BEER BARON OUTDOOR DINING PERMIT 2016

.�� BEERB-2 OP ID:JB `°RO' CERTIFICATE OF LIABILITY INSURANCE DATE 07/26/2016 ) onzsrzots 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 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 Phone: 707-796-7180 MEACT NAME: Janice Bossert Vista International Ins. NA Brokers Ltd,LLC Lie 40110893 Fax: 707-796-7190_(AHC°NLao,Eat).707-796-7100 �n",QNO):707-796-7190 1318 Redwood Way,Suite 250 ADURE Petaluma,CA 94954 ADDRESS:jbossert@vistainternational.com Jeff Rosentreter CIC INSURER(SI AFFORDING COVERAGE NAIL it INSURER A:Arch Specialty Insurance Co. 21199 INSURED Beer Baron Bar and Kitchen INSURER B:Security National Ins.Co. 19879 336 Saint Mary Street Pleasanton,CA 94566 INSURER C: INSURER D: INSURER E: INSURERF: _ COVERAGES 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. MISR- ADOL SWA POBCYEFF—POUCYFXP- LTR TYPE OF INSURANCE INSR %WTI POLICY NUMBER IMMIDDIYYYY) (MMIDDIWYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERALLIABILRY X MBPK000304-00 07/01/2016 07/01/2017 ppEMI5E5(En occurrzncel $ 500,000 —JCL/VMS-MADE X OCCUR MED EXP Any one person) $ 5,000 — A X 41M/S2M MBPK000304-00 07101/2016 07/01/2017 PERSONAL SADVINJURY $ 1,000,000 Liquor Liability GENERAL AGGREGATE $ 2,000,000 GEN-'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OF'AGG $ 2,000,000 POLICY Pjrr9N LOC Liquor $ $1M/$2M AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT jai accident) MY AUG BODILY INJURY(Per person) $ ALOWNED AUTOS DJLED BODILY INJURY(Per amaenq $ HIRED AUTOS AUTOSMJED ((Per ai cident) AGE UMBRELLA LIAB nn_UR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ — DEE) I RETENTION$ $ WORKERS COMPENSATION X WCSTATLI- °O- AND EMPLOYERS'LIABILITY - TORY LIMES ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N SWC1118182 07/01/2016 07/01/2017 EL EACH ACCIDENT $. 1,000,000 OFFICER/MEMBER EXCLUDED, N/A (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 fESCRIPTION under PERATIONS below EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The Certificate Holder is included as an Additional Insured for General Liability per attached form CG20120798 as respects Outdoor Dining Permit (PDIN-21-336 Mary Street) . CERTIFICATE HOLDER CANCELLATION CITYPLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Pleasanton ACCORDANCE WITH THE POLICY PROVISIONS. City Manager P.O. Box 520 AUTHORIZED REPRESENTATIVE Pleasanton,CA 94566 O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD