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CAZALES, RODOLFO, DBA: TOYAMA KARATE-DO ORGANIZATION (2)
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CAZALES, RODOLFO, DBA: TOYAMA KARATE-DO ORGANIZATION (2)
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Last modified
6/9/2022 2:22:30 PM
Creation date
5/14/2019 3:23:23 PM
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Contracts
Company Name
CAZALES, RODOLFO, DBA: TOYAMA KARATE-DO ORGANIZATION
Contract #
N-2019-082
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
6/30/2020
Destruction Year
2025
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Policy Number; Date Entered: 01/02/2019 <br />A%*.i CERTIFICATE OF LIABILITY INSURANCE DAM <br />(MyffiOpmrn) <br />1/2/2019 <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(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 ondorsemant. A statement on <br />this certificate Ann. not nnnfun ainhrc . . <br />INSURED <br />Reindeer Insurance Services <br />14037 Pioneer Blvd <br />Norwalk CA 90650 <br />Rodolfo Cazalez <br />1030 Moore Street <br />Santa Ana, CA 92704 <br />N -r3mr- <br />B38 <br />com <br />Company <br />THIS <br />FVISIQN NUMBER: <br />IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED <br />INDICATED, <br />TO THE INSUREDRNAMEO ABOVE FOR THE POLICY PERIOD <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />CERTIFICATE <br />DOCUMENT WITH RESPECT TO WHICH THIS <br />MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES <br />EXCLUSIONS_AND <br />DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN <br />ILNR� <br />REDUCED BY PAID CLAIMS, <br />---`_ ADA��rgU-ER—"'—"--'---.---. <br />-'I" a <br />TYPE OP INSURANCE POLICY NUMBER MMIO YEFF POLmb UP <br />LIMITS <br />MERCIALOENERAL UAOILITY <br />CHOCCURRENCE 31, 000, 000 <br />CLAIM9 MADE CCCUR USP262607oL/pl{gore OL/oL/zozo DXTnAAP,-aIk ncei 8ME9E%P <br />7—_ <br />An one rson)$5,000_...... <br />PERSONAL &ADV INJURY s1,000,000 <br />GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000, 000 <br />POLICY 0 <br />❑ LOC — <br />JECT <br />PROOVCTE-COMPIOP AGG $2,000,000 <br />OTHER: —.5— <br />AUTOMOBILE LIABILITY GO el 0 1 L LI 1 <br />S <br />t ANYAUTtl <br />—1{ OWNEDISCHEDULED BODILY INJURY (Perpanon) 5 <br />AUTOS ONAUTOG BODILY INJURY (Par acgden) S <br />HIREDNON-OWN' <br />AUTOS ONAUTOS ONLY FeOacgE <br />S <br />UMBRELLADCCUfl <br />EACMCCCURRENCE <br />CLAMS <br />lA <br />-MADE <br />AGGREGATE <br />@ <br />tlE0 RETENTION @ <br />`% <br />- <br />-"'---"'-- <br />COMPENSATION <br />5 <br />AND EMPLOYERS' LIABILITY <br />F <br />R <br />TyTYIN AEO1H <br />AV PROPRIETORIPARTNEME)ECUTVE <br />OFFlCER)MEMBEREXCWDED? <br />---- <br />!NIA <br />(Mandatory in NH) <br />�* <br />E.L. EACHACCICENi <br />Y <br />DISEASE -EA EMPLOYEE <br />SDCRIPT <br />QESCRIPTION <br />ze��' <br />�15.��EL. <br />C <br />E.L. DISEASE -POLICY LIMIT <br />__.._......_. <br />$ <br />OF OPERATIONS Eebw <br />Q� <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO HH, AdURIMM l Ramargs Schadulo, may bq aNavhed if mom grave is mqurrtd) <br />Karate School <br />Location:2320 N Grand Ave Santa Ana CA 92705 <br />Certificate holder, its officers, agents, and employees are named Be Additional Insured in regard <br />to General Liability <br />CERTWICATF rinl nro <br />Att:PRCSA <br />20 CIVIC CENTER PLAZA M-23 <br />PO BOX 1988 <br />SANTA ANA CA 92702 <br />ArnRn 7C mmain1, <br />SHOULD ANY OF THE ABOVE DESCRIBE POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />01 <br />- ...- . _.... ............... .vev aav IM PaikarcO fnarK$ Or AOUNU <br />Produced usina Forms B053 Plus software, www,FormSBoss.com: Impressive Publishing 800.208.11)77 <br />
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