Laserfiche WebLink
A-2017-304-01 FrancineR. w,'�r gntleyI.— <br />Villareal oa""°'°.".°""°" <br />wawa <br />ACORO CERTIFICATE OF LIABILITY INSURANCE <br />GATE (MMIDOYYYY) <br />06/0312Q20 <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 endorsements . <br />PRODUCER <br />Issac Lewis & Assoc Ins Services LLC <br />800 Stockton Ave., Suite 5 <br />Ripon CA 95366- <br />CONTACT <br />E. <br />PNONE . (877)715-3947 FAXM. ,(877)715-3947 <br />EMAIL <br />INSURER SAFFORDING COVERAGE <br />NAIC tl <br />INSU ER A ,Ohio Security Insurance Co. <br />24082 <br />_ <br />INSURED <br />ICS IControl Systems Online, Inc. <br />CS Online <br />INSURER B:Republlc Indemnity <br />INSURER C.West American Insurance Co. <br />INSURER D: <br />PO Box 381 <br />INSURER <br />Ripon CA 95366 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 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 SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />L <br />POLICY EFF POLICY EXP <br />LIMITS <br />C <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1XI OCCUR <br />BKW 2156378147 <br />02/24/2020 <br />02/24/2021 <br />EACHOCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTEDPREMISES (Fa ncrumarps) <br />$ 100,000 <br />$ 5,000 <br />MEDEXP An ane ersanl <br />PERSONAL &ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER <br />POLICY L JEo LOC <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENT <br />X <br />PRODUCTS-COMP/OP AGG <br />$ 2,000,000 <br />E <br />OTHER <br />A <br />AUTOMOBILE <br />LIABILITY <br />SAS 2156378147 <br />2/24/2020 <br />10212412021 <br />COMBINED SINGLE LIMIT <br />$ 1,000,000 <br />ANY AUTO <br />BODILY INJURY (Per mucan) <br />$ <br />IPROPERTY <br />OWNED ASCHEDULED <br />AUTOS ONLY UT <br />BODILY INJURY Peramitlenl <br />( ) <br />$ <br />X <br />AIRED <br />TOS ONLY X AU OTOS ONLY <br />DAMAGE <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESSLIAB <br />CLAIMS -MADE <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY �' <br />ANY PROPRIETOR/NPARTNEfUEXECUTIVE <br />OFFICERMIEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yac, describe under <br />DESCRIPTIONIONS below <br />NIA <br />16954715 <br />07l0112020 <br />07/01/2021 <br />X SPIEATUTE OTH- <br />E.L. EACH ACCIDENT <br />$_ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />Commercial General Liability insurance provides automatic Additional Insured status, coverage is Primary and Non -Contributory and Waiver of Subrogation is <br />included when required by written contract/agreement. The City of Santa Ana, its officers, employees, agents and representatives are named as additional <br />insured <br />30 day notice of cancellation with 10 day notice for non-payment <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana <br />ACORD 25 (2016103) <br />AI 004051 <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 />CA 92701- I AUTHORIZED REPRESENTATIVE <br />01988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />ReviEwED pp <br />&APPRcyvED BY: <br />FOfA.GN.e V: m"t <br />Ruk Management Analyst <br />