Loading...
HomeMy WebLinkAboutSan Luis Coastal Unified School DistrictCERTIFICATE OF LIABILITY COVERAGE COVERAGE PROVIDER: Self -Insured Schools of CA (SISC II) 2000 K Street Bakersfield CA 93301 NAMED COVERED MEMBER DISTRICT: San Luis Coastal Unified School District 1500 Lizzie Street San Luis Obispo CA 93401 DATE (MM/DD/YYYY) 6/14/2016 THE REFERENCED MEMORANDUM OF COVERAGE(S) ("MOC") AND/OR INSURANCE POLICY(IES) EXTEND INDEMNITY PROTECTION TO THE NAMED COVERED MEMBER IN KEEPING WITH THE TERMS AND CONDITIONS OF THE COVERAGE AGREEMENTS/ POLICIES FOR THE EFFECTIVE COVERAGE DATES AND WITH THE STATED COVERAGE LIMITS. COVERAGE PROVIDED BY MOCS IS EXTENDED PURSUANT TO THE RIGHTS AND LIMITATIONS OF CALIFORNIA GOVT CODE § 990 & 6500 ET SEQ. CERTIFICATE NUMBER: 13 TYPE OF COVERAGE MOC/POLICY EFFECTIVE I EXPIRATION COVERAGE AFFORDED NUMBER DATE(S) I DATE(S) LIMITS GENERAL LIABILITY General Liability Employment SLP 7116 17 07/01/2016 07/01/2017 $ 1,750,000 Practices Educators' Legal Liability AUTOMOBILE LIABILITY Automobile Liability (All SAP 7116 17 07/01/2016 07/01/2017 $ 1,750,000 Owned, Hired, Leased, and Borrowed) $1,000 Deductible ACV COMP/COLL WORKERS COMPENSATION E.L. Each Accident AND EMPLOYERS LIABILITY E.L. Disease — Ea. Employee E.L. Disease — Policy Limit BLANKET BUILDINGS & I Blanket Buildings & Contents, SPP 7116 17 07/01/2016 07/01/2017 $ 250,000 PROPERTY Replacement Cost Rental Interruption, Actual Loss DEDUCTIBLE Sustained $ 10,000 THIS CERTIFICATE CONFERS NO RIGHT, BENEFIT, OR INTEREST IN THE REFERENCED MEMORANDUM(S) OF COVERAGE OR INSURANCE POLICY(II NOR DOES IT AMEND, MODIFY, ENLARGE OR ALTER THE COVERAGE AFFORDED BY SUCH DOCUMENTS. IF THE CERTIFICATE HOLDER CONTRACTUALLY ENTITLED TO BE NAMED AS AN ADDITIONAL COVERED MEMBER ("ACM") UNDER ANY COVERAGE AGREEMENT OR POLICY, � CONTRACT IMPOSING THE OBLIGATION MUST BE PROVIDED TO THE NAMED COVERED MEMBER LISTED ABOVE FOR REVIEW AND APPRO` BEFORE SUCH AN ENDORSEMENT WILL BE ISSUED; ACM COVERAGE IS NOT AUTOMATICALLY GRANTED. Description and Date(s) of Event/Operations/Locations/Vehicle (Additional remarks/schedule may be attached if more space is needed) "Agreement for public, educational, and government (PEG) access channels forthe policyyear, for which the City-dfSalrLuis Obispo, its officers, agents, and employees are named additional insured, as respects to written contract with the insured. Includes Advertising Injury. Above respective Property MOC includes theft of equipment. CERTIFICATE HOLDER: City of San Luis Obispo City Clerk's Office 990 Palm St San Luis Obispo CA 93401 Cancellation of Coverage: If any of the policies described herein cancelled before their expiration dates, notice will be delivered in accords with policy provisions. Issuer of this Certificate: SELF-INSURED SCHOOLS OF CA (SISC II) 2000 K STREET BAKERSFIELD CA 93301 PHONE (661) 636-4495 FAX (661) 636-4418 E-mail Address: sisc_pl@kern.org POLICY NUMBER: SLP 7116 17 THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE. PLEASE READ IT CAREFULLY. ADDITIONAL COVERED MEMBER -DESIGNATED PERSON OR ORGANIZATION This endorsement modified coverage provided under the following: GENERAL LIABILITY Name Covered Member: San Luis Coastal Unified School District 1500 Lizzie Street San Luis Obispo CA 93401 SCHEDULE Name of Additional Covered Person(s) or Organization(s) I City of San Luis Obispo RE: Agreement for public, educational, and government (PEG) access channels during the policy year. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section III — The Definition of a Covered member is amended to Include as an additional covered member 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 A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. COVERAGE IS PRIMARY AND OTHER COVERAGE MAINTAINED BY THE ADDITIONAL COVERED MEMBER SHALL BE EXCESS ONLY AND NOT CONTIBLITING WITH THIS COVERAGE.