AgdaPkt 2018-06-11 Closed and Joint SA PFA

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/ � ® 1 DATE (MM/DD/YYYY) A C CERTIFICATE OF LIABILITY INSURANCE 6.3.C. -Page 27 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 have ADDITIONAL INSURED provisions or 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 (CONTACT Jeff Stephens NAME: Professional Insurance Associates I PHONE (650) 654-5555 I FAX(650) 654-5550 (A/C No. Ext): (A/C, No): Gordon Associates K-2 I E-MAIL jstephens@gordoninsurance.com ordoninsurance.com ADDRESS: P.O. Box 1266 I INSURER(S) AFFORDING COVERAGE NAIC # San Carlos CA 94070 I INSURERA: Philadelphia Insurance Companies INSURED I INSURER B: Peninsula Celebration Association I INSURER C : 463 Brewster St., Suite 4 I INSURER D: INSURER E: Redwood City CA 94063 I INSURER F: COVERAGES CERTIFICATE NUMBER: CL1841610811 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 ADDL SUBR POLICY EFF POLICY EXP LTYPE OF INSURANCE TR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 FX TO TED I 100,000 CLAIMS -MADE OCCUR PREMISES Ea oDAMAGE ccurrence) $ I MED EXP (Any one person) $ 5,000 _ A Y PHPK1798558 05/20/2018 05/20/2019 I PERSONAL &ADV INJURY $ 11000,000 GEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 3,000,000 POLICY ❑ PRO ❑LOC JECT I PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: Liquor Liability per $ 1,000,000 AUTOMOBILE LIABILITY GE)MBINED-SINGLE LIMIT (Ea accident) $ i ANYAUTO I BODILY INJURY (Per person) $ OWNED SCHEDULED I BODILY INJURY (Per accident) $ _ AUTOS ONLY AUTOS HIRED I PROPERTY DAMAGE $ HNON-OWNED AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB X X OCCUR EACH OCCURRENCE 2,000,000 $ A EXCESS LAB CLAIMS -MADE PHUB623343 05/20/2018 05/20/2019 I AGGREGATE $ 2,000,000 DED I XI RETENTION $ 10,000 $ WORKERS COMPENSATION I I AND EMPLOYERS' LIABILITY Y / N SPER TATUTE EORH ANY PROPRIETOR/PARTNER/EXECUTIVEr_1 NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) I E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate is for Peninsula Celebration Association. City of Redwood and its Council, and their boards, officers, commissions, employees, volunteers, and agents (collectively, the "City -Insureds") are additional insureds. Should any of the above-described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. Primary Non Contributory endorsement to follow once policy is issued. CERTIFICATE HOLDER CANCELLATION City of Redwood City & its Council, their boards, officers, commissions, volunteers, and agents 1017 Middlefield Rd. CA 94063 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Redwood City I ACORD 25 (2016/03) 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