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Home My WebLink AboutStick & Move Amatuer Boxing Club - Insurance CertificateSTICAMA -01 AMANDA ,4C0/eoT CERTIFICATE OF LIABILITY INSURANCE kk� DATE(MM /DD/YYYY) 08/09/2017 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 endorse m_ ent. A-statement on -- this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0504035 - Pacific Diversified Insurance, Inc. 15005 Concord Circle, Suite 110 408 -842 -2131 Morgan Hill, CA 95037 NOMTACT Amanda Link, CISR, CL_ C_ S PHONE FAX (A/C, No, Eutp (A/C, Nop — EDDRESS allnk aepdins.com INSURERS ) AFFORDING COVERAGE _ NAIC # INSURER A: Penn-Star Insurance Co INSURED Stick -N -Move Amatuer Boxing Club 7400 Railroad Street Gilroy, CA 95020 INSURER B 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 IN SR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF yyyyl POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X C 08/31/2017 - 08/31/2018 - EACH OCCURRENCE Is 1,000,000 DAMAGE TO RENTED P R EMISE Ea o_c�y ence MED EXP (Any one person) $ 500,000 $ - 5,000 - PERSONAL & ADV INJURY - 1,000,000 h"L AGGREGATE LIMIT APPLIES PER POLICY 1 PE R 8-- LOC OTHER • GENERAL AGGREGATE — 2,000,000 $ — - - — PRODUCTS - COMP /OP AGG $ Included $ - AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY A�TOS ONLDY COMBINED SINGLE LIMIT - Ea accdent) BODILY INJURY Per arson - -- - - $ $ BODILY BODILY INJURY Per accident $ PROPERTY accidentDAMAGE $ UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE MFand toryan NHR EXCLUDEDI If yes, describe under DESCRIPTION OF OPERATIONS below N PER IOTH- I STATUTE ER EL EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE -POLICY LIMIT I $ i DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached d more space is required) Re: 7400 Railroad St., Gilroy, CA 95020 City of Gilroy, its officers, officials, and employees are hereby named as additional insureds in regards to the General Liability Policy where required by written contract. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY y ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy, CA 95020 AUTHORIZED R ENTATIVE /J 25 (2016/03) L/ ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD