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ACORo·· DATE (MM/0D/YYYY)
~ CERTIFICATE OF LIABILITY INSURANCE I01/27/2026
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(les) 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 riahts to the certificate holder In lieu of such endorsementisl.
CONTACT Sara Humphries/ Macy Gorrell
PRODUCER ~ - -
Hylan! Group Inc.
811 Madison Ave,
_f,()8,N~o,E,t), (419) 259-2710 Irie~. No) (419) 255:-7557
Toledo, OH 43604 ~~ss: [email protected] __
IN~,L,l.~E~($] AFFORDING _CQ\l_f;RAGE --~4Ic_p__
-----
J@~~•K~, Westchester Sur,:ilus Lines Ins 10172
-
INSURED INSURER B; ----- -
All Active U.S. Rotary Clubs & Districts
Rotary Foundation of East Aurora J~$_URERC:
ATTN: Risk Management Dept. INSURER D: ------ - ---
1560 Sherman Avenue
INSURER E:
Evanston, IL 60201
INSURER F:
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 WlTH 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.
~~ TYPE OF INSURANCE
AOrii. SUBR
POLICY NUMBER
POLICYEFF POLICY EXP
LIMITS
A X COMMERCIAL GENERAL LIABILITY $
2,000,000
EACH_O,QQJJRRENCE
-
-- 1 CLAIMS-MADE OD OCCUR X G73578917 004 71112025 7/112026
DAMAGE TO RENTED
PREMISES_ (Ea occurr~_nc:e) $
500,000
X- - Liquor Liability
--
---
MED_EXP (Any_gne oersonl
__PERSONAL &_£1,DV INJURY '
$
----
2,000,000
4,000,000
~ OTHER:
n
GEN'L AGGREGATE LIMIT APPLIES PER:
x POLICY LJ llN?i LOC
GENERA_l,AGGREGATE
PRODUCTS - C()MP/OP_AGG
$
$
$
4,000,000
-
A AUTOMOBILE LIABILITY
co_MBINED_ SINGLE LIM!T
1-ilE..111!GC!Qenl} • -
2,000,000
- X
ANY AUTO
OWNED
AUTOS ONLY
tLRT'Ws ONLY
-
~--
X
SCHEDULED
AUTOS
~8¥oi~t~
X G73578917 004 71112025 71112026 BOP!LY INJURY (Per i;iersim)
BOD!LY_J/'IJU_RY,{f'_er accldenll $
PROPERTY DAMAGE
(Per accident) $
•
--- --
-- UMBRELLA LIAB
~~CESS ll~B
H OCCUR
CLAIMS-~-~
EAYH OCCURRENCE
___AQ__GREGA_T!=_
-----
'
$
$__
DE~---n· RETENTION$ $
WORKERS COMPENSATION __ ! PER
STATUTE
I I ER
OTH-
__
ANO EMPLOYERS' LIABILITY
YIN
E.L EACH AQ_CIDE_NT _ $
□ NIA
ANY PROPRIETOR/PARTNER/EXECUTIVE
0(1'.FICE~EMB'i/l EXCLUDED?
( anda ory in N ) E.l DISEASE~!;:_MPL(.)Y!;_j:l $
0 ------
~itt~f~ft3~ ~t~PERATIONS below E.L DISEASE - POLICY LIMIT
'
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more sriace Is required)
The Certificate Holder is included as an additional insured where required by written contract or perm t subject to the terms and conditions of the general
liability policy, but only to the extent bodily injury or property damage Is caused in whole or in part by the acts or omissions of the insured.
CERTIFICATE HOLDER CANCELLATION
Village of East Aurora SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
585 Oakwood Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
East Aurora, NY 14052
AUTHORIZED REPRESENTATIVE
\-.:'
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