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HomeMy WebLinkAboutGilroy Downtown Business Association - Insurance CertificateGILRDOW -01 PATRA2 144C°'`i° CERTIFICATE OF LIABILITY INSURANCE DAT 8 /11/2 DIYYYY) 8/1 /2012 AD L INSR 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. POLICY NUMBER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). POLICY EXP MM /DD/YYYY� LIMITS PRODUCER License # 0726293 '. Chapman a Division of Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. PO Box 5455 Pasadena, CA 91117 -0455 CONTACT NAME: X PHONE 1 626 405 -8031 FAX Al c No Ell: ( ) A/c No): 1 (626) 405 -0585 201208723NPO E -MAIL ADDRESS: 8111/2013 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Nonprofits' Insurance Alliance of California 011845_ INSURED Gilroy Downtown Business Assocation P.O. BOX 2310 Gilroy, CA 95021 INSURER B: PERSONAL & ADV INJURY $ 1,000,000 INSURER C: INSURER D: $ 3,000,000 INSURER E: PRODUCTS - COMP /OP AGG 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 LTR TYPE OF INSURANCE AD L INSR UBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY� LIMITS I�i, A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X Liquor Liab X 201208723NPO 8/1112012 8111/2013 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO T LOC PRODUCTS - COMP /OP AGG $ 3,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS HIRED AUTOS X NON -OWNED AUTOS 201208723NPO 811112012 8/11/2013 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- 1OTH- TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ -- E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Gilroy, its Officers, Employees and Special Agents are named additional insured only as respects their interest in the event per the attached CG 2026 endorsement. CERTIFICATE HOLDER CANCELLATION City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 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 a,g_ ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:201208723NPO COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanizationlsl Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, and for which a certificate of insurance naming such person or organization as additional insured has been issued, but only with respect to their liability arising out of their requirements for certain perform- ance placed upon you, as a nonprofit organization, in consideration for funding or financial contribu- tions you receive from them. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. City of Gilroy, its Officers, Employees and Special Agents Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑ GILRDOW -01 PATRA2 ACQROI" �.,..� CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 81112012 ADDL INSR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS POLICY NUMBER CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES POLICY EXP MM /DD/YYYY ) BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. X IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to 201208723NPO 8/11/2012 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). $ 1,000,000 PRODUCER License # 0726293 CONTACT NAME: Chapman PHONE No El: :1 (626) 405 -8031 aI /c No ; 1 (626) 405 -0585 a Division of Arthur J. Gallagher & Co. E-MAIL Insurance Brokers of California, Inc. ADDRESS: PO Box 5455 $ 500,000 MED EXP (Any one person) $ 20,000 Pasadena, CA 91117 -0455 INSURER(S) AFFORDING COVERAGE NAIC # $ 1,000,000 INSURER A: Nonprofits' Insurance Alliance of California 011845 _ INSURED INSURER B : $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PE OT- LOC PRODUCTS - COMP /OP AGG Gilroy Downtown Business INSURER C : Association P.O. BOX 2310 INSURER D : Gilroy, CA 95021 INSURER E : $ A AUTOMOBILE 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 LTR TYPE OF INSURANCE ADDL INSR UBR WVD POLICY NUMBER POLICY EFF (MWDDIYYYY POLICY EXP MM /DD/YYYY ) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X Liquor Liab X 201208723NPO 8/11/2012 8/11/2013 EACH OCCURRENCE $ 1,000,000 PREMISES Eaoccurrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PE OT- LOC PRODUCTS - COMP /OP AGG $ 3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 201208723NPO 8/11/2012 8111/2013 COMBINED SINGLE LIMIT O accident $ 1,000,000 X X _ X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ _ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRO PRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- 1OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ -- E.L. DISEASE - POLICY LIMIT - $ II DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: 7780 Monterey St. Gilroy. City of Gilroy, its Officers, Officials, Employees and Special Agents are named additional insured with respect to the operations of the named insured per the attached CG 2011 endorsement. I I CERTIFICATE HOLDER CANCELLATION City of Gilroy, its Officers, Officials Employees and Special Agents 7351 Rosanna Street Gilroy, CA 95020 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 oju__ ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:201208723NPO COMMERCIAL GENERAL LIABILITY CG 2011 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES = This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased to You): Re: 7780 Monterey St. Gilroy 2. Name of Person or Organization (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming ffective during the term of this policy, and for which a certificate of insurance naming that person or organization as additional insured has been issued. City of Gilroy, its Officers, Officials, Employees and Special Agents 3. Additional Premium: INCLUDED (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the prem- ises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 ❑ GILRDOW -01 PATRA4 ACCOmi� D DATE (MM /DD/YYYY) 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 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 License # 0522024 N CONTACT PHONE FAX E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE N NAIC # _INSURER A: Nonprofits' Insurance Alliance N NIAC _ INSURER C: 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 T TYpE OF INSURANCE L L U U P POLICY NUMBER M POLICY EFF P POLICY EXP L LIMITS A X GENERAL LIABILITY E X 2 201108723NPO 8 8/1112011 8 8/11/2012 P EACH OCCURRENCE $ $ 1,000,000 PREMISES Eaoccurrence $ $ 500,000 MED EXP (Any one person) $ $ 20,000 PERSONAL & ADV INJURY $ $ 1,000,000 X L Liquor Liab G GENERAL AGGREGATE $ $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: P PRODUCTS - COMP /OP AGG $ $ 3,000,000 $ A X AUTOMOBILE L LIABILITY C 201108723NPO 8 8/1112011 8 8/1112012 B COMBINED SINGLE LIMIT Ea accident $ $ BODILY INJURY (Per person) $ $ 1,000,000 BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE $ $ $ UMBRELLA LIAB O OCCUR E EACH OCCURRENCE $ $ AGGREGATE DED I I RETENTION $ $ $ WORKERS COMPENSATION W NIA WC STATU- ' OTH- E.L. EACH ACCIDENT $ $ E.L. DISEASE - EA EMPLOYEE $ $ E.L. DISEASE - POLICY LIMIT $ $ i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: 7780 Monterey St. Gilroy. City of Gilroy, its Officers, Officials, Employees and Special Agents are named additional insured with respect to the operations ,of the named insured per the attached CG 2011 endorsement. I CERTIFICATE HOLDER CANCELLATION City of Gilroy, its Officers, Officials A 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 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 201 108723NPO COMMERCIAL GENERAL LIABILITY CG 20 11 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased to You): 7780 Monterey St. Gilroy. 2. Name of Person or Organization (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming effective during the term of this policy, and for which a certificate of insurance naming that person or organization as additional insured has been issued. City of Gilroy, its Officers, Officials, Employees and Special Agents 3. Additional Premium: INCLUDED (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the prem- ises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 11