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Sheryl Cathers - Insurance Certificate (2019)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/16/2019 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 SUBROGATIONIS WAIVED, 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 CONTACT NAME: PACIFIC DIVERSIFIED INS SVCS 57151705 PHONE (866) 467-8730 I FAX (888) 443-6112 15005 CONCORD CIRCLE (A/C, No, Ext): (A/C, No): MORGAN HILL CA95307 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: The Sentinel Insurance Company 11000 INSURED, INSURER B : DABBLE ART CENTER INSURER C : 7680 MONTEREY ST STE 106 GILROY CA 95020-5271 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP I LIMITS LTR INSR VIVID (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED $1,000,000 PREMISES (Ea occurrence) X General Liability I MED EXP (Any one person) $10,000 A X 57 SBA BH7094 08/30/2018 08/30/2019 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO- LOC FX I PRODUCTS - COMP/OP AGG $2,000,000 JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS 57 SBA BH7094 08/30/2018 08/30/2019 BODILY INJURY (Per accident) _ HIRED NON -OWNED X X PROPERTY DAMAGE I AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR I EACH OCCURRENCE _ EXCESS LIAB CLAIMS - MADE (AGGREGATE DEDILI RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I SPER TATUTE I I EORH ANY Y/N I E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE NIA OFFICER/MEMBER EXCLUDED? C I E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. City of Gilroy, its officers, representative, agents, and employees for the graffiti abatement mural program are additional insureds per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Gilroy , its Officers SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Representative, Agents, and Employees BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 7351 ROSANNA ST IN ACCORDANCE WITH THE POLICY PROVISIONS. GILROY CA 95020-6141 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THEATHE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 City of Gilroy, its Officers Representative, Agents, and Employees 7351 ROSANNA ST GILROY CA 95020-6141 Account Information: Policy Holder Details : I DABBLE ART CENTER April 16, 2019 Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone: (866) 467-8730 Fax: (888) 443-6112 Email: aaencv.services ..thehartford.com Website: httr)s:Hbusiness.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTRO05 THE j ARTFO.D Policy number 57- SBA- BH7094 DABBLE ART CENTER AGENCY NAME: PACIFIC DIVERSIFIED INS SVCS/PSIS Producer Code 57152358 i To whom this may concern, i The following insured DABBLE ART CENTER, does not carry Workers' Compensation Insurance through The Hartford. Please do not reply to this E-mail directly, Thank you. Your Hartford Services Team, (877)853-2582 (Agency Callers) (866)467-8730 (Policyholders) Aaencv.ServicesO.TheHartford.com, (All Customers) GE 1 E@ Tel: 1-800-841-3000 9431COWCOM GEICO GENERAL INSURANCE COMPANY P.O. Box 509090 San Diego, CA 92150-9090 Date Issued: December 20, 2018 JEFFERY C CATHERS AND SHERYL A CATHERS 5875 MILLER AVE GILROY CA 95020-6807 Email Address: jcathersl@me.com Named Insured Jeffery C Cathers Sheryl A Cathers Vehicles VIN Declarations Page This is a description of your coverage. Please retain for your records. Policy Number: 4520-85-89-13 Coverage Period: 12-20-18 through 06-20-19 12:01 a.m. standard time at the address of the named insured. Additional Drivers None Vehicle Location 1 2013 Toyota Tacoma 3TMLU4EN3DMI13151 GilroyCA95020 ..................................................................... -- .... .... --------------------------------------------------- ............ ­ ................ 22007 --- Volks ------------- Rabbit ---------------- WVWAS7-l-K97WO-53-7-1-5-Gilroy --CA--95-02-0 --------- Coverages* Limits and/or Deductibles Bodily Injury Liability Each Person/Each Occurrence State -Minimum $15,000/$30,0000 --------------------------------------------------------------------------------- Property Damage Liability State Minimum $5,000 ... . ............... .................................................... Uninsured & Underinsured Motorists Each Person/Each Occurrence Uninsured Motorists Property Damage -- .... ------------------------------------------------------------------------ Comprehensive --------------------------------- I -------------------------- Collision $15,000/$30,000 Finance Comr)anvl Lienholder Wells Fargo Dealer Svcs ------------------- ------------- --------------- ...... ------ - -- ------- ------ - --------------------------- ----------- Vehicle I Vehicle 2 $51.90 $56.70 ------------- ---------------------------------------------------------------- -------------------------------------------- ------------- ­­ --- $5,000 $85.50 $95.50 ---------------------------------- -- ------------------------------------------------------------------------------------------ ------------------------------- ............ $1-5,00-0/$3-0,00-0 ------------------------------------------ -$1.5-.90 --------------------------------- $1.5...90. $3,500 $4.40 ........................................ - --------------------------------------------------------------------------------------- --------------------------- ...... $500 Ded $24.90 ------------------------------- - - -- - ---------------------------------------------------- -- ----------------------------------------------- $500 Ded $169.60 -------------------------------------------------------------------------------------- ................... -- ----------------------------------------------- .................................................................................... Six Month Premium Per Vehicle $346.90 $172.50 Total Six Month Premium $519.40 *Coverage applies where a premium or $0.00 is shown for a vehicle. If you elect to pay your premium in installments, you may be subject to an additional fee for each installment. The fee amount will be shown on your billing statements and is subject to change. f DEC —PAGE (03-14) (Page 1 of 4) Continued on Back New Policy Page 7 of 58 Discounts Multi -Car (All Vehicles) Subclass Factor (All Vehicles) Anti -Theft Device (Veh 1) California Good Driver (All Vehicles) Group Insurance Plan: Professional Group Insurance Plan Contract Type: A30CA Contract Amendments: ALL VEHICLES - A30CA A54CA Unit Endorsements: A426 (VEH 2); UE316C (VEH 1) Class: A -N -34MF Z (VEH 1); A -M -34MM G (VEH 2) Important Policy Information -Please verify that the coverages you requested are accurately reflected on your Declarations Page. Visit geico.com to review additional coverages and/or limits available to you. -No coverage is provided in Mexico. -Reminder - Physical damage coverage will not cover loss for custom options on an owned automobile, including equipment, furnishings or finishings including paint, if the existence of those options has not been previously reported to us. This reminder does NOT apply in VIRGINIA, however, in Virginia coverage is limited for custom furnishings or equipment on pick-up trucks and vans but you may purchase coverage for this equipment. Please call us at 1-800-841-3000 or visit us at geico.com if you have any questions. -You have elected to receive your insurance documents via electronic delivery at the following electronic mail address: jcathersl@me.com. To change the address where you receive your policy documents, visit. geico.com, or call 1-800-841-3000. -Congratulations! Your policy qualifies for the Professional Group Insurance Plan and includes a savings of $116.30. -Claims incurred while an insured vehicle is being used to carry passengers for hire may not be covered by this contract. Please review the contract for a full list of exclusions and contact us if you plan to use any of your insured vehicles forth is purpose. -In California, you have the right to designate one person to receive notices from GEICO if your policy is about to cancel or expire -for non-payment. Your designee will not have any rights or benefits under your policy other than the right to receive the notice or make a payment. You can change or remove the designee at any time. If you would like to add, change or remove a designee from your policy, simply log into your account at geico.com or call us at 1-800-841-3000. -In accordance with Section 1872.87 of the California Insurance Code, in addition to your premium, a $0.88 charge per vehicle is assessed to fund auto insurance fraud reduction initiatives. This charge is applied once per policy term per vehicle. -Your policy has been assessed a one-time fee to cover the cost of restarting your policy. This fee will not be reassessed at subsequent renewals. -Please verify that the coverages shown on these Declarations are those you desire. -Confirmation of coverage has been sent to your lienholder and/or additional insured. Continued on Next Page DEC —PAGE (03-14) (Page 2 of 4) New Policy Page 8 of 58 Important Policy Information -Your previous policy was terminated because the required payment was not received in time to stop the policy cancellation action in progress. We have reissued your policy with a lapse of coverage. -Since we expedited the mailing of your policy papers, the payment schedule may not reflect your most recent payment. DEC —PAGE (03-14) (Page 3 of 4) New Policy Page 9 of 58 Evidence of Insurance Here are your Evidence of Liability Insurance Cards. Two cards have been provided for each vehicle insured. One card must be carried in the proper insured vehicle. Proof of insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability insurance meeting the basic requirements of California law. A violation of these requirements can result in a fine of up to: $1,000 for the first time $2,000 for additional times Also, a judge can have your vehicle impounded. False proof of insurance may result in a fine up to $750 and 30 days in prison. Due to space limitations on the ID card, only the Named Insured and the Co-insured are listed. For a full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which is included with your insurance packet. If you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000. GEIC0m California Evidence of Liability Insurance geico.cam 1-800-841-3000 GEICO GENERAL INSURANCE COMPANY P.O. Box 509090 •San Diego, CA921,;5®9090 NAIC Code: 35882 Policy Number Effective Date Expiration Date 4520-85-89-13 12-20-18 06-20-19 Vehicle ID No. 3TMLU4EN3DM113151 The coverage provided by this policy meets the minimum requirements of sections 16056 & 16500.5 of the California Vehicle Code, minimum liability limits prescribed by the law. JEFFERY C CATHERS AND SHERYL A CATHERS 5875 MILLER AVE G I LROY CA 95020-6807 G ICM California Evidence of Liability Insurance saica.com 1-800-841-3000 GEICO GENERAL INSURANCE COMPANY P.O. Box 509090 • San Diego, CA921,;5, s,9090 NAIC Code: 35882 Policy Number Effective Date ¢' Expiration Date 4520-85-89-13 12-20-18 06-20-19 Year Make Model+ Vehicle ID No. 2013 TOYOTA TACOMA 3TMLU4EN3DM113151 Insured: Jeffery Carl Cathers She I Anne Cathers rJ 5875 Miller Ave Gilroy CA 95020-6807 The coverage provided by this policy meets the minimum requirements of sections 16056 & 16500.5 of the California Vehicle Code, minimum liability limits prescribed by the law. Rachel Munoz From: Sheryl Cathers <sherylcathers@me.com> Sent: Tuesday, April 16, 2019 12:16 PM To: Rachel Munoz Subject: Insurance To: City of GIlroy, Police Dept. Re: Anti Graffiti Artwork This is to confirm that I am self employed as sole proprietor of Dabble Art Center. I do not have any employees and therefore do not offer workers compensation. Thank You Sheryl Cathers Dabble Art Center 7680 Monterey St. Suite 106 Gilroy, CA 95020 408 427-2204 URL: dabbleartcenter.com Please detach license at this perf and post it in a conspicuous place. h IN