Laserfiche WebLink
rranane K. Francine R Villareal <br />Date: 1020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />"� h® CERTIFICATE OF LIABILITY INSURANCE <br />DA OW31MO20MMVD20 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />AOn Risk Services Northeast, Inc. <br />New York NY office <br />one Liberty Plaza <br />165 Broadway, Suite 3201 <br />CONTACT <br />NAME: <br />INC. No, Exd); (866) 283-7122 FAR (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAICk <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon wireless <br />INSURERA: National Union Fire Ins CO of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance Company <br />19399 <br />INSURER C: American Home Assurance Co. <br />19380 <br />1095 Avenue Of the Americas <br />New York NY 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />NSURER E: <br />NSURER F: <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br />INSR TYPE OF INSURANCE POLICYNUMBER LS INSD WVD MMIODIYYYY POLI LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE M OCCUR <br />DAMA RE TE <br />PREMISES Ea occunence <br />$2,000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL& ADV INJURY <br />$2,000.000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PRO- <br />X POLICY JECT LOG <br />GENERALAGGREGATE <br />$5,000.000 <br />PRODUCTS-COMPIOPAGG <br />$5,000,000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />cA 4594298 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />A <br />X ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY(Perpemon) <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDAUTOS NON,OWNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />H <br />CLAIMS -MADE <br />AGGREGATE <br />DEp <br />RETENTION <br />B <br />C[fl <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED] <br />1Nentlmory in NH) <br />DESCRIPTION OF OPERATIONS be. <br />N/A <br />WC045886S76 <br />ADS <br />WCO4SH86575 <br />CA <br />06/30/2020 <br />O6/30/2020 <br />06/30/2021 <br />O6/30/2021 <br />X PER STATUTE <br />I <br />I <br />OTH- <br />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 / LOCATIONS I VEHICLES (ACORD 101, AddNional Remarks Schedule, may be anached Rmom space is required) <br />The above -referenced General Liability policy shall cover the tort liability of the Certificate Holder assumed under the <br />underlying agreement between parties for which the certificate has been issued. City of Santa Ana, its council members, <br />officers and employees are included as Additional Insured with respect to the General Liability policy. The General Liability <br />policy shall apply as Primary and Non -Contributory Insurance to each Additional Insured listed herein. where permitted by law, <br />the Named Insured parties listed herein waive all rights against City of Santa Ana, its council members, officers and employees <br />listed herein for recovery of damages to the extent these damages are covered by the above -referenced General Liability policy <br />and, as further limited by written contract between the parties. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE J <br />POLICY PROVISIONS. <br />City Of Santa Ana AUTHORIZED REPRESENTATIVE <br />Risk Management Division = <br />20 Civic Center Plaza, 4th Floor M a/Ga�iiRveerO �/ ' <br />Santa Ana CA 92701 USA r <br />_ RieirMang riodDlision <br />©1988-2015 ACORD CO �EwED 6 APPROVED fir. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD I Z V:.[LL.1u1 <br />RMk Management Analyst <br />