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MVRCONS-02 GFIETSCH
<br />/4G'OR®, CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/11/20Y
<br />06/11 /208
<br />18
<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 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # 26480
<br />HUB International Mountain States Limited
<br />2600 Rose Hill, Suite 101
<br />PO Box 5815
<br />Boise, ID 83705
<br />COME:NTACT
<br />A
<br />(AIC No, Ext): (208) 433-1000 FAX No ;(866) 898-4905
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Sentinel Insurance Com any, Ltd.
<br />11000
<br />INSURED
<br />INSURER B :
<br />02/22/2019
<br />INSURER C :
<br />-$- .....------- __..... - .....................
<br />1,000,000
<br />._.........._- ......._.-.........
<br />MVR Consulting
<br />INSURER D :
<br />...................I-- ................ ..........._..................... ......."_............. ........................_.............................. ....................._.................................................
<br />INSURER E
<br />.
<br />P.O. Box 236
<br />Calimesa, CA 92320
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER! RFVISION NIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />......................................................................................................................................................................................................................................................................................................................................................................................LTR.......
<br />/NSR ADDL SUER POLICY EFF POLICY EXP
<br />TYPE OF INSURANCE D WVD POLICY NUMBER DD D LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />2,000,000
<br />CLAIMS -MADE I X I OCCUR
<br />- -
<br />X
<br />34SBMIJ6649
<br />02122/2018
<br />02/22/2019
<br />_EACH_OCCURRENCE--- ..........
<br />DAMAGE TO RENTED
<br />_.P..REML,4E3_(E.a_occu..rten&.Qi-..._.....$..-.._.....
<br />-$- .....------- __..... - .....................
<br />1,000,000
<br />._.........._- ......._.-.........
<br />X Hired & Non -Owned
<br />10,000
<br />...................................................
<br />_M ED_EXP_,(Any_one,person)........._$
<br />..........................................................
<br />X Auto Liability
<br />2,000,000
<br />................................
<br />PERSONAL_&_ADV,INJURY
<br />........................................................................
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE.
<br />4,000,000
<br />X POLICY ❑ PRO , LOC
<br />4,000,000
<br />JECT
<br />PR.... ......_
<br />OD..............C-_COMP/0P_AGG ....
<br />OTHER;
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />---------
<br />BODILY,INJURY..{Perpgrson)..,.
<br />...
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />.........................................................
<br />AUTOS ONLY ....... AUTOS
<br />BODILY,INJURY,jPer_accldant)
<br />.
<br />AU
<br />QacRenAMAGE
<br />TOS ONLY .......
<br />., ....................$..........................................................
<br />UMBRELLA LAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGAT -
<br />E ....._..--...........
<br />$._.._.-....--....
<br />DED RETENTION $
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />PER OTH-
<br />ST.A.T.UTE..................E.R..........
<br />..............................................................
<br />YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE "' `"
<br />E;L,,EACH,ACCIDENT
<br />$
<br />FFFICERIMElMWR) EXCLUDED?
<br />N I A
<br />.............
<br />,
<br />(Mandatory In NH)
<br />E LISEASE.-,EA EMPLOYEE
<br />$
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />1 E.L. DISEASE - POLICY LIMIT
<br />$
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, it's officers, employees, agents and representative are Additional Insureds with respects to General Liability when required by written
<br />contract per form SS0008.
<br />REVIEWED BY: EUNIGE HEF2EDIA (PG 11 OFy
<br />City of Santa Ana
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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