|
nrr...... IIIia
<br />I.tK 111-IL ATE OF LIABILITY INSURANCE DATE(MM1DDNYW)
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 312019
<br />BY
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED CERTIFICATETE THE POLICIES HOLDER. HIS
<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 Bolton & Company cc C
<br />AME;
<br />3475 E. Foothill Blvd ., Suite 100 PHONE
<br />Pasadena, CA 91107 EMAIL Nq iao f62 L79s 7000 _ a szs 5a3 z117
<br />ADRE3Ji;_.-----
<br />ww.b0ltonCO.cOm __ INBURERIS)AFFOROING COVERAGE NAJC9
<br />0008309 INSURER A: Zurich American Insurance Company -INSURED �, 16535
<br />EleCtro Construction Corp. INsunER e: Travelers Property Casualty Co of Amer _ 25674
<br />2225 North Windsor Avenue
<br />9100
<br />Altadena CA 9100INSuERrsc: TokiO Marine Specialty Insurance Company_ 23850
<br />1 INSURE0.D:
<br />INSURER E:
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 51636441 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 />MR Ap SUB
<br />LTR TYPE OF INSURANCE INSDIinvo POLICY EFf POLICY E%P
<br />POLICY NUMBER M DpM'Yy MMIDO LIMITS
<br />A ✓ COMMERCIAL GENERA. ✓ ✓ GL 4426516-00 10/1/2019 10/12020
<br />CLAIMS -MADE ✓,OCCUR EACH OCCURRENCE $1000000
<br />- PREMISES Ea acc mfiw S100000
<br />MED EXP (Any one person $ 5 000
<br />PERSONALBADVINJURY $1000000
<br />GENt AGGREGATE LIMIT APPLIES PER: ',GENERAL AGGREGATE $2,000,000
<br />POLICY jECT LOC
<br />I OTHER: PROOUCTS_COMP/OPAGG $2000,000
<br />A AUTOMOSILELIASILITY S
<br />BAP 4426517-00 10/1/2019 1O/1/2020 COMBINamaaED SINGLE LIMIT
<br />✓ 1 My quTo Ea n S 1 000 000
<br />-{ BODILY INJURY Per OWNED SCHEDULED L. ( P°"1O^7 $
<br />AUTOS ONLY AUTOS BODILY INJURY (Per aoc,o nl) $ --- AUTO NON-OWNEDSLY AUTOS ONLY ,_-: AUTOONLY L per, aori eryrlOAMAGE $ -----'
<br />I _
<br />B / UMBRELLALIAB ✓ S occuR ZUP-51 M428B2-19-NF 10/1/2019 1011 /2020 EACHOCCURRENCE EXCESS LITgB_ _ I CLAIMS $8000000
<br />I -IMDE j----
<br />OED ✓ RETENTION 51 O,000 r'AGGREGATE $8000000
<br />A WORKERS COMPENSADON WC 4426515-00 $
<br />AND EMPLOYERS' LIABILITY YIN 10/1/2019 10/1/2020 ,/ STA STATUTE OTH. ANYPROPRIETOR:PARTNER�EXECUTIVEER
<br />OFFICERIMEMBEREXCLUDED9 ❑V N/A E.L. EACH Accinew $1000000
<br />(menae.0 In NMI
<br />If yes, describe under E.L. DISEASE -EA EMPLOYE $
<br />0E tessioON OFO ling, SIR
<br />below I E.L.OISEASE-POUCYLIMIT S1000000
<br />C (Professional Liability, SIR R $100 PPK2042448 10/1l2019 10/1/2020 Limit: $1,000,000; Aggregate: $2,000,000
<br />C Contract Pollution Liab, SIR $10000 PPK2042448 10/1/2019 10l1/2020 Limit: $1,000,000; Aggregate: $2,00,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may 1. attached 11 more space a required)
<br />OGL Waiver of L Blanket Additional Insured & Primary and Non Contributory apply per UGL1175FCW0413 attached, only if required by written contract/agreement.
<br />Re: ECC 419 Ou City of Santation a Iies per A a, Lighting Retrofit attStadiium. Additional nsured(sice of j City Cancellation
<br />SantaaAnag Risk Managemenntt,, i s Offica , mp ogees had.
<br />agents, representatives, and volunteers.
<br />PFVIFWEII K APPPOVFll
<br />City of Santa Ana
<br />Risk Management Divi
<br />20 Civic Center Plaza
<br />Santa Ana, CA 9270
<br />1 2019 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS-
<br />M. LAMBERT AUTHORIZEDREPRESENTATIVE
<br />rChau Tran
<br />ACORD 25 2016/03 ©1988-2015 ACORD CORPORATION. All rights
<br />( ) The ACORD name and logo are registered marks of ACORD
<br />516]6991 ¢LECCON-Ci 119-20 GL. AU- Qmb, a, 2rof & Poll 18olmn Cerci,cate Processing 1 1e/3/2019 1:33:2C PR fPDTI I p%ge 1 of 9
<br />
|