Laserfiche WebLink
OP ID: YC <br />,a►coizo CERTIFICATE OF LIABILITY INSURANCE <br />DATE 11/29/2018 rI <br />11 /29/2018 <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(les) 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 />certificate holder In lieu of such endorsements . <br />PRODUCER <br />Narver Associates Ins Agcy <br />641 W. Las Tunas Drive <br />PO Box 1509 <br />San Gabriel, CA 91778-1509 <br />WESLEY HAMPTON HOUSE <br />CONTACT <br />NAME: June Samalln <br />PHONE FAX <br />•626-943-2237 Ho: 686-299-1010 <br />AoDD&ss: isamarin@narver.com <br />PRODUCER <br />cu-LIEBE-1 <br />INSURER 8 AFFORDING COVERAGE <br />NAIL a <br />INSURED LiebertCassidy Whitmore <br />6033 W.Century Blvd.5th Fir <br />Los Angeles, CA90045 <br />INSURER A: Sentinel Insurance Company <br />11000 <br />INSURER 0: Federal Insurance <br />20281 <br />INSURER C:Aspen Specialty Insurance <br />10717 <br />INSURER 0: Lloyds of London <br />15792 <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 />TYPE OF INSURANCE <br />ADDL <br />S B <br />POLICY NUMBER <br />MMR DfYYYFY <br />MMMOY EXP <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIgI GENERAL LIABILITI' <br />CLAIMS -MADE rL; OCCUR <br />X <br />7258AAK0316 <br />12I1a2018 <br />12114/2019 <br />EACH OCCURRENCE <br />$ 2,000,00 <br />PREMIS Ee ottunarae <br />$ 1,000,000 <br />MED EXP (My we parson) <br />$ 10,00 <br />PERSONAL B ADV INJURY <br />If 2,000,00 <br />GENERALAGGREGATE <br />$ 4,000,00 <br />GEN'L AGGREGATE <br />K POLICY <br />LIMIT APPLIES PER: <br />PRO- LOD <br />PRODUCTS-COMP/OP AGO <br />$ 4,000,00 <br />$ <br />A <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-DWNEO AUTOS <br />72SBAAK0318 <br />72SBAAK0318 <br />1211412018 <br />1211412018 <br />12/14/2019 <br />12/14/2019 <br />COMBINED SINGLE LIMB <br />(Ea accident) <br />E 2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(PERACCIDENT) <br />$ <br />X <br />X <br />$ <br />S <br />q <br />J( <br />UMBRELLA LIAR <br />EXCESS LIAR <br />X <br />OCCUR <br />CLAIMS -MADE <br />72S8AAK0318 <br />12I1a2018 <br />1211a2018 <br />EACH OCCURRENCE <br />$ 2,000,00 <br />AGGREGATE <br />$ 2,000,00 <br />DEDUCTIBLE <br />RETENTION $ 10,000 <br />$ <br />X <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNEWEXECUTNE YIN <br />OFFICEWMEMBER EXCLUOEOT <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />717545-95 <br />0410112018 <br />04101/2019 <br />X WCSTAT0. OTt4 <br />E.L. EACH ACCIDENT <br />$ 1,000,00 <br />E.L. DISEASE - EA EMPLOYEd <br />$ 1,000,00 <br />E 1,000,00 <br />E.L. DISEASE -POLICY LIMIT <br />C <br />D <br />Professional Liab. <br />Cyber Liability <br />LRA9AF817 <br />WN163087 <br />1211012018 <br />12106/2018 <br />12/10/2019 <br />12106/2019 <br />Per Claim 5,000,00 <br />Per Claim 3,000,00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attack ACORD 101, Additional Remarks Schedule, If more space is required) <br />Certificate Holder is named as an Additional Insured in regards to attached <br />General Liability Form SS 00 08, per written contract or agreement. <br />CITYSAA <br />City of Santa Ana <br />20 Civic Center Plaza <br />P.O. Box 1988 <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 REPRESENTATIVE <br />© 1988.2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />