07-6501 - Laserfiche WebLink

Browse Search

NO~DR(07108\) CERTIFICATE OF lNSURANCE SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST, A ~RISKPUROHA:SING ,GROUP 32407 FACILITY OWNER (Additionallnsuredl: .PRODUCER: I :CA License.#0529776 CITY OF ZEPHYRHILLS DIVERSIFIED RISK INSURANCE BROKERS 5900 ,CHRISTIE AVENUE ZEPHYR PARK EMERYVILLE, CA 94608 38116 5TH AVE 510-547..3203 Fax: 510-547-5648 ZEPHYRHILLS, FL 33542 specialevent@drib.com INSURED EVENT HOLDER (Named Insured/Member): EVENT INFORMATION "NPE: CELTIC FESTIVAL CELTIC, HERITAGE SOCIETY OF FLORIDA, INC. DATE(S): 3-2-07 8551 HANDCART ROAD THRU 3-4-07 ZEPHYRHILLS, FL 33544 LOCATION: ZEPHYR PARK ATTENDANCE: I L.IUU I CLASS: I III This is to certify that the policies of insurance listed below have been issued to the insured named .above for the event date(s).indicated ,above. . Notwithstanding anyrequi~ement, .term or condition of any contract or other document with respect to which this certificate may be issuedormaypertain, the insurance afforded :bv the policies described herein is subiect to all the terms, exclusions and conditions .of such policies. Insurers: -I Insurer A: \Colonv SD8cialtvlnsuranceCOmpany Insurer B: Genesis Indemnitv Insurance Company INSR ; LTR Tvoe of Insurance Policy Number Effective Expiration Policy Limits A Primal)' Commercial AR6360147 1/1/2007 1/1/2Q08 General Liability Each Occurrence $250,000 Fire Damage Legalpability $50,000 .Medical Payments $2,000 Personal & Advertising Injury $250,000 General Aggregate $1,000;000 Products/Completed Ooerations 'Aaareaate $1 ;000,000 B Excess Commercial Each Occurrence $750,000 General liability ZXB300938D 1/1/2007 1/1/2008 $750,000 Personal A Advertising Injury General ,Aggregate . $1,500;000 ,l?roducts1Completed Ooerations Aaareaate $1,500,000 ZXB300938D 1/1/2007 1/1/2008 Each Occurrence B Optional Excess Limits General Aaaregate COVERAGE TERMS " The coverage afforded by this -insurance is primary and not contributing with any insurance held Occurrence Form (CGOO01) by .the "ADDITIONAL INSURED OWNER, LESSOR,"'ANAGER 'OF ,PREMISES", -'WHEN Host Liquor Liability included REQUIRED BY WRITTEN CONTRACT, except as respects the sole negligence or strict liability of Full Liquor Liability included when a separate such additional insured or a. pre-existing condition in the premises. The limits of insurance premium has been charged. apply separately to each event insured by -this policy as If .a separate policy of insurance, has been issued for that event Who is an insured is amended to include as an. additional insured Warranty: All particiDants in athletic activities the "Facility Owner _ Additional . Insured" above and any person oromanization .shown in the are reauiredto sian :Release and Waiver of schedule below,but only with respect to liability arising out of the ownership, maintenance or Liabilitvforms. use of the premis8!i.usedl1y4be insured event holder. <This insurance doesnot.apply,to: any "occurrence" which -takes. place after the event holder ceases itObe a tenant in that premises. , This insurance applies .onlytO: :an "occurrence"which "takes .place during the dates .indicated under "Event Infonnation" above. COVERAGE EXCLUSIONS/REFER TO POUCY FOR COMPLETE LISTING OF EXCLUSIONS): . -Real & personal. property ,you own, .rent, Specific 'Events .are excluded from coverage. use or occupy or in your care, custody or control.. Please see reverse side for list of excluded events. -Sexual 'Abuse &.Molestation -Terrorism - On behalf of the Risk Purchasing Group and each ,member, the trustee has declined .coverage for the Terrorism :Risklnsurance Act (TRIA). ,OTHER ADDlTleNALINSUREDS: . . CANCELLA nON: Should the above described policy(s)'be cance/led before the expiration date thereof, the issuing company will endeavor to mail 30 davs written notice to the insured eventho/der and additional insureds listed. AUTHORIZED REPRESENTATIVE: -I ~ ~ DATE ISSUED I 2-27-07 SEP Ed. 1/1107 EVENT HOLDER COPY