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TALLER SAN JOSE HOPE BUILDERS
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Last modified
7/8/2020 4:16:16 PM
Creation date
7/6/2018 10:23:50 AM
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Contracts
Company Name
TALLER SAN JOSE HOPE BUILDERS
Contract #
A-2018-135-15
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
5/15/2018
Expiration Date
6/30/2019
Insurance Exp Date
1/1/1900
Destruction Year
2024
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Page 1 of 1 <br />AC R®r CERTIFICATE OF LIABILITY INSURANCE <br />Do6iMMIDDN eYl <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 <br />Williss Insurance Services of California, Inc. <br />c/o 26 Century Blvd <br />P.O. Box 305191 <br />CONTACT <br />NAME, <br />PHONE 1-877-945-7378 FAX 1-888-467-2378 <br />Alt No: <br />E-MAIL <br />ADDRESS: certificates@willis.com <br />INSURERS AFFORDING COVERAGE <br />NAICq <br />Nashville, IN 372305191 USA <br />INSURER A: Jaynes River Insurance Company <br />12203 <br />INSURED <br />Taller Han Soea Hope Builders <br />INSURER B: Philadelphia Indemnity Insurance Company <br />18058 <br />INSURERC: <br />801 N. Broadway <br />INSURER D: <br />Santa Ana, CA 92701 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: W6637786 REVISION NUMBER' <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 />ILTR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />POLICY EFT <br />MMUDDIYYYY1 <br />POLICYEXP <br />MMrODIYYYYI <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />PREMISES(Be occurrence <br />$ 50,000 <br />MED EXP (Any oneperson) <br />$ 1,000 <br />A <br />PERSONAL &ADV INJURY <br />$ 11000,000 <br />y <br />00055243-5 <br />10/01/2017 <br />10/01/2018 <br />GENL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JEST LOD <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS-COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER', <br />AUTOMOBILE <br />LIABILITY <br />COMBINEDSINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />ANYAUTO <br />BODILY INJURY(Per person) <br />$ <br />BAUTOS <br />JX <br />ONLY AUTOSULED <br />PHPK1720949 <br />10/01/2017 <br />10/01/2018 <br />BODILY INJURY(Per accident) <br />$ <br />AUTOS ONLY X AUTOS ONHIRED ES <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />S <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS'LIABILITY YIN <br />ANYPROPRIETOR/PARTNERIEXECUTIVE <br />OFFICERIMEMBEREXCLUDED7 <br />NIA <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory In NHlIf <br />ESdescribe under <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION <br />DRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Additional Insured <br />with Primary & Non -Contributory Clause applicable under the General Liability per endorsements attached. <br />CERTIFICATE HOLDER CANCFI I ATIr1N <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 />The City of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />Community Development Agency <br />20 Civic Center Plaxa <br />Santa Ana, CA 92701 <br />©1988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />so 1-1 16365060 —cm: 764757 <br />
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