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WACHTER, INC. 2
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Last modified
10/11/2018 9:18:27 AM
Creation date
7/20/2018 2:55:38 PM
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Contracts
Company Name
WACHTER, INC.
Contract #
N-2018-144
Agency
PUBLIC WORKS
Expiration Date
6/30/2019
Insurance Exp Date
8/1/2019
Destruction Year
2025
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,a►coRO� CERTIFICATE OF LIABILITY INSURANCE <br />L.� 8/1/2018 <br />DATE(MM/DD/YYYY) <br />7/17/2017 <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 Lockton Companies <br />444 W. 47th Street, Suite 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />CONTANAME: CT <br />PHONE FAX <br />A/C No Ext): (A/C. <br />A/C No): <br />E-MAIL <br />ADDRESS: <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FxIOCCUR <br />N <br />INSURER(S) AFFORDING COVERAGE NAIC /1 <br />INSURER A: Zurich American Insurance Company 16535 <br />8/1/2017 <br />INSURED WACHTER, INC. <br />6969 16001 WEST 99TH STREET <br />INSURER B: Great American Insurance Co of New York 22136 <br />INSURER C: <br />LENEXA KS 66219 <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES * CERTIFICATE NUMBER: 14711718 REVISION NUMBER: XXXXXXX <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FxIOCCUR <br />N <br />N <br />GL0552579805 <br />8/1/2017 <br />8/1/2018 <br />EACH OCCURflENCE $ 1 000 000 <br />DAMAGE TO PREMISES Ea occurrence) $ 300 000 <br />MED EXP (Any one person) $ 5,000 <br />PERSONAL & ADV INJURY $ 1 000 000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 2,000 000 <br />POLICY FX jE O F-1 LOC <br />PRODUCTS - COMP/OP AGG $ 2,000 000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITYN <br />N <br />BAP552579905 <br />8/1/2017 <br />8/1/2018 <br />Ea aocidentSINGLE LIMIT $ 1 000 000 <br />BODILY INJURY (Per person) $ XXXXXXX <br />X <br />ANY AUTO <br />OWNEDSCHEDULED <br />AUTOS ONLY AUTOS <br />(Per accident) BODILY INJURY (Pident) $ XXXXXXX <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE $ XXXXXXX <br />Per accident <br />Com /Coll Deds. $ 1,000 <br />X PHYS DAM <br />B <br />UMBRELLA LIAB <br />X <br />OCCUR <br />N <br />N <br />UMB9999693 <br />8/1/2017 <br />8/1/2018 <br />EACH OCCURRENCE $ 2,000,000 <br />X <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE $ 2 000 000 <br />DED RETENTION $ <br />$ XXXXXXX <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N / A <br />N <br />WC552580005 <br />8/1/.017 <br />8/1/2018 <br />X STATUTE EERH <br />E.L. EACH ACCIDENT $ 1,000 000 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,00 <br />(Mandatory in NH) <br />DEdescribe under <br />SCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT 1 $ 1,000.000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />FOR CANCELLATION FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURERS) WILL SEND 30 DAYS NOTICE OF <br />CANCELLATION TO THE CERTIFICATE HOLDER. CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND <br />REPRESENTATIVES 1S/ARE ADDITIONAL INSUREDS) ON A PRIMARY AND NON-CONTRIBUTORY COVERAGE BASIS Au RESPECTS LIABILITY <br />COVERAGE FOR THIS PROJECT. INSURANCE SHOWN APPLIES ONLY TO EXTENT OF WRITTEN CONTRACT. <br />REVIEWED BY: EUNICE HEREDIA (PG ( OF q) <br />%-,r-ri i iri,_m i rz nvwr_n <br />14711718 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA (M-30) <br />SANTA ANA CA 92702 <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 <br />(c) 19RRonis ACC)Rr) CC)RPC)RATl0N1 All rinhfc —a --i <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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