GRISWOLD INDUSTRIES - Laserfiche WebLink

Home Browse Search

G " CERTIFICATE OF LIABILITY INSURANCE DATE mvr) lk 2019 0512012019 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(ies) 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 endomement(s). PRODUCER _ -CONTACT Marsh Risk & Insurance Services NAME: 17901 Von Kaman Avenue, Suite 1100 (949)399-5800; License#0437153 Irvine, CA 92614 PHONE FAX EINC.No: E-MANo ADDRESS: INSURERS AFFORDING COVERAGE NAICp Attn: NwpodBeach.CerlRequesl@mamh.cemlF: 212-948A323 CN102166416-STND-GAWUP-19- INSURER A: Hartford Fire Insurance Com n 19682 INSURED Griswold Industries, Cla-Val Company INSURER B : N/A WA Ave Cost Placentia Avenue Costa Mesa, CA 92627-0475 INSURER C: Twin CI Fire Insurance Company 29459 INSURER D: NIA N/A INSURER E INSURER F: �a�rsnvw CENnrH.A l e Numtft=K: Los-W243175001 REVISION NU THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MBER. 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. INSRR A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR $1,000,000 SIR AO UBR POUCYNUMSER 72ECSOA1987 POLICY EFF MMIDDIYYYY 04/01/2019 POLICY EXP MMIDEVYYYY 04/01/2020 LIMITS EACH OCCURRENCE $ 1,0D0,000 PREMISES Ea occumnlM $ 300,000 x MED EXP (Any one person) $ PERSONAL& ADV INJURY $ 11000,000 GENT x AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ LOC JECT GENERA -AGGREGATE g 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: A AUTOMOBILE X x LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED x NON -OWNED AUTOS ONLY AUTOS ONLY 72UENUM3154 04101/2019 04101/2020 Ea aBe 151NGLE LINT $ 1�� BODILY INJURY (Perperson) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per aaident $ 8 UMBRELLALIAB EXCESS DAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE g DEO RETENTION$ WORKERSCOMPENSAMON ANDEMPLOYERS'DABILITY YIN OFFlCERRAEMaEReAicowoED'I ECUTIVE (Mandatory In NH) Use. describe under DESCRIPTION OF OPERATIONS below X PER OTH- STATUTE ER $ A C N/A 7 WNG93100 - 72WEH03564 (L,MD,M,NJ,NC, DR,TX,VA) 04101/2019 /01/2020 04/01/2020 E.L. EACH ACCIDENT $ 1,000.000 E.L DISEASE -EA EMPLOYE 000 $ 1,000,000 E.L. DISEASE -POLICY LIMIT E 1 OW DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be summed IT mom space is mctutmd) The Cilyof Sana Ana, its officers, employees, agents, volunteers, and representatives are included as additional insured (except workers'compensation) where required by written contract. Thisinsuranceis primary and non-conMbutory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditons with respect to General Liability. VED Y RISK Iwil'u— � City of Santa Ana B SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza 19 2 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 198E 14 i7 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services I Claudia Hernandez ©1988-2016 ACORD CORPORATION. All rights reserved. I<o.ory o) i ne Ax ur