ALBI - Laserfiche WebLink

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE ATE D8/21/2017Y) 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 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 endorsements . PRODUCER Harbor West Insurance Agency, Inc. 25330 Marguerite Parkway, Suite B Mission Viejo, Ca. 92692 NAME: Rick Keye IPA HONE949 768-1188 ac we : 949 768-0543 EMAIL ADDRESS: rick harborwestinsurance.com CER CUSTOMER D . 706 INSURER(S) AFFORDING COVERAGE MAIC # INSURED INSURERA:MaXum Indemnity Active Learning Believe and Inspire 505 E. Central Ave. INSURERS; A Santa Ana, CA 92707 INSURER C BDG -3020081-01 INSURER D 07/21/18 INSURERE: Employers Preferred Ins. Co. INSURER F: PERSONAL B ADV INJURY $ 1,000,000 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 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. /XP LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMLOUIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR X BDG -3020081-01 7/21/17 07/21/18 DAMAGE TOR D 100,000 PREMISES Ea occurrence $ MED EXP (Any one person $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 ✓ POLICY PRO ✓ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ E. accident) ANY AUTO BODILY INJURY (Per person) $ ALLOWNED AUTOS BODILY INJURY(Peraccidenl) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC STATU, OTH- E AND EMPLOYERS' LIABILITYTSI ANY OFFICER/MEMBER EXCLUDED ECUTIVE� (Mandatory in NH) NIA EIG2514073 8/17/17 08/17/18 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI $ 1,000,000 i yes, describe under DESCRIPTION OF OPERATIONS be. E,L. DISEASE -POLICY LIMIT 1,000,000 ($j DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ,� 2—'„ - CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED, THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA CA, 92702; ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS CERTIFICATE HOLDER CANCELLATION THE CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SANTA ANA, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Richard Keye © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD