MK PRINTING - Laserfiche WebLink

Home Browse Search

FrancineR. Dlahellye.,.1,Fau- r"u-1 Villareal Der2momae11x11 or'cMEKONGI OP ID: RG .441UORO �� CERTIFICATE OF LIABILITY INSURANCE DATE (MMMD/YYYYI 07/14/2020 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 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 endorsement(s). PRODUCER Lie. 0 Insurance Services, Inc. Lie. 0747420 5800 S. Eastern Ave. Suite 400 Los Angeles, CA 90040 CONTACT Ruth Rodriguez NAME: PHONE Arc No Eat: 323-400-6705 FAXAtc No: 323-248-9310 "D2u, Ruth@pjascins.com INSURERS AFFORDING COVERAGE NAIC'# Anthony Alaterre INSURER A: The Hanover Insurance Group 36064 INSURED Mekong Printing, Inc. DBA: MK Printing INSURER B : Employers Compensation Ins. Cc 11512 2421 W. First Street INSURER C: Santa Ana, CA 92703 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. INS LTRPOLICY TYPE OF INSURANCE NUMBER POLICY EFF MMIDO POLICY EXP MM /YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ix I OCCUR Y ZH39146965-09 05/1912020 II5111372041" PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 X GL BROADEN ENOT GENERALAGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ INCLUDED Poucv JECTPRO- LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMB Ea accitlent $ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO AW39147434-09 06/1912020 05/1912021 ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Peraccident) ( ) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE PER ACCIDENT $ J( UMBRELLA LMB I X OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 A EXCESS LIAR CLAIMS -MADE UH3909166009 05/1912020 0511912021 DIED I X RETENTION$ 0 $ B WORKERS COMPENSATION Me EMPLOYERS' LIABILITY YIN ANY PROPRIEfORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? NIA EIG2878069-01 07/0112020 07101/2021 X 4VC STATU- OTH. TORY L M T ER E.L. EACHACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatoryin NH) If yes, tlesclibe under E.L DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, it's officers, employees, agents and representative are named as Additional Insured in regards to General Liability per COMMERCIAL GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS **PROOF OF WC COVERAGE ONLY ** SANTAAN The City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD COS ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD x.� RhkMnugemenLDiviaion REVIEWED&APPROVED BY: l„iTi �d'J. F44$. L114 Z V' 'jqxqwwil Risk Management Analyst