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CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST,A RISK PURCHASING GROUP <br />Certificate #64S2~ <br />ACILITY OWNER -Additional Insured:(~mu~iple,continued PRODUCER:CA Ucense #075n76 <br />n next page) <br />HUB Intemationallnsurance services Inc.••• <br />ity of stockton,its Mayor,Council,officers,representatives,agents,P.O.Box 4047 <br />mployees and volunteers,425 N EI Dorado Street,Stockton,CA 95292 Concord,CA 945244047 <br />PH:925 609 6500 FX:925 13096550 ~pecialevent@hubinternational.com <br />VENT HOLDER -Named Insured:(If mu~iple,continued on EVENTINFORMATION <br />ext page) <br />lal1<and Kandee Ailon dba TYPE OF EVENT:Runs.;!>-•••.,'" <br />)n Your Marl<:Events EVENT DATElS):4110(1110.&1111112016.:,JI',,- <br />'.0.Box 1199 Muttiple:Downtown Stockton,De Carli Plaza &Streets,stockton,CA85292; <br />,mold,CA 95223 EVENT LOCATlON(S):WOodbridge Winery,5950 E WoodbJ1dge,Acampo,CA 95220;University ofthe <br />Pacific,3601 PacJ'llcAvenue &City Streets,stockton,CA 95292 <br />This is to certify that the policies of insurance listed below have been issued fo the insured named above for the event date(s)lndicaled above.Notwithstanding any requirement,tenn or <br />condition of any contract or other document with respect to vmlch this certificate may be issued or may pertain,the insurance a1"rordedby{he po~ciesdescribed herein is subject toaR the lenns, <br />exclusions and conditions of sud1 policies. <br />INSURER A:COLONY INSURANCE COMPANY <br />INSRLffi Type of Insurance PoJicy Number Effective Expiration Policy Limits <br />Each OCCtlrrence $1,000,000 <br />General Aggregate $2,000,000 <br />Personal &AdvertIsing Injury $1,000,000 <br />ProdactslCompleted Operations $2,000,000 <br />Commercial --A General liability AR6360147-10 1/112016 1/112017 Damage to Premises Rent1!d to You $500,000 <br />Medeal P~yments $5,000 <br />Liquor Liability Each OCCurrence <br />(A,ggregat:eincluded in General NIA <br />Liability Aggregate) <br />:OVERAGE TERMS: <br />)ccurrence Form (CG 0OO1) <br />lost Uquor Uabirity Included.The coverage afforded by this insurance is primary and not contributing with any insuJllnce held by the "ADDITIONAl.INSURED" <br />WHENREQUIRED BY WR!TTEN CONTRACT.The rrmib of insurance apply separately to each event insured by this policy as if <br />separate policy of insurance has been isstJe(l for that evetrt.Who is an insured is amended to include as an addititHlal insUMd th <br />"facility Owner _Additional Insured"above and any person or organization shown In the .schedule beIDw.This insurance does no' <br />'ull Uquor Uability Included when a apply to:any "occurrence"which takes J»at:e after the event holder ceases to be a tenant in that premises..This Insurance appil~ <br />eparate premium has been charged.only to:an "occurrence"which takes ptace during the dates indicated under "Event Information"above. <br />JI participants in athletic activities are <br />~to sign Release and Waiver of <br />iabilityforms. <br />OVERAGE EXCWSl.ONS:{REFER TO POUCY FOR COMPLETE USTING OF EXCLUSIONS] <br />-Sexual Abuse &Molestation Specific Events are excluded from coverage,Please see second page for Jist of excluded events. <br />-Terrorism <br />On behalf of the Risk Purchasing Group and each Member,the TrU$tee has declined coverage for the TerrQrism Risk <br />Insurance Act (TRIA). <br />-Additional Insureds,next page - <br />-------._----_._--------------.-._-----,-----