PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (2)

Home Browse Search

AC ?b® CERTIFICATE OF LIABILITY INSURANCE 111 F DAT (MMIDDIY Y) 1 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 Edgewood Partners Insurance Center 3 Landmark Square, 4th Floor Stamford CT 06901-2515 CO AC NAME: Rusty Brlante PHONE 203-658-0511 ac No: E-MAIL AODREss: rust .briante a icbrokers.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Travelers Prop Casualty Cc of America 25674 INSURED PRUDEN2069A Prudential Financial, Inc. 751 Broad Street INSURER B: The Phoenix Insurance Company 25623 INSURERC: INSURERD: Newark NJ 07102 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1367737038 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. ILTR TYPE OF INSURANCE ADDL INSO SUBR Wive POLICY NUMBER POLICY EFF MMID011'YYY POLICY EXP MM)OD)YYYY LIMITS COMMERCIAL GENERAL LI ABILITY EACH OCCURRENCE $ CLAIMS -MADE F OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-Lo ECT PRODUCTS - COMPIOP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Es accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par accitlenl) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident UMBRELLA LIAB H OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A A R WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANVPROPRIETORIPARTNERIEXECUTIVE TWXJ-UB-12003053-18 TRJ-UB-203T1022-18 TC2N-UB-121D1040-18 11112010 11112010 1/1)2018 1/1/2019 11112019 11112019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Location Address: 20 Civic Center PLaza, M-17 Santa Ana, CA 92701 CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I III , r 4-�- *'i Csari ,r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Finance and Management Services Agency City of Santa ACCORDANCE WITH THE POLICY PROVISIONS. Ana Aur� REPRESENTATIVE ,IV�(j`/-//M�J�j'W+,(L-. Civic Center PLaza, M-17 Santa Ana CA 92701 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I III , r 4-�- *'i Csari ,r