ISSUE DATE YYYY/MM/DD
Company
A
Company
B
BROKER
Company
C
Company
D
INSURED'S FULL NAME AND MAILING ADDRESS
Company
E
COVERAGES
TYPE OF INSURANCE CO
LTR
LIMITS OF LIABILITY
(Canadian dollars unless indicated otherwise)
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
EXCESS LIABILITY
OTHER (SPECIFY)
CERTIFICATE HOLDER CANCELLATION
AUTHORIZED REPRESENTATIVE
Per:_______________________________________
CLAIMS MADE
OCCURRENCE
PRODUCTS AND/OR
COMPLETED OPERATIONS
PERSONAL INJURY
EMPLOYER'S LIABILITY
TENANT'S LEGAL LIABILITY
NON-OWNED AUTOMOBILE
HIRED AUTOMOBILE
DESCRIBED AUTOMOBILES
ALL OWNED AUTOMOBILES
LEASED AUTOMOBILES **
GARAGE LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP
AGGREGATE $
PERSONAL INJURY $
EMPLOYER'S LIABILITY $
TENANT'S LEGAL LIABILITY $
NON-OWNED AUTOMOBILE $
HIRED AUTOMOBILE $
BODILY INJURY
PROPERTY DAMAGE
COMBINED
$
BODILY INJURY
(Per person) $
BODILY INJURY
(Per accident) $
PROPERTY DAMAGE
$
EACH OCCURRENCE
AGGREGATE
$
$
$
$
$
$
$
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HUB International Insurance Brokers
400-4350 Still Creek Drive
Burnaby, BC V5C 0G5
PHONE: 604-269-1000
InTime Services Inc
2140 - 745 Thurlow Street
Vancouver, BC V6E 0C5
Insured Operations: Development, Sales & Service of Time Management, Staff Scheduling Software & Applications. USA and Worldwide Operations Included.
Limits of Liability are in USD
The following are added as Additional Insured on the Commercial General Liability policy but only with respect to liability arising from the operations of the Named Insured:
City of San Marino, and their officers, agents and employees acting in their official capacity as such.
City of San Marino
2200 Huntington Drive
San Marino, CA 91108
Certain Lloyd's U/W as arranged by CFC Underwriting Ltd. 45SKF24N
A
ESM0139891471
ESM0139891471
ESM0139891471
2024/02/28 2025/02/28 5,000,000
Errors & Omissions Liability
Cyber Liability
Limit of Liability - Per Claim
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 0 days written notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives.
Aggregate
Network Security & Privacy
Cyber Incident Response
Legal & Regulatory Costs
5,000,000
5,000,000
5,000,000
5,000,000
5,000,000
500,000
5,000,000
75,000
A 2024/02/28 2025/02/28
5,000,000
5,000,000
5,000,000
5,000,000
X
X
X
X
X
X
X