|
WITTENT-01
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />i CKE
<br />°� 8n/20119 '
<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 polley(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 endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In lieu of such andomemant s .
<br />PRODUCER
<br />Western Elite Insurance Solutions
<br />130 Diamond Creek Place, Suits 2
<br />Roseville, CA 96747
<br />CT
<br />(PU e,Eat:(918) 269.6900 1 nm,NR:(886) 206.8646
<br />INSURERS) AFFORDING COVERAGE
<br />NAICIs
<br />INSURER A: National Fire Insurance Company of Hartford
<br />INSURED
<br />Wittman Enterprises LLC
<br />11093 Sun Center Drive
<br />Rancho Cordova, CA 96670
<br />INSURERS: Continental Insurance Company
<br />INSURER c:Continental Casualty Company
<br />INSURERD:Slats Compensation Insurance Fund
<br />INSURERE:AXIS Surplus Insurance Company
<br />INSURERF: Travelers Casualty Insurance Co of Amer
<br />COVERAGES CERTIFICATE NUMBER' REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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 />INBR
<br />TYPE OF INSURANCE
<br />AODIIselin.
<br />SUe
<br />POUCY NUMBER
<br />POLICY EFF
<br />POUCYEXP
<br />LIMITS
<br />A
<br />TXWAMOPtCtALOM LUABILITY
<br />CIAIMS-MAOE QX OCCUR
<br />X
<br />B6020067350
<br />71112019
<br />71112020
<br />EACH OCCURRENCE
<br />S 2,000,000
<br />PPREMA ETORENrED
<br />1 300,00p
<br />XP An a arson
<br />10,000
<br />PER L A ADVINJURY
<br />S 2,000,000
<br />AGGRE LIMIT APPLIES PER:
<br />iX POLICYj �LOC
<br />Or
<br />GENERALAGGREGATE
<br />S 4,000,000
<br />PRODUCTS -COMP AGG
<br />4AOO,000
<br />EPLI FIDUCIARY
<br />10,000
<br />B
<br />AUTOMOBILE LWBRTfY
<br />IANY AUTO
<br />ONMED SCHEDULED
<br />AUpT�O�S ONLY ANt1UppTµNO4pSWWNN�Ep
<br />AL`i�t46ONLY ANaN 0AY
<br />B6020067396
<br />71112019
<br />71112020
<br />COMBINED SINGLE LIMIT
<br />11000,000
<br />BODILY INJURY Per ems,
<br />BOOpDILY INJURY Par accident
<br />S
<br />PPa?�ERent AGE
<br />S
<br />C
<br />X
<br />A
<br />SEEc
<br />CAIMS.MADE
<br />B6020067431
<br />71112019
<br />7/112020
<br />2,000,000
<br />AGGREGATE
<br />6 2,000,000
<br />CED I X I RETENTXNd1 10,000
<br />D
<br />WORKERS COMPENSATION
<br />MID EMPLOYERS' LIAMUTY
<br />ANY PROPRIET
<br />W.1tl.E=jnmdERUDDCUrn"
<br />a eA deernbe vmler
<br />CRIPTI NOF OPERATI N BNW
<br />MIA
<br />9161868-2019
<br />71112019
<br />71112D2D
<br />OTH-
<br />X PTA
<br />EACH A
<br />1,000,00 0
<br />.L DISEASE -EA M Y
<br />1,000,00O
<br />E.L. DISEASE -POLICY LIMIT
<br />S 1.000,000
<br />E
<br />F
<br />Cybor Liability
<br />E&O1ComelFiduciary
<br />P00100004271101
<br />107019103
<br />111712018
<br />11112019
<br />1117/2019
<br />1MI2020
<br />Aggregate/Limit
<br />Each ClaimlAgg
<br />1,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remade. SchedW may be aRecbad If mare space Is required)
<br />City of Santa Ana, officers, agents, employees, and volunteer are named as Additional Insured as respects the General Liability per the attached
<br />endomementform number SB146932F. General Liability policy applies on a Primary -Noncontributory basis per endorsement form number SB146932F.
<br />Cancellation or Material Change Notification applies per the attaclmd endorosement form number SB147052C.
<br />REVIE D & APPROVED
<br />y Risk NAGEMENT DIVISION
<br />CFRTIFICATF Nnl nFR Xk 1. CANCELLATION
<br />SAMA T A M. LAMBERT
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana
<br />ROVISION6CE WILL BE DELIVERED IN
<br />THE EXPIRATION DATE ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />AUTHORRED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />ACORD 26 (2016103) f01988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|