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HomeMy WebLinkAboutYMCA - Insurance CertificateClient #: 443977 YMCASILIC ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 1. 12/04/2017 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 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 Marsh & McLennan Agency LLC Marsh &McLennan Ins Agency LLC 1340 Treat Blvd #250 Lic OH18131 Walnut Creek, CA 94597 NAME: Felicia McAroy PHONE Fax A/C No Ext :925 482 -9300 A /c, No ; 925 482 -9390 ADDRESS: Felicia.McAroy @MarshMMA.com INSURER(S) AFFORDING COVERAGE NAIC k INSURER A : North River Insurance Company 21105 INSURED YMCA of Silicon Valley 80 Saratoga Avenue Santa Clara, CA 95051 INSURER B: United States Fire Insurance Co 21113 INSURER C: $1,000,000 INSURER D: MED EXP (Any one person) INSURER E INSURER F: PERSONAL & ADV INJURY $1,000,000 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 SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD /YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR X 5068898919 07/01/2017 07/01/2018 EACH OCCURRENCE $110001000 PREMISESOEa occur ante $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY I JECOTI LOC OTHER: GENERAL AGGREGATE $3,000,000 PRODUCTS - COMP /OP AGG $1,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 5068898919 7/01 /2017 07/01 /201 E° .deotslNGLELIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB EXCESS LIAR X I OCCUR CLAIMS -MADE 5821082127 7/01/2017 07/01/2018 EACH OCCURRENCE $110001000 AGGREGATE $1,000,000 DED I X RETENTION $O $ A •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 N/A 4087316214 07/01/2017 07/01/2018 X PER oTH- TAT TE ER E L. EACH ACCIDENT $1 OOO OOO E L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Event on 10/01/2017 to 09/30/2021, Child and. Adult Care Food program (CACFP) and Summer Food Service Program (SFSP), Gilroy Youth Center, 227 IOOF Ave., Gilroy, CA 95020. City of Gilroy, its agents, officers and employees are included as Additional Insured (General Liability), per the attached. City of Gilroy, Recreation Department 7351 Rosanna Street Gilroy, CA 95020 ACORD 25 (2014/01) 1 Of 1 #S3130626/M2818003 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 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WXPXS INSURED: YMCA ofsdioonvalley POLICY #: soseesasts POLICY PERIOD: 07/01/2017 TO o7lov2ot8 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL. INSURED - DESIGNATED PERSON OR ORGANIZATION This ehdorsernent modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Gilroy, it's agents, officers and employees 7351 Rosanna Street Gilroy, CA 95020 Information required to complete this Schedule If not shown above, will be shown In the Declarations. Sectlon II — Who Is An Insured is amended to In- clude as an additional insured the person(s) or organi- zation(s) shown In the Schedule, huf only with respect to IlablUty for 'bodily injury", "property damage" or 'pamonal and advertising injury" caused, in whule or In part, by your acts or omissions or the acts or omis- slons of those acting on your behalf. A. In the performance of your ongoing operations, or H. 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