Roman Catholic Archbishop of San Francisco FROM Phone: Arthur J. Gallagher & Co. Agency: insurance Brokers of California, Inc., License #0726293 Phone : 1-415-546-9300 S u bject:Roman Catholic Archbishop of San Francisco - Town of Tiburon This document was brought to you by Ebix/CertificatesNow and Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. in San.Francisco, CA. If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance. The data included in this notice and in the attached document is confidential to Ebix/CertificatesNow and Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. cc: Winnie Loi (EMAIL), St. Hilary Church CYO (FAX) The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by CertificatesNow - www.ConfiirmNot.com - 877.669.8600 10/7/2011 2:44 Remote ID Imprint ID ❑ 2/3 ,acoRO® CERTIFICATE OF LIABI ~o 06 LITY INSURANCE / /2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 0726293 1-415-546-9300 CONTACT A h J l NAME: rt ur . Ga lagher & Co. PHONE FAX Insurance Brokers of California, Inc., License #0726293 A/C No Exc : A/C No : One Market Plaza, Spear Tower E-MAIL ADDRESS Suite 200 San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC8 INSURERA:ORDINARY MUT RRG CORP 10171 INSURED INSURER B : HARTFORD FIRE IN CO 19682 Roman Catholic Archbishop of San Francisco INSURER C One Peter Yorke Way INSURER D : San Francisco CA 94109 INSURERE , INSURER F t.[ 1V FK 0[, F1 I.FK IIFI(=Y I F Iu1lumiF- • d.33.5UN1-/ OCUICIrlal \II Ia1000. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE DDL g UBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDnYYY LIMITS A GENERAL LIABILITY CGAL00211 07/01/1 07/01/12 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE O NTEU PREMISES Ea occurrence 50 , 000 $ CLAIMS-MADE FTIOCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY PRO LOC Liquor Liability $1,000,000 A AUT OMOBILE LIABILITY CGAL00211 07/01113 Z7701/12 EaM accident) SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per accident) ( ) $ X X NON-OWNED PROPERTY DAMAGE $ H]RED AUTOS AUTOS Per accident $ . UMBRELLA LIAR H OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 57WEFX4185 01/01/1 01/01/12 X OOC LIMIT ER Y / N ANY PROPRIETOR/PARTNER/EXECUTWE a NIA E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 Ityes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required) See Supplement Page for additional information. RE: St. Hilary School, 765 Hilary Dr., Tiburon, CA 94920. As respects Flag Football Games at 765 Hilary Dr. on 9/26, 10/17, 10/24 and 11/14/2011. CERTIFICATE HOLDER CANCELLATION (Town of Tiburon 11505 Tiburon Blvd. (Tiburon, CA 94920 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA ACORD 25 (2010105) premasan 23530917 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 10/7/2011 2:44 Remote ID Imprint ID D 3/3