ORANGE COUNTY FIRE PROTECTION - Laserfiche WebLink

Home Browse Search

ORANCOU-06 PHILLIPSC 1 All a CERTIFICATE OF LIABILITY INSURANCE DA6/2912018 V, 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 have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER License # OE67768 IOA Insurance Services 130 Vantis Suite 250 Aliso Viejo, CA 92656 N-20`18463 NAMTACT Elizabeth Leach nI°NN , Ext : (949) 297-5537 52011 �Alc, Ne):(949) 297.5960 .m EDDal . Elizabeth. Leach@ioausa.com INSUREI AFFORDING COVERAGE NAIC Is INSURER A: Tokio Marine Specialty Insurance Company 23850 INSURED !INSURERB:Philadelphia Indemnity Insurance Company 18058 I INSURER C : Everest National Insurance Company 10120 Orange County Fire Protection INSURER D: PPK1781002 137 W. Bristol lane Orange, CA 92865 INSURER E NSURER F: r ,Ylll Al_CC rFRTIFICATP NI IMRFR, 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR TypE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS -MADE � OCCUR X X PPK1781002 02/28/2018 02/28/2019 DAMAGE TO RENTED 100,000 PREMISES fEa occurre MED EXP An oneperson) $ 5'000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2'000'000 � YE � OTHER: 2,000,000 PRODUCTS Deductible 51000 B AUTOMOBILELIABILITY- CEOOMBacItlEEDLNGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $OWNE X ANVAUTO X X PHPK1781733 02/28/2018 02/28/2019 BODILY BODILY INJURY Per accident $ AAUITOSDONLY AUOS _ dtOPERTY AMAGE er acadent X AUR S ONLY X AUTOS ONED X Ded Comp. $500 X Ded Call. $1,000 A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4'000'010 AGGREGATE $ 4'000'000 X EXCESS LIAB CLAIMS.MADE PUB618666 0212812018 0212812019 OED X RETENTION$ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN (Mandat.y NHS EXCLUDED? n NIA X 5300003485181 07101/2018 07/01/2019 X STATUTE EERN 1,000,000 E.L. EACH ACCIDENT $ 1,111,111 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT S If Yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Aral Remarks Schedule, may be attached If more space Is required) **This certificate voids and supersedes the certificate issued on 612812018.** The City of Santa Ana, it's officers, employees, agents, and representative are included as an Additional Insured for General Liability and Auto Liability with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement Nos. CG 20 10 0413, CG 20 37 0413 and PI -CA -001 (05110). Liability Coverage is Primary and Non -Contributory, per endorsement No. PIC-GLN-036 (08114). Blanket Waiver of Subrogation applies to General Liability, Auto Liability and Workers' Compensation coverages, per Endorsement Nos. CG 24 04 05 09, PI -CA -001 (05110) and WC 040306. Per Project Aggregate Endorsement per form PIC-GLN-028 (08114). 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions. City of Santa Ana Public Work Agency 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVEe�J ✓l."."" .rl A'�>i'fL^ ��vl k �� Parr9�rgL .Z'I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD V I/