HomeMy WebLinkAboutSKMBT_C35112010410261- - - -Dec-2011
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CERTIFICATE OF COVERAGE- I
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF EVIDENCE ONLY AND CONFERS
Alliant Insurance Services, Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
100 Pine Street AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE MEMORANDUM(S) OF COVERAGE (MOC) BELOW.
11th Floor
San Francisco, CA 94111 (415) 403-1400 THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A CONTRACT
BETWEEN THE ISSUING INSURER, AUTHORIZED REPRESENTATIVE OR
- - - PRODUCER, AND THE CERTIFICATE HOLDER.
INSURED Sanitary District No. 5 of Marin County
Member of CSRMA
P.O. Box 227
Tiburon, CA 94920-
172
MEMORANDUM OF COVERAGE NUMBER PROGRAM AFFORDING COVERAGE
CSL SD 5 1112 1 California Sanitation Risk Management Authority (C.S.R.M.A.)
COVERAGES
THIS IS TO CERTIFY THAT THE COVERAGE IS AFFORDED TO THE ABOVE NAMED MEMBER, AS PROVIDED BY THE MEMORANDUM(S) OF COVERAGE, FOR THE
COVERAGE PERIOD SHOWN BELOW, NOTHWITHSTAN DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE PROGRAM DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM(S) OF COVERAGE. THE FOLLOWING COVERAGE IS IN EFFECT:
PUBLIC ENTITY LIABILITY IS DEFINED IN THE MEMORANDUM(S) OF COVERAGE ON FILE WITH THE ENTITY, AND COPIES ARE AVAILABLE ON REQUEST.
Type Of Coverage: EffectiveDate ExpirationDate S.I.R. Deductible Liability Limit Per
Public Entity Liability Including: Occurrence
General Liability (Coverage)
General Liability 31-Dec-2011 31-Dec-2012 - $10,000
$1,000,000
Products/Completed Operations
Contractual Liability - 1
_A_utomobile_Liability (Coverage) _
Non-Owned Automobiles 31-Dec-2011 31-Dec-2012 - $10,000 $1,000,000
Owned Automobiles
Hired and Non-Owned Auto j 1 L
DECHWE
JAN 4 2012
TOWN CLERK
~-OWN OF TIBURON
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTS/SPECIAL PROVISIONS
THE HOLDER IS NAMED AS AN ADDITIONAL COVERED PARTY PER THE MEMORANDUM OF COVERAGE WITH RESPECTS TO THE USE OF
PREMISES DURING THE POLICY TERM.
COPIES OF THE MEMORANDUM OF COVERAGE ARE AVAILABLE UPON REQUEST.
ERTIFICATE HOLDER
TIBURON TOWN CLERK
1505 TIBURON BOULEVARD
TIBURON, CA 94920
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUM(S) OF COVERAGE BE
15366- 382 CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE MEMORANDUM(S) OF COVERAGE PROVISIONS.
AUTHORIZED REPRES 14*WCO