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HomeMy WebLinkAboutSLO Childrens Museum Insurance Letter___1 JAN 0 6 2011 SANLUIS-15 LDOUST ACOR TI IATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) - 1/3/2017 THIS CERTIFIC TiiS-`1SSUEDAS A NIA 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(les) must 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 License # OE02096 NAM ACT DiBuduo & DeFendis Insurance Brokers, LLC PHONE SAX 100 Cross Street, Suite 104 Uuc, N�,Ext): (805) 593-1400 i,vc, NQ)_(8o5) 593-1401 San Luis Obispo, CA 93401 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC M INSURED San Luis Obispo Children's Museum 1010 Nipomo Street San Luis Obispo, CA 93401 INSURER A: Nonprofits Insurance Alliance of California 29700 4�)I INSURER B: Zurich American Ins. Co. At XV 16535 INSURER C; ` INSURER D INSURER E : 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 VIMICH 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- tiODL 1UBRP&L-10—EFF POLICY EXP LTR TYPE OF INSURANCE SD WVD POLICY NUMBER (MMIDONYYY)_(MMIDDIYYYYJ_ LIMITS A X COMMERCIAL GENERAL LIABILITY I =OCCURRENCE $ 1,000,00 X X 201601639NPO 06105/2016 06/05/2017 S� LU 500,00 CLAIMS -MADE OCCUR PR $ MED EXP JAny one person) $ _ 20,000 PERSONAL& ADV INJURY $ 1,000,00 kGEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,00 POLICY PRO -X LOC ❑ PRODUCTS -COMP/OP AGG . $ 2,000,00 OTHER: OTHER: $ _ _ _ _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea 8cCtfer@ ANY AUTO I BODILYINJURY (Per person) $ ALL OWNED SCHEDULED BODILYINJURY(Per accident) $ AUTOS AUTOS NON -OWNED O DAMAGE $ HIREDAUTOS AUTOS Peracrrd $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED RETENTION $ ` $ WORKERS COMPENSATION PER Of" - X ER AND EMPLOYERS' LIABILITY AND YIN B ANY PROPRIETOR/PARTNER/EXECUTIVE WC919592804 08/01/2016 08/01/2017 EL EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N 1A 1,000,00 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E L, DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as an Additional Insured for General Liability per form CG 20 26 04 13 attached and where required by written contract or agreement respects 1010 Nipomo Street, San Luis Obisp, CA CERTIFICATE HOLDER City of San Luis Obispo City Clerk's Office 990 Palm Street San Luis Obispo, CA 93401 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 4( © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2016-01639 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. 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): 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. 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. A. 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: 1. In the performance of your ongoing operations; or 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 law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured 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 III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will 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 © Insurance Services Office, Inc., 2012 Page 1 of 1 City Administration 990 Palm Street, San Luis Obispo. CA 93401-3249 ' 805 781 7114 December 28, 2016 San Luis Obispo Children's Museum 1010 Nipomo Street San Luis Obispo, Ca 93401 Subject: Expired Insurance Certificates for San Luis Obispo Children's Museum To Whom It May Concern: Our records indicate the following insurance coverage(s) will expire as of the referenced date below. According to the contract, you must maintain insurance coverage throughout the term of the contract. We would greatly appreciate your prompt attention to this matter. Worker's Comp/Emp. Liability: Expiration date: 08/1/2016 For General Liability coverage, you will need to submit a binder or certificate of insurance with the "Additional Insured Endorsement" prior to the date of expiration. If you submit a binder, you will need to send the certificate of insurance and the "Additional Insured Endorsement" once it is issued. The documents may be emailed in advance to hgoodwinAslocity.org and then hard copies mailed. All documents should be sent to: City of San Luis Obispo Attn: City Clerk's Office 990 Palm Street San Luis Obispo, CA 93401 If you have any questions, please phone me at (805) 781-7103. Our fax number is (805) 781-7109. Sincerely, � �U Heather Goodwin Deputy City Clerk ___541i SANLUIS-15 LDOUST 'AC_ CERTIFICATE OF LIABILITY INSURANCE DATDVYYY) �� 6 6/9/2/9/2016 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(les) must 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 License # OE02096 DiBuduo & DeFendis Insurance Brokers, LLC 100 Cross Street, Suite 104 San Luis Obispo, CA 93401 INSURED San Luis Obispo Children's Museum 1010 Nipomo Street San Luis Obispo, CA 93401 593-1400 FAX NL1�; [8D5j 593-1401 ll INSURERS AFFORDING COVERAGE NAIC # (�N F 7016 INSURER A: Nonprofits Insurance Alliance of California 29700 , INSURER B: Zurich American Ins. Co. Ale 16535 INSURER C : INSURER D: INSURER E: 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. Nsill TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP T- .INSD WVD. POLICY NUMBER MMIDD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR I X I 1201601639NPO 06/05/2016 06/05/2017 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 17 PRO FX LOC JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EXCESS LAB CLAIMS -MADE _ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [:]N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WC919592803 LIMITS EACH OCCURRENCE $ DAli RENTED PRE ISES tEa oceumancs $ 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 DA $ Per accident EACH OCCURRENCE $ AGGREGATE $ $ 1 1 08/01/2015 08/01/2016 .E,LEACH ACCIDENT I $ 1,000,0 E.L. DISEASE - EA EMPLOYE $ 1,000,0 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is named as an Additional Insured for General Liability per form CG 20 26 04 13 attached and where required by written contract or agreement As respects 1010 Nipomo Street, San Luis Obisp, CA TE City of San Luis Obispo City Clerk's Office 990 Palm Street San Luis Obispo, CA 93401 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 A4� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2016-01639 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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): 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. 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. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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: 1. In the performance of your ongoing operations; or 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 law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured 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 III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will 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 0 Insurance Services Office, Inc„ 2012 Page 1 of 1 City Administration 990 Palm Street, San Luis Obispo, CA 93401-3249 805.781.7114 slocity org April 08, 2016 San Luis Obispo Children's Museum 1010 Nipomo Street San Luis Obispo, Ca 93401 Subject: Expired Insurance Certificates for San Luis Obispo Children's Museum To Whom It May Concern: Our records indicate the following insurance coverage(s) will expire as of the referenced date below. According to the contract, you must maintain insurance coverage for the duration of the term, as outlined in the attached excerpt. We would greatly appreciate your prompt attention to this matter. General Liablity Expiration date: 06/05/2016 For General Liability coverage, you will need to submit a binder or certificate of insurance with the "Additional Insured Endorsement" prior to the date of expiration. If you submit a binder, you will need to send the certificate of insurance and the "Additional Insured Endorsement" once it is issued. The documents may be emailed in advance to hgoodwin(rt?sloci y.org and then hard copies mailed. All documents should be sent to: City of San Luis Obispo Attn: City Clerk's Office 990 Palm Street San Luis Obispo, CA 93401 If you have any questions, please phone me at (805) 781-7103. Our fax number is (805) 781-7109. Sincerely, Heather Goodwin Deputy City Clerk