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Last modified
4/27/2022 5:29:07 PM
Creation date
10/23/2020 8:51:24 AM
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Contracts
Company Name
CHIHIRO SANO
Contract #
N-2020-173
Agency
Parks, Recreation, & Community Services
Expiration Date
10/9/2021
Destruction Year
2026
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PRODUCER <br />Maguire lnsuranm Agency.lnc FWI <br />I Rate PIT 51e IGO <br />Bdla Cynwyd. PA lixi 1401 <br />61061TT900 <br />Chlhiro Sans <br />4365TOY anna Ave <br />LdewpW,CA90J13- <br />COVERAGES <br />CERTIFICATE OF LIABILITY INSURANCE <br />THIS CERTIFICATION 15 ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />All <br />INSRU <br />TYPEOFIMURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/YYYY) <br />MOO dAIRATION <br />DATE(MM/DD/YYYY) <br />UNITS <br />A <br />k <br />GENERAL <br />LIABILITY <br />mEXCIAI GENERAL LIaBIUtt <br />CIAIMSMADE � OCCUR <br />UABUTY <br />AGGREGATE LIMIT APPLIES PER. <br />POUO PROJECT LOC <br />PHPKR03sm9 s <br />12MB12019 <br />12/09/2020 <br />Da OCWRENCE <br />$I.ow.w <br />GEGI <br />PREM15ESTA oc... ra'e <br />SLOO,OIIO <br />MEDEXPLAny One Parsanl <br />5L500 <br />�G�RO'JFESSHONAL <br />GEN"L <br />K <br />PERSONAL B AOV INJURY <br />SL.OW.000 <br />GENEMLAGGREGAtE <br />53.000.000 <br />PRODUCTS-COMP/OPAGG <br />53,0110.000 <br />AUTOMOBILE <br />UABIUtt <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIREDAUTOS <br />NONOWNED AUTOS <br />COMBINED SINGLE LIMIT <br />JFAacabentl <br />BODILY INJURY <br />JPar pe rani <br />BODILY INJURY <br />IPeraaWent) <br />PROPERTY DAMAGE <br />Peta sidentl <br />GAMGE LMBlllry <br />ANYAUTO <br />AUTO ONLY - EA ACCIDENT <br />iNLN EA ACC <br />AUTO <br />AUTO ONLY AGO <br />UA /UMBREWLIMIUTY <br />-CUP ❑ MIMSMADE <br />DEDUCTIBLE <br />RETEN TON <br />LOCH OCCURENCE <br />AGGREGATE <br />EMIlOYERS'IMBNTY Y/N. <br />ANY PROPRIETOR/PARTN%EKECUTIVE ❑ <br />OFFICER/MEMBER E%CLUOEO) <br />(Mandatory in NU <br />If Yes. describe antler <br />SPECIAL PROVISIONS W. <br />TORV LIMITSOTH <br />ER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA AMPLOYEE <br />E. DISEASE -POLICY OMIT <br />OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVLSIOM <br />It is understood and agreed that the lollowlrig early Is added as as addaunpi Insured lad Doty w0h respmUsl .,he opera xas of the named assured except that haOdilY resulting from The additional insured s sole <br />negligence Cmlduale of Insurance hill provide Way NO) da, Ene, wn,,a. notice of cancellaonn <br />CERTIFICATE HOLDER CANCELLATION <br />Lrty of Santa Ana Risk Management Drvman <br />20 Cm¢ Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DEXRIBED POLICIES BE CANCELCN BEFORE THE EXPIRATION DATE <br />THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE <br />CENOFICATE HOWER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR <br />UA9U1rf OF ANY KIND UPON THE INSURER. in ME" OR REPRESENTATIVES. <br />AUTHORIZEO REPRESENTATIVE <br />REVIEW D & APPROVED <br />y !RiZskNA1qEA`1ENT DIVISION <br />f <br />1 492019 <br />ACORD 25 (2009/01) $AMAN A M. LAMBERT O 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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