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HomeMy WebLinkAboutCOI - Rebekah Children's Services - Certificate No. N/A | Start Date: 2024-02-01 | End Date: 2025-02-01 (2)ACOR®" REBECHI-02 CERTIFICATE OF LIABILITY INSURANCE SRSPATRA3 DATE (MM/DD/` 2/6/202, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR1— 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 ProCo Insurance Services 910 E Hamilton Ave #410 Campbell, CA 95008 INSURED Odd Fellow - Rebekah Children's Services 290 1OOF Avenue Gilroy, CA 95020 CONTACT Jeannie Kilekas NAME: (A /CC,NNo, Ext): (408) 510-5456 ADDRESS: jeannie.Kilekas@proco.global INSURER(S) AFFORDING COVERAGE FAX (A/C, No): INSURER A:Nonprofits Insurance Alliance of California INSURER B : Service American Indemnity Company INSURER C : NAIC # 39152 INSURER D : INSURER E : INSURER F : COVER """" "'^' ` '""'•""_"' REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS INSR IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYYI POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY - X CLAIMS EACH OCCURRENCE $ 1,000,000 -MADE OCCUR 2024-10268 2/1/2024 DAMAGE TO RENTED X Sex Abuse $1 M/$1 M 2/1/2025 PREMISES (Ea occurrence) $ 500 000 20,000 X Prof Liab $1M/$1M MED EXP (Any one person) $ 1 000 PERSONAL & ADV INJURY $ ,000 GEN'L X AGGREGATE LIMIT APPLIES PER: PE O GENERAL AGGREGATE $ 3,000,000 POLICY CT LOC PRODUCTS - COMP/OPAGG $ 3,000,000 A OTHER: $ AUTOMOBILE X LIABILITY COMBINED SINGLE LIMIT )Ea accident) $ 1,000,000 ANY AUTO OWNED SCHEDULED 2024-10268 2/1/2024 2/1/2025 BODILY INJURY (Per person) $ A AUTOS ONLY H RED AUTOS NON -OWNED BODILY INJURY (Per accident)_ $ A A TOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident) $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR EACH OCCURRENCE $ $ 5,000,000 CLAIMS -MADE 202410268UMB 2/1/2024 2/1/2025 5,000,000 AGGREGATE $ DED RETENTON$ ISC/SSP 2,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N SATIS0564100 Xy PER STATUTE EERH _ $ ANY PROPRIETOR/PAC NEED?ECUTIVE I a(Mandatory In NH) N/A 2/1/2024 2/1/2025 E.L.EACHACCIDENT $ 1,000,000 If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,000 D DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 A BPP 2024-10268 2/1/2024 2/1/2025 BPP Limit $ 1,999,072 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage. nr PTIMrAT= LJnI nco Blanket Al Gilroy, CA 95020-6141 ACORD 25 (2016/03) CANCELLATION 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 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and Togo are registered marks of ACORD AGENCY CUSTOMER ID: REBECHI-02 SRSPATRA3 ACG RD LOC #: 0 ADDITIONAL REMARKS SCHEDULE Page 1 c AGENCY ProCo Insurance Services POLICY NUMBER SEE PAGE 1 CARRIER SEE PAGE 1 ADDITIONAL REMARKS NAIC CODE SEE P 1 NAMED INSURED Odd Fellow - Rebekah Children's Services 290 IOOF Avenue Gilroy, CA 95020 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Employee Dishonesty Policy #: CCP9546363-04 Effective Date: 2/1/2024 - 2/1/2025 Carrier: Zurich Limit: $4,500,000 Employee Dishonesty Policy #: 202410268 Effective Date: 2/1/2024 - 2/1/2025 Carrier: Nonprofits' United Limit: $100,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD REBECHI-02 CERTIFICATE OF LIABILITY INSURANCE SRSPATRA3 DATE (MM/DDP Z/b/ZUZ. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR:—.." REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. '+.Y' 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 ProCo Insurance Services 910 E Hamilton Ave #410 Campbell, CA 95008 NAMEACT Jeannie Kilekas PHONE (A/C, No, Ext): (408) 510-5456 FAX No): ADDRIES• S. Jeannie.Kilekas@proco.global INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Nonprofits Insurance Alliance of California INSURED Odd Fellow - Rebekah Children's Services 290 IOOF Avenue Gilroy, CA 95020 INSURER B : Service American Indemnity Company 39152 INSURER C : INSURER D INSURER E : INSURER F : • KtVIJION NUMI3ER: 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 POLIC ES 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/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 2024-10268 2/1/2024 2/1/2025 EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR DAMAGE TO R(EaoNTEDence) $ 500,000 X Sex Abuse $1 M/$1 M MED EXP (Any one person $ 20,000 X Prof Liab $1 M/$1 M PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS NON -OWNED D 2024-10268 2/1/2024 2/1/2025 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 202410268UMB 2/1/2024 2/1/2025 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ ISC/SSP $ 2,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/ yEMBER EXCLUDED? (Mandator In NFFii)) If yes, describe under YIN N I A SATIS0564100 2/1/2024 2/1/2025 X STATUTE EEORH _ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E,L. DISEASE - POLICY LIMIT $ 1,000,000 A BPP 2024-10268 2/1/2024 2/1/2025 BPP Limit 1,999,072 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage. CANCELLATION Blanket Al Gilroy, CA 95020-6141 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 I'} ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: REBECHI-02 SRSPATRA3 ACORD LOC #: 0 ADDITIONAL REMARKS SCHEDULE Page 1 c AGENCY ProCo Insurance Services POLICY NUMBER SEE PAGE 1 CARRIER SEE PAGE 1 ADDITIONAL REMARKS NAIC CODE SEE P 1 NAMED INSURED Odd Fellow - Rebekah Children's Services 290 IOOF Avenue Gilroy, CA 95020 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Employee Dishonesty Policy #: CCP9546363-04 Effective Date: 2/1/2024 - 2/1/2025 Carrier: Zurich Limit: $4,500,000 Employee Dishonesty Policy #: 202410268 Effective Date: 2/1/2024 -2/1/2025 Carrier: Nonprofits' United Limit: $100,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD REBECHI-02 CERTIFICATE OF LIABILITY INSURANCE SRSPATRA3 DATE (MM/DD/` L/O/LUL, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR{«„ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. F 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 ProCo Insurance Services 910 E Hamilton Ave #410 Campbell, CA 95008 NAMEACT Jeannie Kilekas PHONE (A/C, No, Ext): (408) 510-5456 I (A/C, No): ROOK{Ess:jeannie.Kilekas@proco.global INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Nonprofits Insurance Alliance of California INSURED Odd Fellow - Rebekah Children's Services 290 IOOF Avenue Gilroy, CA 95020 INSURER B :Service American Indemnity Company 39152 INSURER C : INSURER D ; INSURER E : INSURER F : • '—"""—""' ^"'•"'_.`. RCVIJIUN NUIVICSCK: 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 POLIC ES 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 SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 2024-10268 2/1/2024 2/1/2025 EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 X Sex Abuse $1 M/$1 M MED EXP (Any one person) $ 20,000 X Prof Liab $1 M/$1 M PERSONAL&ADVINJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE X LIABILITY SCHEDULED 2024-10268 2/1/2024 2/1/2025 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY (Per accident)_ $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 202410268UMB 2/1/2024 2/1/2025 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION$ ISC/SSP $ 2,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBE� EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N / A SATIS0564100 2/1/2024 2/1/2025 Xy PER STATUTE OOTH ER EL. EACH ACCIDENT 1,000 000 $ r E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A BPP 2024-10268 2/1/2024 2/1/2025 BPP Limit 1,999,072 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requl ed) Evidence of coverage. Blanket Al Gilroy, CA 95020-6141 CANCELLATION 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: REBECHI-02 SRSPATRA3 ACORES' LOC #: 0 ADDITIONAL REMARKS SCHEDULE Page 1 c AGENCY ProCo Insurance Services POLICY NUMBER SEE PAGE 1 CARRIER SEE PAGE 1 ADDITIONAL REMARKS NAIC CODE SEE P 1 NAMED INSURED Odd Fellow - Rebekah Children's Services 290 IOOF Avenue Gilroy, CA 95020 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Employee Dishonesty Policy #: CCP9546363-04 Effective Date: 2/1/2024 - 2/1/2025 Carrier: Zurich Limit: $4,500,000 Employee Dishonesty Policy #: 202410268 Effective Date: 2/1/2024 - 2/1/2025 Carrier: Nonprofits' United Limit: $100,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD