HomeMy WebLinkAboutCertificate of Liability InsuranceACORDe CERTIFICATE OF LIABILITY INSURANCE
DATE MWDD,NYYY)
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(ies) 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
Willis of Illinois, Inc.
425 N. Martingale Road, Suite 1100
Schaumburg, IL 60173
cNAAMMECT John Adams
FAX
PNHC. No, Fmk 1-800-316-6705 (A/c. Nok 1-888-467-2378
EDo Es5: lionsdubs@WIIIis.COm
INSURER(S) AFFORDING COVERAGE
HAWK
INSURER A: ACE American Insurance Company
22667
INSURED
National City CollegeCampus Lions Club/ 4L6
CaliforniaiNational City Califo
INSURER a
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 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
INSR
TYPE OF INSURANCE
'TPi L3USR
INSR
MD
POLICY NUMBER
POLICY EFF
IMMIDPNYYYI
POLICY EXP
ImWDTYYYYI
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERA( LIABILITY
HDOG25531541
09/01/2011
09/01/2012
EACH OCCURRENCE
$ 1,000.000
uAMAGE t?Ia:Meu
PREMISES tEa occunmce)
S 1,000,000
�
CLAIMS -MADE I ^ I OCCUR
MED EXP (Any one person)
s 1,000
X
Agg Per Named Insured
PERSONAL &ADV INJURY
51,000,000
is S2,000,000
GENERAL AGGREGATE
5 10,000,000
GEN'LAGGREGATE
TO POLICY
UMITAPPLIES
n ECT n
PER:
LOC
PRODUCTS• COMP/OP AGG
5 2,000,000
5
A
AUTOMOBILE
X
LIABILITY
_
X
SCHEDULED
AUTOS
AAUUTNOS ED
HDOG25531541
09/01/2011
09/01/2012
UT
tCOMBBII UMIT
s Included
BODILY INJURY (Per person)
S
BODILY INJURY (Per wedeln)
$
t4P aPERTY
$
S
UMBRELLA UAB
EXCESS LNN
—
OCCUR
CVVMSStADE
EACH OCCURRENCE
5
AGGREGATE
S
DEO RETENTIONS
S
WORKERS COMPENSATION
AND EMPLOYERS' UABRRY
ANY PROPRIETOWPARTNEWEXECUT E
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
It es. descNle under
DESCRIPTION OF OPERATIONS below
YIN
N/A
I WCSTATU- OTH-
TORVIIL5TS FR
EL, EACH ACCIDENT
S
EL DISEASE• EA EMPLOYEE
S
E.L. DISEASE -POLICY LIMIT
S
DESCRIPTION OF OPERATIONS / LOCATIONS IVEHICLES (Attach ACORD 101. Additional Remarks Schedule, 9 more spate is required)
Provisions of the policy apply to the named insureds participation in the following activity during the policy period shown above: Spirit of the Holidays December 16 and 172011
ial�md. as an Additional Insured(s), but only with respect to General Labilty arising out of the use of premises by the Insured
t ploof e�es,eropl��d elf secteidadditional officials
shown NaationarCCy, its employees,
PROVISIONS OF THE POLICY DO NOT APPLY TO THE `;AI F OR SERVING OFALCOHOLIC BEVERAGES
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of National City
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1293 National City Blvd
ACCORDANCE WITH THE POLICY PROVISIONS.
National Cfty California 91950
AUTHORIZED REPRESENTATIVE
614e/n�4
ACORD 25 (2010105)
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