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HomeMy WebLinkAboutCertificate of Liability Insurance• TUNI ACORD,.CERTIFICATE OF LIABILITY INSURANCE 0612112010DATE YYY) PRODUCER BB&T Insurance Svcs of CA,Inc. 750 B Street, Suite 2400 San Diego, CA 92101 800 421-6744 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE NAIC # INSURED San Diego County SchootslJPA Sweetwater Union H.S. District 1130 Fifth Avenue Chula Vista, CA 91911 ENSURER A: San Diego County Schools Risk NSUftERA: Permissively Self -Insured INSURER a AWACICRC* 10690 INSURER0: Endurance/CRC* 41718 INSURER E: ContinentallGr.Am/*CRC 20443 V TI-iE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TI'IE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI-IIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TI'IE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCI1 POLICIES, AGGREGATE LIMITS SHOWN MAY }'LAVE KEEN REDUCED BY PAID CLAIMS. 1 LIR ADD'L RIJ NSRU TYPE OF INSURANCE POLICY NUMBER POLICY (MM/DDJYlY)E POLICY (MMIPD/YIYOjN LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY *Per MOC on file 07/01/10 07101/11 EACH OCCURRENCE S5,000,000 DAMAGE RENTED Pf2EMISES (RENTED TX occurrence} S —1 CLAIMS MADE X OCCUR MED EXP (Any one person) 5 X $500,000 S.I.R. PERSONAL & ADV INJURY 5 GENERAL AGGREGATE 510,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY J CTPRO- ILOG PRODUCTS - COMP/OP AGG 5102000 000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS $500,000 S.I.R. *Per MOC on file 07101/10 07/01/11 COMBINED SINGLE LIMIT (Ea accident) $5 000,000 r BODILY INJURY (Per person) S X BODILY INJURY (Per accident} 5 X X PROPERTY DAMAGE (Per accEden!) 5 GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT 5 OTHER THAN EA ACC S AUTO ONE Y: AGG 5 EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE S AGGREGATE S DEDUC1 IBL E RETENTION 5 S S S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, descrhe undor SPt=CIALPItOVIS10N5Uelotti. JPA MEMORANDUM OF COVERAGE 60 Days Notice of Cancellation 07/01110 07/01/11 WC RYLIMIu- oTH- It E.L. EACH ACCIDENT S1,000,000 E.L. DISEASE - EA EMPLOYEE S1,000,000 E.L. DISEASE - POLICY LIMIT S1,000,000 C I7 E OTHER Blanket Prop Blanket Prop Blanket Prop 030567751N CPN10002136200 RMP2083564156 07/01110 07101/10 07101/10 07101/11 07/01/11 07101/11 $5,000,0001$175,000 SIR $20,000,000 XS $5M $225,000,000 XS $25M DESCRIPTION OF OPERATIONS f LOCAT#DNS f VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS *Issued CRC permission. Property policy inci Special Form/Replacement Cost. Certificate is subject to policy limits, conditions and exclusions. *MOC Memorandum of Coverage -Approved Self Insurance Program reinsured by Munich Reinsurance America Inc. Re: Use of premises. City of National City, its officials, agents and (See Attached Descriptions) CERTIFICATE HOLDER City of National City Parks & Recreation Dept. 140 E 12th Street National City, CA 91950 CANCELLATION 10 Days for Non -Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL gn DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - °Ilia. ACORD 25 (2001108) 1 of 3 #551656671M5165597 TTCAR © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) 2 of 3 #S51656671M5165597 DESCRIPTIONS (Continued from Page 1) employees are additional insureds (general liability policy) per the attached form. AMS 25,3 (2001108) 3 of 3 #551656671M5165597 SAN DIEGO COUNTY SCHOOLS RISK MANAGEMENT JOINT POWERS AUTHORITY (SDJPA) Additional Insured Endorsement WHO IS A COVERED MEMBER (Per section 11 item 3 of the MOC — Memorandum of Coverage) Any person(s), entity(ies), or organization(s) you are required by a covered member contract to include as an additional insured solely with respect to bodily injury and property damage and arising out of: a. Premises leased, used or occupied by you; b. Automobiles leased or rented by you; c. Equipment owned, leased or rented by you; d. Mortgagees and Loss Payees of a Covered Member; or e. Property owners and property managers of property owned, leased, rented or occupied by you However, the additional insured status and coverage does not apply to: (1) Any occurrence which takes place prior to or after you cease to occupy the premises as stated in the covered contract; (2) Any structural alteration, new construction or demolition operations performed by or on behalf of the additional insured; (3) Any wrongful act, employment practices wrongful act or employee benefit wrongful act. This coverage will be further limited to the extent and Limits of Liability required by the covered member contract and will not increase the limits stated in SECTION ill-LIMIT(S) OF COVERAGE nor alter any of the terms of coverage stated in this MOC. The covered member contract must be effective and executed prior to a covered occurrence. San Diego County Schools Risk Management Joint Powers Authority. #SDJPA0070110 July 1, 2010 to July 1, 2011. MOC Effective 7.1.10