KIWANIS INTERNATIONAL - Laserfiche WebLink

Home

AC��2"® CERTIFICATE OF LIABILITY INSURANCE DATE ( M MID DIYYYY) 9/30/2016 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 endorsement(s). PRODUCER Hylant Group Inc -Indianapolis 301 Pennsylvania Parkway, #201 Indianapolis IN 46280 CONTACT Lisa Christenson PHONE 317-8 1 7-5172 FAX 317-817-5151 '°''c "D E-MAIL kiwaniscert h lant.com ADDRESS: y INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Lexington Insurance Company 19437 INSURED KIWAN03 INSURER B: INSURER C: DAMAGE TO RENTED PREMISES Ea occurrence $500,000 Kiwanis International, All Clubs and Their Members 3636 Woodview Trace Indianapolis IN 46268 INSURER D: X Liquor Liability PERSONAL & ADV INJURY $2,000,000 INSURER E: INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER:APPROVED GENERAL AGGREGATE $2,000,000 COVERAGES CERTIFICATE NUMBER: 1315632767 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 013136005 11!112015 11!112016 EACH OCCURRENCE $2,000,000 CLAIMS -MADE FXIOCCUR DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $5,000 X Liquor Liability PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:APPROVED GENERAL AGGREGATE $2,000,000 PO -F-] LOC POLICY � PRODUCTS - COMP/OP AGG $2,000,000 Liquor Liability $1,000,000 OTHER: A AUTOMOBILE LIABILITY 013136005 11/1/2015 11/1/2016 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident)$ Aggregate $3,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? H N 1 A E.L. DISEASE - EA EMPLOYEE $ (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Self -Insured Retention 013136005 11!112015 11/1/2016 All Claims $75,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is named as Additional Insured as respects to General Liability only regarding the following Kiwanis event (setup, take down & rain date(s) during the policy term are included): October 3rd thru October 31st, 2016 or any future date(s) during the policy term. Banner Hanging for (Riverside Got Talent) Located @ Municipal Auditorium Kiwanis Club of Uptown Riverside CERTIFICATE HOLDER CANCELLATION ©'1988-20'14 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Riverside, Its Officers, Employees, & Agents THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3900 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Riverside, CA 92622 AUTHORIZED REPRESENTATIVE ©'1988-20'14 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD