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CERTIFICATE OF LIABILITY COVERAGE <br />Issue Date <br />ADMINISTRATOR <br />COVERED PARTY <br /> <br />COVERAGE PROVIDER <br />TYPE OF COVERAGE POLICY NUMBER EFFECTIVE <br />GENERAL LIABILITY <br />DESCRIPTION OF OPERATIONS / LOCATIONS / RESTRICTIONS / SPECIAL PROVISIONS: <br />CERTIFICATE HOLDER <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE <br />EXPIRATION DATE THEREOF, WILL ENDEAVOR TO MAI L ______ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE <br />SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THIS ENTITY, ITS AGENTS <br />OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />COVERAGE DOUMENTS BELOW. <br />OTHER COVERAGES <br />$ <br />$ <br />EXPIRATION <br />General Aggregate <br />GENERAL LIABILITY <br /> [ ] Claims Made <br /> [ ] Occurrence <br />THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CANCELLATION <br />LIABILITY COVERAGES <br />PROFESSIONAL LIABILITY <br />$ <br /> <br />COVERAGE LIMITS <br />PROFESSIONAL LIABILITY <br /> [ ] Claims Made <br /> [ ] Occurrence <br />Each Occurrence <br />Aggregate $ <br /> [ ] <br /> [ ] <br />Each Occurrence <br /> [ ] <br /> [ ] <br />8/29/2024 <br />Aon Insurance Managers <br />P.O. Box HM 2450 <br />Hamilton HM JX Bermuda <br />1-M0101-00-2024 9/1/2024 9/1/20253 <br />Aon Insurance Managers <br />3 <br />SUMIT INSURANCE COMPANY LTD. (SUMIT) <br />SUMIT <br />Stanford Health Care <br />Lucile Packard Children's Hospital Stanford <br />Stanford Health Care Tri-Valley <br />c/o 300 Pasteur Drive, Risk Mgmt MC5713 <br />Stanford CA 94305 <br />City of Pleasanton <br />Attn: City Manager <br />123 Main Street <br />Pleasanton CA 94566 <br /> 30 <br />RE: Mobile blood drive at Pleasanton City Hall, 200 Old Bernal Ave Pleasanton, CA 94566 on 09/04/2024 and any remaining drives in FY 2024/2025. <br />City of Pleasanton, its officers, employees and agents are additional insureds with respect to General Liability in accordance with policy provisions. <br />Stanford Blood Center <br />2,000,000 <br />2,000,000 <br />81677803 | 24-25 Higher Limits - GL Only | Daniel Yim | 8/29/2024 6:25:35 PM (PDT) | Page 1 of 2 <br />Docusign Envelope ID: F0658C2C-1AC0-4997-AEA6-DAB640E049E3