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HomeMy WebLinkAboutCOI - Sharks Ice, LLC - Expires 2024-02-04ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD SHARK-1 OP ID: DB 10/03/2023 Jessica Huang EQ Professional Ins Assoc. P.O. Box 830 Los Gatos, CA 95031 Jessica Huang 888-343-8685 dabbie@expertquote.com Pennsylvania Manufacturers QBE Ins Corp. Sharks Sports & Entertainment525 W Santa Clara StreetSan Jose, CA 95113 A X 1,000,000 X X 3023011138668 02/04/2023 02/04/2024 1,000,000 X 02/04/2023 02/04/2024 Excluded 1,000,000 None X 2,000,000 1,000,000 1,000,000A X 1523011138668 02/04/2023 02/04/2024 XX 5,000,000A 6523011138668 02/04/2023 02/04/2024 5,000,000 10,000X B 100044890 02/04/2023 02/04/2024 Limit/Ded $5M/$25K A Sexual Misconduct 3023011138668 02/04/2023 02/04/2024 Limit $1M/$2M RE: Gilroy Ice Center City of Gilroy, its officers and employees are additional insureds per ttached endorsement. 30 days written notice of policy lapse or cncellation, or of a material change applies, except 10 days notice for non-payment of premium. GILRO00 City of Gilroy 7351 Rosanna St Gilroy, CA 95020 888-343-8685 12262 39217 Liquor 3023011138668Liquor Liability Media Liability DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF COMMERCIAL GENERAL LIABILITY PGL 48 24 11 17 PGL 48 24 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission Pennsylvania Manufacturers’ Association Insurance Company, 2017 Page 1 of 4 o COMMERCIAL GENERAL LIABILITY ENHANCEMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Amendments Contained in this Endorsement: Amendment Of Liquor Liability Exclusion Non Owned Watercraft Personal Property Loaned Or In Your Care, Custody Or Control Damage To Rented Premises – Fire, Lightning Or Explosion Bail Bonds Loss Of Earnings Additional Insureds Newly Acquired Organizations Time Period Damage To Premises Rented To You Limit Medical Expense Limit Duties – Reporting As Worker's Compensation & Knowledge Of Occurrence Other Insurance – Fire, Lightning Or Explosion Representations – Unintentional Errors Waiver Of Rights Of Recovery Mental Anguish A.The following changes are made to Section I – Coverages – Coverage A Bodily Injury And Property Damage Liability 1. Amendment Of Liquor Liability Exclusion Paragraph 2. , Exclusions- c. Liquor Liability is deleted in its entirety and replaced by the fol- lowing: a."Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1)Causing or contributing to the intoxica- tion of any person; (2)The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3)Any statute, ordinance or regulation re- lating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you: (a)Manufacture, sell or distribute alco- holic beverages; (b)Serve or furnish alcoholic beverages for a charge whether or not such ac- tivity: (i)Requires a license; (ii)Is for the purpose of financial gain or livelihood; or (iii)Serve or furnish alcoholic bever- ages without a charge, if a li- cense is required for such activi- ty. However, this exclusion does not apply to "bodily injury" or "property damage" arising out of the selling, serving or furnishing of alcoholic beverages at functions sponsored, organized or hosted by you. 2. Non Owned Watercraft Paragraph 2., Exclusion g. Aircraft, Auto or Watercraft, is amended by the replacement of item g. (2) (a) with the following: (2)A watercraft you do not own that is: (a)Less than 52 feet long; and 3. Personal Property Loaned To You Or In Your Care, Custody or Control Paragraph 2., Exclusion j. Damage to Proper- ty is amended by the replacement of item(s) j. (3)and (4) with the following: (3)Property loaned to you; INSURED COPY POLICY NUMBER: 3023011138668 DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission Pennsylvania Manufacturers’ Association Insurance Company, 2017 PGL 48 24 11 17 o However, if the business designated in the Declarations is other than “contracting”, “servicing”, or “rental”, this exclusion does not apply to "property damage" to personal property that is loaned to you, but only if the damage is caused by your negligence. The most we will pay is $25,000 for each “occur- rence”. This limit is part of the Each Occur- rence Limit and not in addition to the Each Occurrence Limit. (4)Personal property in the care, custody or control of the insured; However, if the business designated in the Declarations is other than “contracting”, “servicing”, or “rental”, this exclusion does not apply to "property damage" to personal property that is in your care, custody or control, but only if the damage is caused by your negligence. The most we will pay is $25,000 for each “occurrence”. This limit is part of the Each Occurrence Limit and not in addition to the Each Occurrence Limit. Any payment for the same occurrence de- scribed in paragraphs (3) or (4) above will re- duce the amount of insurance remaining under the other paragraph and is subject to the same maximum limit. 4. Damage To Premises Rented To You The last paragraph of 2., Exclusions is delet- ed in its entirety and replaced by the following: Exclusions c. through n. do not apply to dam- age by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III – Limits of Insurance. 5.Supplementary Payments – Bail Bonds and Loss of Earnings Paragraphs 1.b. and 1.d. of Supplementary Payments – Coverages A and B are deleted in its entirety and replaced by the following: b.Up to $2500 for cost of bail bonds required because of accidents or traffic law viola- tions arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d.All reasonable expenses incurred by the in- sured at our request to assist us in the in- vestigation or defense of a claim or "suit", including actual loss of earnings up to $500 a day. B.Section II – Who Is An Insured is amended as follows: 1.The following are added as additional insureds when you have agreed in a written contract or written agreement that such person or organi- zation be added as an additional insured on your policy: a. Managers Or Lessors Any managers or lessors of premises but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and sub- ject to the following exclusions which apply in addition to the Section I paragraph 2 ex- clusions: This insurance does not apply to: (1)Any "occurrence" which takes place af- ter you cease to be a tenant in that premises. (2)Structural alterations, new construction or demolition operations performed by or on behalf of the person or organiza- tion from whom you rent or lease a premises. b.Lessors Of Equipment Any person or organization from whom you lease equipment. Such person or organiza- tion is an insured only with respect to liabil- ity for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, op- eration or use of equipment leased to you by such person or organization. A person’s or organization’s status as an additional in- sured under this endorsement ends when their contract or agreement with you for such leased equipment ends. c.Governmental Agencies Or Political Sub- divisions Any state or governmental agency or politi- cal subdivision subject to the following ex- clusions which apply in addition to the Sec- tion I paragraph 2 exclusions: (1)This insurance applies only with re- spect to: (a)Premises you own, rent, or control; or (b)Operations performed by you or on your behalf; for which the state or governmental agency or subdivision or political subdi- vision has issued a permit or authoriza- tion. (2)This insurance does not apply to: INSURED COPY DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF PGL 48 24 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission Pennsylvania Manufacturers’ Association Insurance Company, 2017 Page 3 of 4 o (a)"Bodily injury", "property damage" or "personal and advertising injury" aris- ing out of operations performed for the government, state or municipali- ty; or (b)"Bodily injury" or "property damage" included within the "products- completed operations hazard". d. Mortgagee, Assignee Or Receiver Any person or organization who is a mort- gagee, assignee or receiver of your prem- ises or business, but only with respect to their liability as mortgagee, assignee, or re- ceiver and arising out of the ownership, maintenance, or use of the premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. However, the written contract or written agreement referenced in paragraph 1. above must be: (1)In effect at the inception of the policy peri- od or become effective during the policy period; and (2)Executed prior to the “bodily injury”, “prop- erty damage”, “personal and advertising in- jury” covered under this coverage part. The Limits of Insurance applicable to the addi- tional insureds in a., b. and c.,above are those specified in the valid written contract or written agreement or in the Declarations for this policy, whichever is less. These Limits of Insurance are part of and not in addition to the Limits of Insurance shown in the Declarations. In addi- tion, (a)The insurance afforded to such additional insured(s) only applies to the extent permit- ted by law; and (b)The insurance afforded to such additional insured(s) will not be broader than that which you are required by the contract or written agreement to provide for such addi- tional insured. 2.Paragraph 3.a. is replaced by the following: a.Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the poli- cy period, whichever is earlier; C.Section III – Limits of Insurance is amended as follows: Paragraph 6. Is deleted in its entirety and replaced by the following: 6.Damage To Premises Rented To You Subject to Paragraph 5. above, the Dam- age To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of “property damage” to any one premises; a.W hile rented to you; or b.In the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with per- mission of the owner. The Damage To Premises Rented To You Limit is the greater of $300,000 or the limit shown on the Declarations page. Paragraph 7. Is deleted in its entirety and replaced by the following: 7.Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses be- cause of "bodily injury" sustained by any one person. The Medical Expense Limit is the greater of $10,000 or the limit shown on the Declara- tions page. D.Section IV – Commercial General Liability Con- ditions is amended as follows: 1.The following is added to Condition 2. Du- ties in the Event of Occurrence, Offense, Claim or Suit: e.In the event that an insured reports an inju- ry, accident, or occurrence to the worker’s compensation carrier of the Named In- sured, and which later develops into a General Liability claim to which this insur- ance applies, the failure to report such “oc- currence” to us at the time of the “occur- rence” shall not be deemed a violation of this condition. You must, however, give us notice as soon as practicable after being made aware that the particular claim is a General Liability claim rather than a Work- er’s Compensation claim. f.If your “employee” or agent knows of an “occurrence” or offense which may result in a claim under this policy, you will not be considered to have knowledge of that “oc- currence” or offense until your “employee” or agent reports it to: (1)You, if you are an individual; (2)A partner, if you are a partnership; (3)An “executive officer” or the “employee” designated by you to give notice to us of such “occurrence” or offense, if you are a corporation; INSURED COPY DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission Pennsylvania Manufacturers’ Association Insurance Company, 2017 PGL 48 24 11 17 o (4)A manager, if you are a limited liability company; or (5)A trustee, if you are a trust. 2.Condition 4. Other Insurance item b.(1)(a)(ii) of the Commercial General Liability Occur- rence Form and item b.(1)(a)(iii) of the Com- mercial General Liability Claims Made Form is replaced by the following: That is Fire, Lightning or Explosion insurance for premises rented to you or temporarily occu- pied by you with permission of the owner; 3.Condition 6. Representations is deleted in its entirety and replaced by the following: Representations a.By accepting this policy, you agree: (1)The statements in the Declarations are accurate and complete; (2)Those statements are based upon rep- resentations you made to us; and (3)We have issued this policy in reliance upon your representations. b.It will not be considered a violation of this condition if you: (1)Unintentionally fail to disclose all haz- ards existing at the inception of this poli- cy; or (2)Unintentionally make an error, omission or provide an improper description of premises or other statement of infor- mation in applying for this insurance. c.You must notify us as soon as possible after the discovery of any hazards, errors or omissions in the information provided or any other relevant information that was not provided to us prior to the acceptance of this policy. 4.Condition 8. Transfer of Rights of Recovery Against Others To Us is amended by the ad- dition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage if there is a contract, executed prior to the loss, with that person or organization that requires you to waive rights of recovery. E.Section V – Definitions (Commercial General Liability Occurrence Form) and Section VI Defi- nitions (Commercial General Liability Claims Made Form) are amended as follows: 1.Definition 3. in the Definitions Section is re- placed by the following: 3."Bodily injury” means bodily injury, sickness or disease sustained by a person including mental anguish, emotional distress, humilia- tion or death resulting from bodily injury, sickness or disease. 2.The following definitions are added: “Contracting” means an establishment whose principal operation involves installation, con- struction, demolition or maintenance. This in- cludes any owner-contractor, general contrac- tor or subcontractor, whether or not he/she actually performs any part of such work or has employees on the site. “Servicing” means an establishment whose principal operation is in providing of a personal or commercial service. Included are establish- ments providing entertainment or recreation, or warehousing of property of others. “Rental” means an establishment whose prin- cipal operation is providing temporary use of a good, service or property in exchange for a monetary payment. INSURED COPY DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. DocuSign Envelope ID: 2B3064C4-9807-48A0-9832-471D170847BF