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CHAZPAR-01 ( <br />�a ® CERTIFICATE OF LIABILITY INSURANCE I DA3/1112020YY) <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 policyges) 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 riahts to the certificate holder in lieu of such endorsement(s). <br />PRODUCER wcenae B erot r in <br />HUB International Insurance Services Inc. <br />16030 Ventura Blvd., Suite 500 <br />Enclno, CA 91436 <br />INSURED <br />Chazey Partners, Inc. <br />62 Chestnut Avenue <br />Los Gatos, CA 95030 <br />of Amerle <br />COVERAGES CERTIFICATE NUMBER: RECISION 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. NOTWII"HSTANDING 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 />IN$R_--�AptlL 5U6R __._.. _..__—__.___ PO�ICY EFF O--- .._....._—LIMITS <br />_ _TYPE OF INSURANCE D POLICY NUMBER IMP <br />A <br />X COMMERCIAL GENERAL DABIUTY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />.. <br />CLAIMS�MADC {X'{OCCUR <br />X <br />680087017d1 <br />8f21/2010 <br />6I211202q <br />°Ah"A emRENrcO <br />3RLMI.Es�€a4cr_uualacel <br />_mm.. <br />3Dt1006 <br />"MED, F�(P An one <br />..__..___ <br />F UNAL& nuV INJURY <br />a 000,000 <br />GENT AGGRF(GATE URMptT. APPLIES PER: <br />tIc <br />IZ;+ENERAL_AGGfiE6A1F <br />.. <br />-1 <br />X� POLICY i._..� JECT I,,,... _� LOC <br />PRODI.T3_ COJOP AGG_ <br />2 DOq,OOg <br />--__..__...._Included <br />Or 1Frgr, <br />HIRED NONOWNDE <br />AU TOMOBILRLIABILITY <br />COMDINED SINGLE LIMIT <br />ANY AUTO <br />Y INJURY�Pce,P_esw <br />$ <br />_ <br />ou LED <br />AOU7�$ONLY AUTOSS <br />YINJURY(Par xo*k,i <br />NN W Ep <br />ONLYAN 7V('ONNLV <br />H <br />idYANIAGE <br />1-qgqlam� <br />UMaREi.LA LIAROCCUR <br />t <br />O.,, <br />($ <br />EX ESSUAD <br />DED RETENTION$ <br />AGGREGATE <br />_ <br />WORKERS COMPENSATION <br />ER p7H <br />1AL1ffE__--" <br />I <br />AND EMPWYERSLYBILITY YIN <br />ANY PROPRI6TORIPARTNER/PXECUTIVE <br />E ACQNENT <br />- -'-- <br />OOFFFIDERR//NIFMe�� EXCLUDEP`l I <br />v <br />N1A <br />UFACH - <br />.__ - --- <br />{MantlataylnNH} <br />EL DISEASE-EA-SA§PLOYE <br />$ <br />DESCRPnOewrdar <br />DESCRIPTION OP OPEftATiQNS beimx <br />E.L. DISEASE -POCKY LIMIT$ <br />DESCRIPTION OF OPERATIONS 7 LOCATIONS IVEHICLES(ACORO 101, Adrl4tlw14 RemarksSched.i% ewy ba eaachad if more space F "'N'adrJ <br />Additional Insured applies The City of Santa Ana, it's officers, employees, agents, and representative tpor General Liability policy per attached form #CG D1 86 <br />1103. Primary and non-contributory wording applies per attached form NCG DO 37 04 05, <br />30 day notice of cancallationl10 days for non-payment of premium. <br />'REVISED CERTIFICATE` Thts Certificate voids and supersedes Certificate issued on 03102i20. <br />ERTIFICATE HOLDER [V1�W t"" �yVY DIVIStvI� CANC LLA IQk <br />— -sF OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFLLCD BPI -ORE <br />Cif of Banks Ana L.1f <br />Y <br />Risk Management Division !" <br />THC EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 4th Floor <br />— - -- -- <br />AUTHORIZED REPRESENTATIVE <br />i2G`, Zal lv— <br />Santa Ana, CA 92701 <br />ACORD 25 (2010103) m ©19$8.2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />