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ACORD. CERTIFICATE OF LIABILITY INSURANCE OP,D <br /> 05/19/03 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATFER OF INFORMATION <br /> Suhr Risk Services - San Jose ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> San Jose Branch HOLDER. THIS CERTIFICATE DOES NOTAMEND, EXTEND OR <br /> 1338 Bayshore Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Burlingame CA 94010 <br /> Phone: 650-3%2-9535 Fax.' 650-343-5941 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURERA: NonDrofits Ins. Alliance of CA <br /> INSURER B: <br /> Peninsula Conflict Resolution <br /> 520 South E1 Camino Real, #640 INSURERO: <br /> San Mateo CA 94402 <br /> COVERAGES <br /> <br /> LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE (MM~D/YY~ DATE {MM~D/YY} LIMITS <br /> G__ENERAL UABILITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY 200310854 04/10/03 04/10/04 PREMIsEsUAM~ru"~NIbU(Ea occurence) $ 100,000 <br /> I CLAIMS MADE ~ OCCUR MED EXP (A~y one person) $ 10,000 <br /> X__ Lic~uor $1mil PERSONAL&ADVINJURY $ 1,000,000 <br /> __ GENERAL AGGREGATE $ 2, 0 0 0, 0 0 0 <br /> [-]Loc 1.000,000 <br /> -- COMBINED SINGLE LIMIT <br /> A __ ANY AUTO 200310854 04/10/03 04/10/04 (Ea acOdent) $ 1, 000, 000 <br /> ALL OWNED AUTOS <br /> <br />~ OCCUR [] CLAIMS MADE AGGREGATE $ <br />EMPLOVERS' I.I~BIMTY <br />SPEC~L PROVISIONS below E.L DISEASE. POLICY LIMIT $ <br />OTHER <br />'10 days notice for non-payment of premium. <br />CERTIFICATE HOLDER CANCELLATION <br /> <br />~T~028 SHOULD ANY OF THE ABOVE DESC~BED POLICIES BE CANCELLED BEFORE THE EXPIRATIO~ <br />City Of aedwood c~ty NOTICETOTHECERTIFICATEHOLDERNAMEDTOTHELEFT, BUTFNLURETODOSOSHAL <br />Attn: City Manager's Office <br />1017 Middlefield Road IMPOSENOOBLIGATIONORMABILFFYOFANYKINDUPONTHE~NSURER,~SAGENTBOR <br />Redwood City CA 94063 REPRESENTATP~ES. <br />ACORD 25 (2001108) © ACORD CORPORATION 198 <br /> <br /> <br />