HomeMy WebLinkAboutSecond Harvest Food Bank - Insurance Certificate (2019)279841
ACC) " CERTIFICATE OF LIABILITY INSURANCE
DATE
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
3 /2 /20D/YYYY)
3/2/2018
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: Susan Boutchie
Commercial Lines - (628) 201 -9001
PHONE FAX
A/c No, Ext : (628) 201 -9041 we No
USI Insurance Services National, Inc. - CA Lic #: OD08408
PHPK1785657
AE-MAIL susan.boutchie @usi.com
201 Mission St, 11th Floor
EACH OCCURRENCE
S 1,000,000
INSURER(S) AFFORDING COVERAGE
NAIC#
San Francisco, CA 94105
INSURER A: Philadelphia Indemnity Insurance Company
18058
INSURED
INSURER B
Second Harvest Food Bank
INSURER C
PERSONAL & ADV INJURY
of Santa Clara and San Mateo Counties
INSURER D
750 Curtner Avenue
INSURER E:
AGGREGATE LIMIT APPLIES PER:
San Jose CA 95125
INSURER F:
COVERAGES CERTIFICATE NUMBER: 12802217 REVISION NUMBER: See below
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
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM /DDIYYYY
POLICY EXP
MM /DD /YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
X
PHPK1785657
03/01/2018
03/0112019
EACH OCCURRENCE
S 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
S 1,000,000
MED EXP (Any one person)
$ 20,000
PERSONAL & ADV INJURY
S 1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S 2,000,000
GEN'L
X
POLICY —1 PRO JECT ❑ LOC
PRODUCTS - COMP /OP AGG
S 2,000,000
Per Occ /Agg
S 1,000,000
X
OTHER: Sexual Abuse molestation
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
5
BODILY INJURY (Per person)
S
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS AUTOS ONLY AUTOS ONLY
D
PROPERTY DAMAGE —
(Per accident
$
I
1
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTIONS
$
WORKERS COMPENSATION
PER OTH-
AND EMPLOYERS' LIABILITY YIN
STATUTE ER
E.L. EACH ACCIDENT
$
ANYPROPRIETOR/PARTNER /EXECUTIVE
OFFICERIMEMBER EXCLUDED?
NIA
E.L. DISEASE - Fes, EMPLOYEE
S
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
7
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Gilroy, its officers, employees, and agents are included as additional insureds as respects General Liability in accordance with the terms and
conditions of the policy.
CERTIFICATE HOLDER CANCELLATION
City of Gilroy, its agents, officers and employees
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7351 Rosanna Street
ACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy CA 95020
AUTHORIZED REPRESENTATIVE
The ACORD name and logo are registered marks of ACORD @ 1988 -2015 ACORD CORPORATION. All rights reserved.
ACORD „ °0.0„ u11111 1ui 1� 111 1u 1E lit EimPu1 1u 111 1u 1111111 11i ,_.._....
POLICY NUMBER: PHPK1785657 COMMERCIAL GENERAL LIABILITY
CG 20 26 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endurst-ment modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
City of Gilroy, its 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.
A, Section it - Who Is An Insured is amended to
include as an additional insured the person(s) or
arganization(s) shown in the Schedule, but only
with respect to liability for "bodily injury ", "property
damage" 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:
1. In the performance of your ongoing operations;
W
2. In connection with your premises owned by or
rented to you,
However;
1. The insurance afforded to such additional
insured only applies to the extent permitted by
lave; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional lnsured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section fit - Limits Of Insurance--
If coverages provided to the additional insured is
required by a contract or agreement, the most we
wiff pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2, Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase: the
applicable Limits of Insurance shown in the
Declarations.
CG 20 26 04 13 O Insurance Services Office, Inc., 2012 Page 1 of 1
' CYB01 A05/001090/03/03/01010/0'