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Last modified
5/22/2018 4:00:10 PM
Creation date
5/22/2018 1:26:19 PM
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Contracts
Company Name
C3 TECHNOLOGY SRVCS
Contract #
A-2016-273-01
Agency
FINANCE & MANAGEMENT SERVICES
Council Approval Date
9/20/2016
Expiration Date
9/30/2019
Insurance Exp Date
5/23/2019
Destruction Year
2024
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ACC>R br CERTIFICATE OF LIABILITY INSURANCED4�a4/z0 <br />) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />e <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY .AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poticy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in Ileu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />_NAME <br />Tutton Insurance Services <br />T <br />PAHIONG N Eztl_(949).261-5935 FAXNes, (sas)xs1-x911 <br />2913 S Pullman Street <br />EMAIL <br />ADDRESS: <br />License #OB89376 <br />....__ INSURERf5)AFFORDINGCOVERAGE <br />NAIL# <br />INSURER A:Travelera Casualty Insurance <br />19046 <br />Santa Ana v CA 92705 _ <br />INSURED <br />INSURERB:Oak River Insurance Company <br />34630 <br />INSURER G <br />Reprographics Fax Group, Inc., DSA: C3 Office <br />Office Solutions LLC DEA:C3 Technology Svcs <br />INSURERD: <br />1536 E Warner Avenue <br />_ <br />INSURER E: <br />INSURER F: <br />Santa Ana CA 92705 <br />l4\l`laYdl�I:k�Na:\\I'itNe\�iVleli`II:1�:A�RarY'itF9/:},1IRl elyU F9f\id\.lt�i,Gle?f"JF� <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIR CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />A LSUB <br />POLICY NUMBER <br />POLICYEFF <br />MMt D Y <br />POLICYEXP <br />MMIDO <br />I <br />f LIMITS <br />A <br />X <br />COMMERCIALGENERALLIABILITY <br />CLAIMSMADE OCCUR <br />EACH OCCURRENCE $ .21000,000 <br />OREMISES Ea occurDm $ B00,000 <br />MED EXP (Any onaperso,) $ 5,000 <br />9809BO1277718. <br />5/23/2018 <br />5/23/2019 <br />PERSONAL B AOV INJURY $ 2,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />PRO- [ —] LOC <br />POLICY JECT <br />GENERAL AGGREGATE $ 41000,000 <br />GEN'L <br />X <br />PRODUCTS COMP/OP AGO. $ 4.000„000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea acc1d' nt <br />BODILY INJPRY(Per Person) $ <br />A <br />X <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTO$ AUTOS <br />BA8B8S091918 <br />$/23/2818 <br />5/23/2019 <br />BODILY INJURY (Per accident $ <br />( ) <br />HIRED AUTOS AUT06WNED <br />PROPERTYDAMAGE $ <br />Medicalo encs $ 51000 <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENT ION $ <br />$ <br />B <br />WORKERS ATION <br />AND EMPLOYERSILABILITY YINANY <br />OFHCER/MEPROPRIMBOEREXCLUD DEXECUTIVE <br />(Mandatory in NH) <br />9 yes, describe under-L—WD <br />NIA <br />REWC811397 <br />10/2/2017 <br />10/2/2018 <br />X' STATUTE <br />E4 EACH ACCIDENT $ 11000,000 <br />E.1-EAEMPLOYE 0.,000 <br />E. L. DISEASE - POLICY LIMIT $ 11000,000 <br />DESCRIPTION OF OPERATIONS below <br />i <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) <br />City of Santa Ana, its officers, Employees, agents, volunteers and representatives are namedadditional <br />insured per attached forms CGT4911188, CGDO37 0405, ILT400 1209. <br />At Or l <br />``\ -1 <br />City of Santa Ana <br />20 Civic Center plaza <br />Banta Ana, CA .92702 <br />SHOULD ANY OF THE ABOVE; DESCRISEtj PGi1,1C+IF ikjtl6 LE <br />THE EXPIRATION DATE THEREOF, N6110Ea; <br />ACCORDANCE WITH THE POLICY PROVISIOA($: <br />AUTHORIZED REPRESENTATIVE <br />Tutton/ICART,A <br />BEFORE <br />RED IN <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 611P <br />INS026 (201407) Vw <br />
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