The URL can be used to link to this page

Tiburon - Insurance Certificate (2020)DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/22/2018 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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: Aon Risk Services Northeast, Inc. PHONE I FAX Boston MA office (A/C. No. Ext) (866) 283-7122 : (A/C. No.): (800) 363-0105 53 State Street E-MAIL Suite 2201 ADDRESS: Boston MA 02109 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 Coploclic, a RELX Inc Company INSURERB: Lloyd's Syndicate No. 2623 AA1128623 231 Market Place Suite 520 INSURER C: Zurich Insurance Plc AA1780059 San Ramon CA 94583 USA INSURER D: Zurich American Ins Co 16535 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570074373296 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY OGLG24876512 01/01/2019 01/01/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $1,000,000 CLAIMS -MADE X❑ OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2 , 00O 000 X POLICY ❑PRO ❑ LOC JECT OTHER: D AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED — ONLY _ AUTOS ONLY X Collision Ded $1,000 X Comp Ded $1,000 C UMBRELLA LIAB H OCCUR X EXCESS LIAB CLAIMS -MADE DED I (RETENTION D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below B E&O—PL—Primary PRODUCTS - COMP/OP AGG Liquor Liability Lim 8376848 20 01/01/2019 01/01/2020 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) 7053081 01/01/2019 12/31/2019I EACH OCCURRENCE (AGGREGATE $2,000,000 $5,000,000 $5,000,000 L 4) c Q d 0 rn N M (` M ti 0 0 ti L0 $5,000,000' V $5,000,000 $1,000,000 $1,000,000 $1,000,000 $3,000,000 $1,000,000 2 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 4j City of Gilroy is added as additional insured on the General Liability subject to the policy limitations, conditions and W exclusions. CERTIFICATE HOLDER CANCELLATION 837684520 01/01/2019 01/01/2020 X1 PER I IEORH E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE -POLICY LIMIT FSCE01900015 01/01/2019 12/31/2019 Aggregate Limit SIR applies per policy terns & condi-ions Per occurence SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE �r POLICY PROVISIONS. City of Gilroy AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy CA 95020 USA CA roazrje ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Northeast, Inc. coplogic, a RELX Inc Company POLICY NUMBER see Certificate Number: 570074373296 CARRIER NAIC CODE see certificate Number: 570074373296 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFFECTIVE EXPIRATION LIMITS LTR INSD wVD DATE DATE (MM/DD/YYYY) (MM/DD/YYYY) OTHER C E&O-PL-XS FSCE01900059 01/01/2019 12/31/2019 Any one Claim Aggregate $10,000,000 $10,000,000 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Aon Risk services Northeast, Inc. CoDloaic. a RELX Inc Company POLICY NUMBER see Certificate Number: 570074373296 CARRIER NAIC CODE see Certificate Number: 570074373296 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Companies Affording coverage LINE OF BUSINESS DESCRIPTION POLICY NUMBER POLICY POLICY EFFECTIVE EXPIRATION COMPANY DATE DATE (MM/DD/YYYY) (MM/DD/YYYI) E&O - Professional FSCE01900059 1/1/2019 12/31/2019 Zurich Insurance Plc Liability - Excess Excess Liability 7053081 1/1/2019 12/31/2019 Zurich Insurance Plc Coverage Workers Compensation - 837684520 1/1/2019 1/1/2020 Zurich American Ins Co Casualty Business Auto Coverage 8376848 20 1/1/2019 1/1/2020 Zurich American Ins co E&O - Professional FSCE01900015 1/1/2019 12/31/2019 Lloyd's Syndicate No. 2623 Liability - Primary E&O - Professional FSCE01900015 1/1/2019 12/31/2019 Lloyd's syndicate No. 623 Liability - Primary General Liability OGLG24876512 1/1/2019 1/1/2020 ACE American Insurance Coverage Company Page _ of _ NAIC PRIMARY PERCENTAGE (YN OF FLAG RISK AA1780 Y 100 AA1780 Y 100 16535 Y 100 16535 Y 100 AA1128 Y 82 AA1126 N 18 22667 Y 100 The Subscribing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co -subscribing insurer who for any reason does not satisfy all or part of its obligations. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD This page intentionally left blank.