Laserfiche WebLink
AC®Ro® CERTIFICATE OF LIABILITY INSURANCE <br />Illi <br />DATE(MMIDD/YYYY) <br />01/21/2021 <br />THIS-CERTIFICATE-IS-ISSUEDAS-A-MAT-TER-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 Annette Chawki <br />Ni <br />The Liberty Company Insurance Brokers <br />AICNN Ext : (949) 777-057D FAX No): (877) 893-9834 <br />Lie#0D79653 <br />AGoRESS. a ehawkI@Iibertycompany.com <br />111 Pacifica, Suite 230 <br />INSURERIS) AFFORDING COVERAGE <br />NAIC# <br />Irvine CA 92618 <br />INSURERA: Ins Cc of the West <br />27847 <br />INSURED <br />INSURER B : <br />B & D Towing, Inc, DBA: Balacaceres & Davalos Towing <br />INSURER c: <br />1502 N Susan St <br />INSURER D: <br />INSURER E : <br />Santa Ana CA 92703 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 20-21 WC Only 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 />ILTR <br />TYPE OF INSURANCE <br />ADULSUBR <br />INSD <br />WVD <br />POLICYNUMBER <br />POLICYEFF <br />MMIDDP/YYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />CLAIMS -MADE OCCUR <br />PREMISES Ea occurrence <br />$ <br />MED EXP (Anyone eraon) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERALAGGREGATE <br />$ <br />POLICY PRO ❑ <br />ECT OC <br />PRODUCTS-COMPIOP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINEDNGLE LIMIT <br />Ea accidentSI <br />$ <br />BODILY INJURY (Par Person) <br />$ <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED NON-OWMEO <br />AUTOS ONLY AUTOS ONLY <br />UMBRELLNUAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />A <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDEDP <br />EKOW <br />NH) <br />If <br />NIA <br />NNE 502471107 <br />10/01/2020 <br />10/0112021 <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E. L. DISEASE-EAEMPLOYEE <br />$ 1,000,000 <br />y.a, doryln <br />Nunder <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION <br />E. L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />Proof/Evidence of Insurance <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Santa Ana Police Department Traffic Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />©1988.2016 ACORD <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />RiaFManay,2lnentD(Walon ' <br />A/A t RENEWED & APPROVED By., <br />.j/� F p'I st p <br />8` r'9F ev:..hk Fes, Y:kcRAdAG <br />Risk Management Analyri <br />