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HomeMy WebLinkAbout11-9-12 Chevrolet Campus Promotions OP ID: RB CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/25/12 THISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THIS CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)mustbeendorsed.IfSUBROGATIONISWAIVED,subjectto thetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnotconferrightstothe certificate holder in lieu of such endorsement(s). CONTACT Phone: 408-241-0014 PRODUCER NAME: InsPro Agents & Brokers Ins. FAX PHONE Fax: 408-241-0037 License #OB18019 (A/C, No): (A/C, No, Ext): 4020 Moorpark Avenue, #104 E-MAIL ADDRESS: San Jose, CA 95117 PRODUCER SGROP-1 Inspro Agents&Brokers Ins Serv CUSTOMER ID #: INSURER(S) AFFORDING COVERAGENAIC # EdVenture Partners The Hartford INSURED INSURER A : 2536 Cambridge Drive INSURER B : Antioch, CA 94509 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD INDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD 1,000,000 GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED AX57UUNUP2684 02/11/1202/11/13300,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurrence) X 10,000 CLAIMS-MADEOCCURMED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ X Contractual PER HG00010605 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- $ POLICYLOC JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) AX57UUNUP2684 02/11/1202/11/13 ANY AUTO BODILY INJURY (Per person)$ ALL OWNED AUTOS BODILY INJURY (Per accident)$ SCHEDULED AUTOS PROPERTY DAMAGE $ (Per accident) HIRED AUTOS $ NON-OWNED AUTOS $ 4,000,000 UMBRELLA LIAB EACH OCCURRENCE$ OCCUR 4,000,000 EXCESS LIAB CLAIMS-MADEAGGREGATE$ A57RHUUP2580 02/11/1202/11/13 $ DEDUCTIBLE X10,000 $ RETENTION$ WC STATU-OTH- X WORKERS COMPENSATION TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N A57WEGZ5256 02/11/1202/11/131,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured as required by written contract with respect to operations of the named insured per form HG00010605 as part of policy. CERTIFICATE HOLDERCANCELLATION CITY-15 SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE THEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDIN City of Iowa City ACCORDANCE WITH THE POLICY PROVISIONS. 419 E Washington St. Iowa City, IA 52240 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09)The ACORD name and logo are registered marks of ACORD