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HomeMy WebLinkAboutEmpowering Our Community - Insurance Certificate (2019)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/2/2019 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 CONTI NAME: Jennifer Wells ONE CONNECT INSURANCE 1PHONE xt) (888)565 1326 FAX (A/C. No): 716 Capitola Ave Ste B AODRess: info(dlconnectinsurance.com Capitola, CA 95010 I INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : N IAC 524126 INSURED INSURERB: Employers 11512 Empowering Our Community for Success INSURER C E.O.C.S. I INSURER D 1764 Queenstown Drive I INSURER E : San Jose, CA 95132 I 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR IN510 WV❑ POLICY NUMBER (MM/DD/YYYYI (MMIDD/YYYYI I LIMITS COMMERCIAL GENERAL LIABILITY = CLAIMS -MADE �X OCCUR A x x 2018-45570 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOG JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO A AOUTOS ONLY AUTODULED x 2018-45570 XHIRED �/ NON -OWNED AUTOS ONLY /9 AUTOS ONLY UMBRELLA LAB OCCUR HCLAIMS-MADE EXCESS LAB DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNER/EXECUTIVE B OFFICER/MEMBER EXCLUDED? N / A EIG 2510957-00 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Professional Liability A Improper Sexual Conduct 6/20/2018 6/20/2019 6/20/2018 6/20/2019 IEACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) EACH OCCURRENCE AGGREGATE I X I PER STATUTE I I EERH 6/7/2018 617/2019 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ Professional Liability 2018-45570 6/20/2018 6120/2019 ImorocerSexual Conduct DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 1,000,000 500,000 20,000 1,000,000 1,000,000 1,000,000 1,000,000 1 I 1,000,000 I 1,000,000 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPP SENTATIVE I ©1988-2015 A RD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2018-45570 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFULLY. 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 Organization(s) City of Gilroy its officers, representatives, agents and employees 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 performance placed upon on you, as a nonprofit organization, in consideration for funding or financial contributions 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. 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 include as an additional insured the Person(s) Or Organization(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: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. C. The insurance shall be primary as respects the additional insured shown in the schedule above, or if excess, shall stand in an unbroken chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the additional insured scheduled above shall be in excess of this insurance and shall not be called upon to contribute with it. CG 20 26 07 04 © ISO Property, Inc., 2004 Page 1 of 1