Laserfiche WebLink
r ranane h. Francine R7Villareal <br />Date: 1020.09.02 <br />Villareal <br />10:18:53-07'00' <br />``� CERTIFICATE OF LIABILITY INSURANCE <br />DATOOMlDD/Y YV) <br />MMID020 <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 />Ann Risk Services Northeast, Inc. <br />New York NV Office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />CONTACT <br />NAMEPKUN: <br />(AC. No. Ext: (866) 283-7122 FAX (800) 363-0105 <br />A C. Ne. <br />E-MAIL <br />ADDRESS, <br />New <br />New York NV 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC k <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 />INSURER E: <br />INSURER 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 />Lm TYPE OF INSURANCE INSO WVD POLICY NUMBER IUUUMMIDDEFF MMIDD XP LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />V <br />V <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE X❑ OCCUR <br />AMA E ENTED <br />PREMISES Ea occurrence <br />$2,000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL& AOV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PR6JECT F LOC <br />X POLICY <br />GENERALAGGREGATE <br />—PRODUCTS- <br />$5,000,000 <br />COMPIOPAGG <br />$5,000,000 <br />OTHER: <br />A <br />AUTO MOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/202 1 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />BODILY INJURY( Per person) <br />A <br />% ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOSONLY 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(Peraoaiden) <br />PROPERTY DAMAGE <br />Pera¢itlent <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />H <br />CLAIMS -MADE <br />AGGREGATE <br />OED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED] Fq <br />(Mandatory in NH) <br />8 yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />wco45886576 <br />ADS <br />WC045886575 <br />CA <br />06 30 2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X PER STATUTE I <br />OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$1, OOQQOQ <br />E.L. DISEASE-Eq EMPLOYEE <br />$1,000,000 <br />ELpISEASE-POLICY LIMn <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be anached if more 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 />CERIIFICATE HOLDER CANCELLATION °?? <br />on <br />ad <br />on <br />m <br />a <br />n <br />N <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. 91 <br />City Of management <br />And AUTHORIZED REPRESENTATIVE a'k{ <br />Risk Management Division _ <br />20 Civic Denier Plaza, 4th Floor <br />Sonia Ana CA 92701 USA ``�N�" Jp•, a// � <br />_ RseFMgrogewtt Ditivwl <br />©1988-2015 ACORD CO REVIEWED, & Sr. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks Df ACORD d'~t'� F4aLa.�:-tea Q, v:[1w4eL1 <br />Ruk Management Analyst <br />