My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
25Q - AGMT DT OP
Clerk
>
Agenda Packets / Staff Reports
>
City Council (2004 - Present)
>
2018
>
12/18/2018
>
25Q - AGMT DT OP
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/13/2018 8:37:00 PM
Creation date
12/13/2018 8:28:45 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25Q
Date
12/18/2018
Destruction Year
2023
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
40
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
CERTIFICATE OF LIABILITY INSURANCE ( DA 12JO71201Y7 <br />1 2/0 712 01 7 <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 pollcy(los) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />PRODUCER 1AME6_I Mlke <br />Michael Rodglck(971832A) PHONE 94, <br />196 TechnologyOr Ste B ADDRESS; <br />goDREss: mrod <br />CA <br />SANTA, ANA BUSINESS COUNCIL, <br />400 E. 4TH STREET <br />COVERAGES CERTIFICATP NI IMPOPP. omliainns ur moee�. <br />THIS IS TD 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 />IITTt <br />TYP50FINSURANCE <br />INSR <br />SUB�CYNUMSER <br />PIDWoo EPS <br />MMIDD E%P <br />LIMITS - <br />GENERALUABILITY <br />X <br />COMMERCIAL GENERAL LIABILITY <br />'CLAIMS -MAGE nOCCUR <br />EACH OCCURRENCE "-- <br />_bw6E'Yb'TIERTED <br />RISES EagwfmKW <br />MEO EXP Any an�oreanj-_ <br />5 11000,0000 - <br />S 1000000 <br />S 10,000 <br />Y <br />N <br />605503396 <br />12/0712017 <br />12/07/2018 <br />PERSONALBADVINJURY <br />s <br />GENERAL AGGREGATE_ <br />x11000000 <br />S__2,000,DOO <br />GENL AGGREGATE <br />POUCV <br />LIMIT APPLIES PER: <br />PRO LOC <br />II <br />PRODUCTS -COMPIOPAGG <br />S_ 2,000,00_0 <br />E <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLC OMIT <br />En accMa,l <br />1,000,00_0__ <br />BODILY INJURY (P.ALL person) <br />___ <br />$ <br />_ <br />ANY AUTO_ <br />B <br />AUTOS NEO SCHEDULED <br />OS <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />605503398 <br />12fD7/2017 <br />12/07/2018 <br />BODILY INJURY(Pwacritlsne <br />S <br />5 <br />UMBRELLA LIAR OCCUR <br />EACH OCCURRECE <br />SrEXCESSLIAB <br />W <br />WSOE <br />O—RETE <br />I <br />_ — <br />AGGREGATE <br />$ <br />S <br />D <br />(WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY YIN <br />IANY PROPRIETOWPAATNEWEXECUTIVE <br />OFFICERJMEMBER EXCLUDED? <br />NIA <br />I <br />9081384 <br />121102017 <br />12A%2018 <br />v WC STATU I OTH- <br />^ TORY IMITS�._ _EB. <br />EL EACH ACCIDENT <br />—'--qqT----- <br />__— <br />$ 1,000,000 <br />S - -- <br />IlMandalPrylnNHl <br />Ilya, desmbe under <br />DESCRIPTION OF OPERATIONS balwr <br />E.L 2.SEgSE_EA tLPLOYE <br />E.L. O7SEASE-POLICY LIMIT <br />$ 11000,000 <br />5 1,000,000 <br />E j <br />Fidelity Bond <br />D80 <br />EPL <br />106032811 <br />12/10/2017 <br />12/102018 <br />11.000 <br />5,000 SIR $500,000 <br />1,000 SIR $1,000,000 <br />SIR $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAHech ADGflD 101, gddlHansi Romarks Schoduln, Ilnwrn epaco le mqulmtl) <br />400 E. 4TH STREET, SANTA ANA, CA 92701 <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS FOR GENERAL LIABILITY <br />PURPOSES. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY, WITH THIRTY (30) DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS FOR <br />NONPAYMENT OF PREMIUMS <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLZ ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />SANTA ANA CA 92707 <br />010/05)"1•I-n`'V0✓199BBB-2010ACOR1/D�COR RAT102N!'.^Ail Tiahts Teserved. <br />The ACORD name and I o aegl e d marks of ACORD <br />5U39- <br />
The URL can be used to link to this page
Your browser does not support the video tag.