ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/BD/YYYY) 01/31/2023
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 endorsements).
Fluetsch and Busby Insurance Karla Wainwright
PO Box 780 (209)722-1541 [AC, No): (209)723-8189
E-MAIL [email protected]
Merced, CA 95341 ADDRESS:
License #: 0358327 INSURERS) AFFORDING COVERAGE WAIC #
INSURER A: Hanover Ins Companies
INSURED
INSURER B:
Merced County Regional Arts Council, Inc INSURER C:
645 West Main Street INSURER D:
Merced, CA 95340 INSURER E :
INSURER F:
CERTIFICATE NUMBER: 00014566-640535 REVISION NUMBER: 2
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 EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS
X COMMERCIAL GENERAL LIABILITY CF1-ML-1001431-04 07/06/2022 07/06/2023 EACH OCCURRENCE 1,000,000 CLAIMS-MADE |X OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence 100,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY LOC PRODUCTS - COMP/OP AGG 2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMI $
Ea accident
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident)
AUTOS ONLY AUTOS $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
RETENTIONS $
WORKERS COMPENSATION STATUTE
AND EMPLOYERS' LIABILITY
VY PROPRIETOR/PARTNER/EXECUTIV E.L. EACH ACCIDENT $
FFICER/MEMBER EXCLUDED
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S
LESS STOP 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) City of Merced, Its officers agents and employees and volunteers are included as additional insured. Regarding the February 18th March.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Merced, Its officers agents and employees and volunteers ACCORDANCE WITH THE POLICY PROVISIONS. 678 W 18th Street
Merced, CA 95340 AUTHORIZED REPRESENTATIVE
Mara Winninght
(KDW)
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ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by KDW on 01/31/2023 at 02:01PM