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Last modified
2/22/2021 11:01:46 AM
Creation date
9/24/2020 3:19:43 PM
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Contracts
Company Name
C3 TECHNOLOGY SERVICES
Contract #
A-2020-176
Agency
Information Technology
Council Approval Date
9/1/2020
Expiration Date
2/28/2023
Insurance Exp Date
10/2/2020
Destruction Year
2028
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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />ACCW? CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMMD/YYYY) <br />09/08/2020 <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 Teresa Shen <br />NAME: <br />Milestone Risk Management & Insurance Services <br />(949) 852-0909 Fax 852-1131 <br />PHIC ONENo <br />AICNo(gqg) <br />A, : <br />E#: <br />License No. OB72766 <br />E-MAIL tshen@mileslanepromise.com <br />ADDRESS: <br />8 Corporate Park, Suite 130 <br />INSURER(S)AFFOROING COVERAGE <br />NAIC iI <br />INine CA 92606 <br />INSURER A: Travelers Casualty Insurance Company of America <br />019046 <br />INSURED <br />INSURER B: The Travelers Property Casualty Company of America <br />025674 <br />C3 Office Solutions LLC dba C3 Technology Services <br />INSURER C: Oak River Insurance <br />34630 <br />1536 E. Warner Ave. <br />INSURER D : <br />.SURER E <br />Santa Ana CA 92705 <br />1 INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 20/21 Master 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 SUBJECTTO 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 INSURANCE <br />ADDLSUBR <br />INSD <br />WVO <br />POLICY NUMBER <br />POLICY FEE <br />MM/DDNYYY <br />POLICY E P <br />MMIDDNYYY <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACHOCCURRENCE <br />g 2,000,000 <br />PREMISES Ell occurrence <br />g 1,DDD,D00 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL B ADV INJURY <br />$ 2,000,000 <br />A <br />6806N797658 <br />05/23/2020 <br />05/23/2021 <br />GEN-L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO X LOC <br />JECT <br />GENERALAGGREGATE <br />$ 4,000,000 <br />PRODUCTS-COMPIOPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY(Per person) <br />$ <br />ANYAUTO <br />AOWNED <br />I <br />SCHEDULED <br />AUTOS ONLY AUTOS <br />BA6N7980902042G <br />05/23/2020 <br />05/23/2021 <br />BODILY INJURY (Par auddlen) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per acntlent <br />$ <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACH OCCURRENCE <br />5 1,000,000 <br />AGGREGATE <br />g 1,000.000 <br />B <br />EXCESS LIAR <br />CLAIMS -MADE <br />CUP7N4477972042 <br />05/23/2020 <br />05/23/2021 <br />DED <br />X RETENTION $ 0 <br />g <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETOMPARTNEMEXECUTIVE YIN <br />OFFICEWMEMBER EXCLUDED? F <br />Mandatory in NH) <br />If yes, descnbe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />REWC019767 <br />10/02/2019 <br />10/02/2020 <br />PER Eol <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />EL.DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insureds with respects to GL per the attached <br />endorsement. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City of Santa Ana shall be excess and <br />noncontributory per attached endorsement. *30 days written notice of cancellation to the certificate holder/10 days notice for nonpayment of premium. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Fir <br />Santa Ana <br />ACORD 25 (2016103) <br />CA 92701 <br />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 />AUTHORIZED REPRESENTATIVE <br />© 1988-201 <br />The ACORD name and logo are registered marks of ACORD <br />REVIEVJm 6 APPROVED BY: <br />R. VJ4,,4-1 <br />Ruk Management Analyst <br />
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