HomeMy WebLinkAboutCOI - Stanford Health Care - Expires 2020-09-01CERTIFICATE OF LIABILITY COVERAGE
Issue Date
9/9/2019
ADMINISTRATOR
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
Aon Insurance Managers
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
P.O. Box HM 2450
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
Hamilton HM JX Bermuda,
COVERAGE DOUMENTS BELOW.
COVERAGE PROVIDER
SUMIT INSURANCE COMPANY LTD. (SUMIT)
COVERED PARTY
Stanford Health Care
Lucile Packard Children's Hospital Stanford
Stanford Health Care-ValleyCare
c/o 300 Pasteur Drive, Risk Mgmt MC5713
Stanford CA 94305
THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF COVERAGE
POLICY NUMBER
EFFECTIVE
EXPIRATION
COVERAGE LIMITS
LIABILITY COVERAGES
GENERAL LIABILITY
[✓] GENERAL LIABILITY
1-MO101-00-2019
9/1/2019
9/1/2020
Each Occurrence$ 1,000,000
A Claims Made
[ ] Occurrence
[ ]
General Aggregate $ 3,000,000
PROFESSIONAL LIABILITY
[ ] PROFESSIONAL LIABILITY
Each Occurrence $
[ ] Claims Made
[ ] Occurrence
[ ]
Aggregate $
OTHER COVERAGES
DESCRIPTION OF OPERATIONS I LOCATIONS I RESTRICTIONS I SPECIAL PROVISIONS:
Re: Agreement between The City of Gilroy and Stanford Health Care for Professional Services (Emergency Medical Services) 8/2017 - Ongoing
The City of Gilroy, its elected or appointed officals, boards, agencies, officers, agents, employees, and volunteers, and its elected or appointed
officals, boards, agencies, officers, agents, employees, and volunteers, are included as additional insureds.
SUMIT's general liability policy is a claims -made policy with an extended reporting period ("tail"). The extended reporting period is unlimited.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE
Emergency Medicine
EXPIRATION DATE THEREOF, SUMIT WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Gilroy Fire Department
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
7070 Chestnut Street
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THIS ENTITY, ITS AGENTS
Gilroy CA 95020
OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Aon Insurance Managers (Bermuda) Ltd.
Aon Insurance Managers
51042300 1 19-20 GI, Only I Janet Sencenbaugh 1 9/9/2019 5:40:14 PM (PDT) I Page I of 2
IMPORTANT
If the certificate holder is an ADDITIONAL COVERED PERSON, the policy(ies) must be endorsed. A
statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
DISCLAIMER
This certificate does not constitute a contract between SUMIT and the Certificate Holder,
nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the coverage
documents listed theron.
eCcilAhihm: ami
51042300 1 19-20 GL Only I Janet Sencenbaugh 1 9/9/2019 5:40:14 PM (PDT) I Page 2 of 2