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ACORD®
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CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
I DATE {MMIDD/YYYY)
7/1/2026
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 have ADDITIONAL INSURED provisions or 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).
CONTACT
PRODUCER NAME:
Arthur J. Gallagher Risk Management Services, LLC j fffc Nol:
r_ngN:o Evt'· 716-549-2000
200 Delaware Ave Ste 1100 E•MAIL
Buffalo NY 14202 ADDRESS:
INSURER($) AFFORDING COVERAGE NAIC#
INSURER A: Utica National Insurance Companv of Ohio 13998
INSURED EASTAUR-05
INSURERS:
East Aurora Union Free School District
INSURERC:
430 Main Street
East Aurora NY 14052 INSURERD:
~§_l:l!_tERE: ----
\NSURERF:
COVERAGES CERTIFICATE NUMBER· 368388426 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
":':D!JL S_U_B_R
POLICY NUMBER ,:~M%Yv~1 ,~a}6%~ LIMITS
A X COMMERCIAL GENERAL LIABILITY y 4051326 7/1/2026 7/1/2027 EACH OCCURRENCE S 1,000,000
0,-,.,.,AGE TO RENTED
I CLAIMS-MADE [8J OCCUR _f!il;:MISES IEa occurrence\ S 1,000,000
MED EXP (Any one person) S 10,000
-
PERSONAL & ADV INJURY S 1,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000
0
~
POLICY □ r:;rg'f LOG PRODUCTS - COMP/OP AGG $3,000,000
OTHER:
s
COMBINED SINGLE LIMIT S 1,000,000
A AUTOMOBILE LIABILITY BAC4051327 7/1/2026 7/1/2027 /Ea accident\
~
X ANY AUTO BODILY INJURY (Per person) s
~
OWNED
- SCHEDULED BODILY INJURY (Per accident) s
~ AUTOS ONLY ~ AUTOS
NON-OWNED PROPERTY DAMAGE
X HIRED X AUTOS ONLY iPer accident\ $
1-- AUTOS ONLY ~
$
A
~
X UMBRELLALIAB
EXCESS LIAB
OED IXI
n
RETENTION$ ..,,,
OCCUR
CLAIMS-MADE
-
CULP4055492 7/1/2026 7/1/2027 EACH OCCURRENCE
AGGREGATE
S 10,000,000
$10,000,000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
1 ;frTUTE 1 I OTH-
ER
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
□ N/A E.L. DISEASE - EA EMPLOYEE $
lf yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $
A Educators Professional liability 4051326 7/1/2026 7/1/2027 Each Loss $1,000,000
AGGREGATE $2,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more spac;:e ls required)
RE: EA Middle School student team building event I Hamlin Park in East Aurora I Friday, September 11, 2026 - Rain Date: Tuesday, September 15, 2026
Village of East Aurora is included as Additional insured is on the General Liability under form number BE3042, as required in written and executed contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Village of East Aurora
585 Oakwood Ave AUTHORIZEO REPRESENTATIVE
East Aurora NY 14052 Avt;l-..u;- J. G ~ 1<i.~1v / v i ~ Sevvlce¥, LLC
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