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BLUERAY MANAGEMENT, LLC.
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Last modified
1/4/2021 9:33:49 AM
Creation date
1/29/2020 11:21:48 AM
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Contracts
Company Name
BLUERAY MANAGEMENT, LLC.
Contract #
A-2020-007
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
1/21/2020
Expiration Date
12/31/2024
Insurance Exp Date
3/15/2021
Destruction Year
2025
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ACORbr CERTIFICATE OF LIABILITY INSURANCE <br />14� <br />DATE(MMIDONYYY) <br />1 02/12/2020 <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(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 endorsement(s). <br />PRODUCER- <br />CONTACT <br />NAME: <br />Automatic Data Processing Insurance Agency, Inc. <br />PHONE FAX <br />NC No Eal:INC,No: <br />E-MAIL <br />ADDRESS: <br />1 Adp Boulevard <br />Roseland NJ 07068 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Sewdly Nat] ins Co <br />19879 <br />INSURED <br />INSURERS: <br />BLUERAY MANAGEMENT LLC <br />INSURER C: <br />10661 Ellis Ave, Ste E <br />INSURERD: <br />INSURER E : <br />Fountain Valley CA 92708 <br />1 INSURER F: <br />CUVtKAGE5 CERTIFICATE NUMBER: 1Jd1110 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 />LTR <br />TYPE OF INSURANCEADDLSUHH <br />INSD <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYYl <br />POLICYEXP <br />(MM1DDTYYYI <br />LIMITS <br />COMMERCIAL GENERAL DABILITY <br />CLAIMS -MADE ❑OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAut ToPREMISES Ea occurrence <br />$ <br />MED EXP (Any one parson) <br />$ <br />PERSONAL B ADV INJURY <br />$ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- JECT ❑ LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OP AGG <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED F SCHEDULED <br />AUTOS ONLY AS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />GOMBINED SING IMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />UMBRELLA LWB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED <br />RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? ❑N <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS be. <br />NIA <br />N <br />SWC7273878 <br />02/10/2020 <br />02/10/2021 <br />R <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000.000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 1.000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD REVIEWED & 1,Ad�naall R@�;,Lks Schedule, may It aIf It d If more space Is required) <br />By Risk MANAftEMENT DIVISION <br />FEBI m- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana, Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />ACORD 25 (2016103) <br />9)1988-2015 <br />The ACORD name and logo are registered marks of ACORD <br />reserved. <br />
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