|
c' ���
<br />Pae I0 z
<br />ACC7ltL7® CERTIFICATE OF LIABILITY INSURANCE
<br />Mt
<br />003/2o/201zolYY)
<br />13/afi
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 />Willis of Texas, Inc.-'—
<br />a/c 26 Century Blvd
<br />CONTACT
<br />'-"'- ------
<br />PHONE 1 877.945 7378 fN�. Not. 1.888-467-2378
<br />Ski I XU----- .�-....._--..._..—..._
<br />P.O. Box 305191
<br />gpp cart{ Eicate®®willis.com
<br />INSURER131 AFFORDING COVERAGE
<br />NAICq__
<br />Nashville, IN 372305191 VBA
<br />INSURERA: Travelers Indemnity Company
<br />25658
<br />I
<br />INSURED
<br />NEC Corporation of Acacia.
<br />3929 W. John Carpenter Praeway
<br />INSURER B: Travelers Indemnity Company of America
<br />--
<br />25666
<br />INSURER C; Travelers Property Casualty Company of Amo
<br />25674
<br />INSURER O: Charter Oak Fire Insurance Company
<br />25615
<br />Irving, TX 75863
<br />INSURER E:
<br />_
<br />INSURER F: —
<br />_
<br />CUVERAGES CERTIFICATE NII M B ER a wap S e T a a RRVISIr3N NI IMRFR•
<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 />IOCY
<br />LTR
<br />TYPE OF INSURANCE
<br />IDDL
<br />BWVD UB
<br />_POLICY NUMBERi
<br />SIT
<br />MMlOOA'YYY
<br />M !DO VY
<br />LIMITS
<br />X
<br />COMMERCIALGENERALLIABIDTY
<br />CLAIMS -MAGE X OCCUR
<br />I
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />E-TCSRENTED
<br />PREMISE9IFa syyyUgPca,
<br />$_Y 300,000
<br />MED F.XP An ons smon)
<br />s 10,000
<br />A
<br />y
<br />y
<br />SX-DL8A-16206431-18
<br />04/01/2018
<br />07/01/2010
<br />PERSONAL$ ADV INJURY
<br />$ 1, D00,000
<br />L.IES PER:
<br />GEN'LAGGREGATE LIMIT APP`'
<br />POLICY ❑ PRCTO- ju LOC
<br />E
<br />GENERALAGGREGATE
<br />$— 21000,000
<br />PRODUCTS-COMPIOPAGG
<br />$ 1,000,000
<br />S —
<br />OTHER:
<br />AUTGMODILEUABILrrY
<br />COMBINED SINGLE LIMI
<br />E.ecoldeeal
<br />$ 1,000,000
<br />BODILY INJURY (Pet person)
<br />S v
<br />)(
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOSONLY AUTO$
<br />y
<br />y
<br />SU,CAP-162D6418-17
<br />04 01/2018
<br />/
<br />07/01/2018
<br />BOUILY INJURY Par accltlent
<br />( )
<br />$
<br />HIRED q
<br />ALTOS ONLY AUTOS ONLY
<br />PROPERTY DA AGE
<br />POrden —__
<br />$
<br />:i—NON-OWNED
<br />$
<br />C
<br />X
<br />UMBRELLALIAB
<br />X
<br />_
<br />•OCCUR
<br />EACN OCCURRENCE
<br />$ 51000,000
<br />—��GREGA .�. �-..�
<br />AGGREGATE -
<br />$---,—
<br />8,000,000
<br />EXCESS LIAR
<br />CLAIMu"-MADE
<br />y
<br />y
<br />a$MJ-CDP-162D6f 2A- 17
<br />04/01/2018
<br />07/01/8018
<br />DED I X I RETENTION$ 10, 000
<br />$
<br />C
<br />WORKERS COMPENSATIONPER
<br />AND EMPLOYERS'LIABILITY Y!N
<br />ANYPROPRIETORIPARTNEREXECUTIVE
<br />OFFICEWMEMBERE%CLUgED7 No
<br />(MandatorylnNH)
<br />K vyee, describe under
<br />DESCRIPTIONOFOPERATIONSbelow
<br />NIA
<br />X
<br />BC2JUB-162D6443d8
<br />04/01/2018
<br />07/01/2018
<br />I OTH.
<br />X RvTP. ER
<br />IL EACH ACCIDENT
<br />s 1,000,000
<br />_
<br />F..L. DISEASE -EA EMPLOYEES
<br />-
<br />1,000,000
<br />E,L DISEASE -POLICY LIMIT
<br />—
<br />$ 110001000
<br />D
<br />Workers Compensation and
<br />HRODS-413339258-18
<br />04/01/2010
<br />07/01/2018
<br />E.L. Bach accident
<br />g1, 000, 000
<br />employes Liability -
<br />E.L. Disease - Ea am
<br />$1,000,000
<br />Por Statute
<br />E L Diaeaee-Pal limi
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORO 101, Additional Remarks Sohedute, may W attached it mora apace Ia required)
<br />The City of Santa, 20 Civic Center Plaza, Santa Ana, California, its Officers, Employees, Agents, and Volunteers are
<br />included as Additional Insured with regard to liability and defense of suite arising from the operations and uses
<br />performed by or on behalf of the Named Insured. With respect to bodily injury or property damage claims arising out of
<br />the operations performed by or on behalf of the Named Insured, such insurance as is afforded by this policy is primary
<br />and is not additional to or contributing with any other insurance carried by or for the benefit of the Additional
<br />Insured provided claims that give rise are from the Named Insured 's negligenceand arising out of operations
<br />The City of Santa Ana,
<br />its Officers, Agents end
<br />Attn: Carl Marek
<br />PO Box 1988
<br />Santa Ana, CA 92702
<br />Ilk
<br />lie^'''i 1 HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />r ACCORDANCE WITH THE POLICY PROVISIONS,
<br />�,`'��pKttpl�ey
<br />AUTHORIZED REPRESENTATIVE
<br />©1988.2015 ACORD
<br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />OR To, 15831977 aArm: 640766
<br />
|