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Home My WebLink AboutSLO - Aiporti.lf E VED CERTIFICATE NO. I JAN 0 6 2017 ISSUE DATE (MM/DD/YYYY) GL1-3055 All Ti OF COVERAGE 06/24/2016 '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 CSAC Excess Insurance ALTER THE COVERAGE AFFORDED 8ELOW. THIS CERTIFICATE OFCOVERAGE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE Authority CERTIFICATE HOLDER. C/O ALLIANT INSURANCE SERVICES, INC. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF PO BOX 6450 NEWPORT BEACH, CA 92658-6450 SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endarsement(s). PHONE (949) 756-0271 / FAX (619) 699-0901 LICENSE#OC36861 COVERAGE A - CSAC Excess Insurance Authority AFFORDED Member: COVERAGE SAN LUIS OBISPO COUNTY AFFORDED B ATTN: PAMELA MITCHELL COVERAGE COUNTY GOV. CTR, RM D-250 AFFORDED C 1055 MONTEREY STREET COVERAGE SAN LUIS OBISPO, CA 93408 AFFORDED D Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE 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 MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF COVERAGE MEMORANDUM COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR NUMBER DATE (MMIDD/YYYY) DATE (MM/DDIYYYY) A General Liability EIA 16 EL -10 07/01/2016 07/01/2017 $1,000,000 Limits inclusive of the Members Self -Insured Retention of $250,000 Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS AGREEMENT BETWEEN SAN LUIS OBISPO COUNTY AND CITY OF SAN LUIS OBISPO FOR BACK UP POLICE EMERGENCY SERVICES. CITY OF SAN LUIS OBISPO IS INCLUDED AS AN ADDITIONAL COVERED PARTY, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. Certificate Holder Cancellation SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS CITY OF SAN LUIS OBISPO ATTN: CITY CLERK'S OFFICE AUTHORIZED REPRESENTATIVE 990 PALM STREET SAN LUIS OBISPO, CA 93401-3249 U,W EXCESS INSURANCEAUTHDHITY PAGE 1 OF 2 ENDORSEMENT NO. U-1 CSAC EXCESS INSURANCE AUTHORITY GENERAL LIABILITY I ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT It is agreed that the "Covered Party, Covered Persons or Entities" section of the Memorandum is amended to include the person or organization named on the Certificate of Coverage, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated. Coverage provided under this endorsement is limited to the lesser of the limits stated on the Certificate of Coverage or the minimum limits required by contract. ADDITIONAL COVERED PARTY. NAME OF PERSON OR ORGANIZATION SCHEDULED PER ATTACHED CERTIFICATE OF COVERAGE PER ATTACHED CERTIFICATE OF COVERAGE It Is further agreed that nothing herein shall act to increase the Authority's limit of liability. This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: PER ATTACHED CERTIFICATE OF COVERAGE Issue Date: June 24, 2016 Authorized Representativ CSAC Excess Insurancethority PAGE 2 OF 2 „, i • City Administration 990 Palm Street, San Luis Obispo CA 93401-3249 805-781 7114 December 28, 2016 San Luis Obispo County ATTN: Pamela Mitchell County Gov. CTR, RM D-250 1055 Monterey Street San Luis Obispo, CA 93408 Subject: Expired Insurance Certificates for San Luis Obispo County Airport Contract 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. General Liability: Automotive Liability: Errors/Omissions Liability: Expiration date: 07/01/2016 Expiration date: 07/01/2016 Expiration date: 07/01/2016 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 hgoodwineslocity.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. Sincerel , Heat er Goodwin Deputy City Clerk CERTIFICATE NO. ISSUE DATE (MM/DD/YYYY) G1-1-3055 Al CERTIFICATE OF COVERAGE 1 06/24/2016 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CSAC Excess Insurance CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE Authority CERTIFICATE HOLDER. C/O ALLIANT INSURANCE SERVICES, INC. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF PO BOX 6450 NEWPORT BEACH, CA 92658-6450 SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PHONE (949) 756-0271 / FAX (619) 699-0901 LICENSE #OC36861 COVERAGE A - CSAC Excess Insurance Authority AFFORDED Member: COVERAGE SAN LUIS OBISPO COUNTY AFFORDED B ATTN: PAMELA MITCHELL COVERAGE COUNTY GOV. CTR, RM D-250 AFFORDED C 1055 MONTEREY STREET COVERAGE D SAN LUIS OBISPO, CA 93408 AFFORDED Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE 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 MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO TYPE OF COVERAGE MEMORANDUM COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR NUMBER DATE (MM/DDNYYY) DATE (MM/DD/YYYY) A General Liability EIA 16 EL -10 07/01/2016 07/01/2017 $1,000,000 Limits inclusive of the Member's Self -Insured Retention of $250,000 Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS AGREEMENT BETWEEN SAN LUIS OBISPO COUNTY AND CITY OF SAN LUIS OBISPO FOR BACK UP POLICE EMERGENCY SERVICES. CITY OF SAN LUIS OBISPO IS INCLUDED AS AN ADDITIONAL COVERED PARTY, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. Certificate Holder Cancellation SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS CITY OF SAN LUIS OBISPO ATTN: CITY CLERK'S OFFICE AUTHORIZED REPRESENTATIVE 990 PALM STREET SAN LUIS OBISPO, CA 93401-3249 CSAC EXCE55INSURANCE AUTHOWTY PAGE 1 OF 2 ENDORSEMENT NO. U-1 CSAC EXCESS INSURANCE AUTHORITY GENERAL LIABILITY I ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT It is agreed that the'Covered Party, Covered Persons or Entities" section of the Memorandum is amended to include the person or organization named on the Certificate of Coverage, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated. Coverage provided under this endorsement is limited to the lesser of the limits stated on the Certificate of Coverage or the minimum limits required by contract. ADDITIONAL COVERED PARTY: NAME OF PERSON OR ORGANIZATION SCHEDUILED PER ATTACHED CERTIFICATE OF COVERAGE AS RESPECTS: PER ATTACHED CERTIFICATE OF COVERAGE It is further agreed that nothing herein shall act to increase the Authority's limit of liability. This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: PER ATTACHED CERTIFICATE OF COVERAGE Issue Date: June 24, 2016_ Authorized Representativ CSAC Excess Insurance Lthority PAGE 2OF2 CERTIFICATE NO. ISSUE DATE (MM/DD/YYYY) GL1-3056 Al CERTIFICATE OF COVERAGE 1 06/24/2016 'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CSAC Excess Insurance CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE Authority CERTIFICATE HOLDER. C/O ALLIANT INSURANCE SERVICES, INC. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF PO BOX 6450 NEWPORT BEACH, CA 92658-6450 SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PHONE (949) 756-0271 / FAX (619) 699-0901 LICENSE #OC36861 COVERAGE A - CSAC Excess Insurance Authority AFFORDED Member: COVERAGE SAN LUIS OBISPO COUNTY AFFORDED B ATTN: PAMELA MITCHELL COVERAGE COUNTY GOV. CTR, RM D-250 AFFORDED C 1055 MONTEREY STREET COVERAGE D SAN LUIS OBISPO, CA 93408 AFFORDED Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE 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 MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF COVERAGE MEMORANDUM COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR NUMBER DATE (MM/DD/YYYY) DATE (MM/DD/YYYY) A X� General Liability EIA 16 EL -10 07/01/2016 07/01/2017 $1,000,000 Limits inclusive of the Member's Self -Insured Retention of $250,000 Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS AGREEMENT BETWEEN SAN LUIS OBISPO COUNTY AND CITY OF SAN LUIS OBISPO FOR USE OF CITY FACILITIES BY VARIOUS COUNTY DEPARTMENTS FOR COVERED SPECIAL EVENTS. CITY OF SAN LUIS OBISPO IS INCLUDED AS AN ADDITIONAL COVERED PARTY, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. Certificate Holder Cancellation SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS. CITY OF SAN LUIS OBISPO ATTN: CITY CLERKS OFFICE AUTHORIZED REPRESENTATIVE 990 PALM STREET SAN LUIS OBISPO, CA 63401 CSAC EXCESS INSURANCE AUTHORITY PAGE 1 OF 2 ENDORSEMENT NO. U-1 CSAC EXCESS INSURANCE AUTHORITY GENERAL LIABILITY I ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT It is agreed that the "Covered Party, Covered Persons or Entities" section of the Memorandum is amended to include the person or organization named on the Certificate of Coverage, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated. Coverage provided under this endorsement is limited to the lesser of the limits stated on the Certificate of Coverage or the minimum limits required by contract. ADDITIONAL COVERED PARTY: NAME OF PERSON OR ORGANIZATION SCHEDULED PER ATTACHED CERTIFICATE OF COVERAGE AS RESPECTS: PER ATTACHED CERTIFICATE OF COVERAGE It is further agreed that nothing herein shall act to increase the Authority's limit of liability. This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: PER ATTACHED CERTIFICATE OF COVERAGE Issue Date: June 24, 2016 Authorized Representativ CSAC Excess Insurance Lthority PAGE 2OF2