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HomeMy WebLinkAboutWestwind Riding Institute (3)WFSTW.1 nP In- KI _, - - _,�ry�' C �FICATE OF LIABILITY INSUI aNCE DATE (MM/DD/YYYY) 08/15/2018 THIS AND CONFERS NO CERTIFICATE I TI EIM Y GtRTIFRATEDOES LY OR NEGATIVELY AMEND, OR ALTER HE COVERAGE AFFORDED BY THE POLICES EC BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:oee�Ia�ITlONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to t e 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 endorsemeht s . PRODUCER 916-669-1362 Sypolt Insurance Services, Inc 11344 Coloma Road, Suite 635 Gold River, CA 95670 Mary Blincoe Sypolt NAMEACT %gist! Lindsey PHONE 916-669-1362 FAX 916-669-1363 (A/C, No, Ext): A/c, No>: E pAIE , kristi@sisins.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Argonaut Insurance Co 08/2012019 INSURED Westwind Riding Institute Westwind 4-H Riding for the Handicapped C/O Nancy Couperus 27210 Altamont Road Los Altos Hills, CA 94022 INSURER B: INSURERC: INSURER D: INSURER E: GENERAL AGGREGATE $ 2,000'000 PRODUCTS - COMP/OP AGG 1,000,000 INSURER F: r_t' VFRAnFR 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y ELP0208939-01 0812012018 08/2012019 EACH OCCURRENCE $ 1,000,000 TO R DAMAGE ENTED 50,000 occu ce $ MED EXP (Any one erson $ 6,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY El woT E] LOC OTHER: GENERAL AGGREGATE $ 2,000'000 PRODUCTS - COMP/OP AGG 1,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AU S ONLY L AUTOS ONLY COMBINED.SINGLE LIMIT $ BODILY INJURY Perperson) $ BODILYBRORDILY INJURY Per accident $ Pori acC% n DAMAGE $ 1 $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ Fand.t IM in NH) EXCLUDED If yes, describe under DESCRIPTION OF OPERATIONS below PER OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED ON THE POLICY AS PER THE CONDITIONS OF ENDORSEMENT #EPL312 (05116) ATTACHED 110DTn=If`ATC L.InI nGD CANCFI I ATWIN ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TOWN OF LOS ALTOS HILLS 27210 ALTAMONT ROAD LOS ALTOS HILLS, CA 94022 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART EQUINE CARE, CUSTODY, OR CONTROL COVERAGE PART SECTION II — WHO IS AN INSURED is amended to include the person or organization shown in the Schedule below, but only as respects liability imposed or sought to be imposed on such additional insured because of an alleged act or omission of the Named Insured. 1. If liability for injury or damage is imposed or sought to be imposed on the additional insured because of: a. Its own acts or omissions, this insurance does not apply; Its acts or omissions and those of the Named Insured, as to defense of the additional insured, this insurance will act as coinsurance with any other insurance available to the additional insured, in proportion to the limits of insurance of all involved policies, and the Other Insurance provisions of this policy (SECTION IV - CONDITIONS) are amended accordingly. However, this insurance does not apply to indemnity of the additional insured for its own acts or omissions. 2. If an agreement between the Named Insured and the additional insured providing indemnity or contribution in favor of the additional insured exists or is alleged to exist, the extent and scope of coverage under this insurance for the additional insured will be no greater than the extent and scope of indemnification of the additional insured which was agreed to by the Named Insured. SCHEDULE Town of Los Altos Hills Victoria Dye Equestrian, Westwind Barn ELP 312 (05/16) Page 1 of 1