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MULTI W SYSTEMS, INC. (2)
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MULTI W SYSTEMS, INC. (2)
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Last modified
8/24/2022 1:34:40 PM
Creation date
7/8/2021 3:51:36 PM
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Contracts
Company Name
MULTI W SYSTEMS, INC.
Contract #
N-2021-143
Agency
Public Works
Expiration Date
6/30/2022
Insurance Exp Date
8/1/2023
Destruction Year
2027
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Digitally signed by Francine R. <br />Francine R. Villareal Yllareal <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE OAT D/YYYY) <br />1118/1 <br />2:ar_o2o <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME: Matthew Cowan <br />LIC#OE3R105 <br />PH NE 3l0)3CIS63o X 10(i <br />A/C, No. Ex[ : ( IAIC, No): (SR8) J60-8728 <br />ADDRESS: Teai@juhansummers.com <br />Julian Summers Insurance <br />5155 W RU$¢l'mn5 Avenue Suite 205 <br />INSURER(S) AFFORDING COVERAGE <br />NAIL # <br />Hawthome CA 90250 <br />INSURER A: TRAVELERS INDEMNITY CONIPANY OF CT <br />25682 <br />INSURED <br />INSURER B : TRAVELERS PROP CASUALTY CO OF ANIERICA <br />25674 <br />INSURER C <br />MULTI W SYSTEMS INC <br />INSURER D: <br />2615 STROZIER AVE <br />INSURER E: <br />EL MONTE CA 91733 <br />INSURER F: <br />GUVtHRUI=b CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />TYPE OF INSURANCE <br />INSO <br />WVD <br />POLICY NUMBER <br />IMMIDDMYY) <br />IMWDDNYYY) <br />LIMITS <br />x <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1.000,000 <br />CLAIM$ -MADE OCCUR <br />PREMISES IEa occunenon <br />Is 100.000 <br />MED EXP(Any one person) <br />S 5.000 <br />PERSONAL B ADV INJURY <br />S 1.000,000 <br />A <br />Y <br />630-7122389A-TCT-20 <br />08/01/2020 <br />08/01/2021 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />S 2,000,000 <br />POLICY ✓y PRO- <br />JECT ❑LOG <br />PRODUCTS - COMPIOP AGO <br />$ 2,000,000 <br />DEDUCTIBLE <br />$ NONE <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />(Ea acedean <br />$ <br />1,000,000 <br />BODILY INJURY(Per person) <br />$ <br />BALL <br />JANYAUTO <br />OS SCHEDULED <br />AUTOS AUTOS <br />Y <br />BA-3N112945-20-CAG <br />08/01/2020 <br />08/01/2021 <br />BODILY INJURY Peraccidmt <br />( ) <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />(Per accident)$ <br />COMP/COLL DED <br />$ 500 <br />UMBRELLA LIAR <br />I <br />OCCUR <br />EACH OCCURRENCE <br />$ 2. 000000 <br />X <br />AGGREGATE <br />S 2,000.000 <br />B <br />EXCESS LIA6 <br />x <br />CLNMS-MADE <br />CUP-77229094-20-14 Follows GL <br />08/01/2020 <br />08/01/2021 <br />DIED <br />RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />V _ <br />/� STATUTE ER <br />AND EMPLOYERS' LIABILITY YIN <br />E.L. EACH ACCIDENT <br />$ L000,000 <br />B <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? 0E <br />LB-7J230124-20-14 <br />08,01 2020 <br />08/01/2021 <br />E.L. DISEASE -EA EMPLOYEE$ <br />1,000,000 <br />(Mandatory in NH) <br />It yes, describe underDESCRIPTION <br />E.L. DISEASE -POLICY LIMIT <br />S 1,000,000 <br />OF OPERATIONS below <br />ABUSINESS <br />PERSONAL PROPERTY630-7d22389A-TCT-20 <br />08,01;2020 <br />08/01/2021 <br />$308,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) <br />RE: Agreement No N-2020-11 l <br />City of Santa Ana, officers, agents, employees, and volunteers are named as Additionally Insured on this policy pursuant to written contract, agreement, or <br />memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and <br />noncontributory. Waiver or Subrogation applies to Workers' Compensation. CITY WILL BE MAILED 30 DAYS WRITTEN NOTICE OF POLICY <br />CANCELLATION. <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA, 4th FLOOR <br />SANTA ANA CA 92701 <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 />AUTHORIZED REPRESENTATIVE <br />©1988-2014 <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />REmewm 6 APPROVED Or <br />FylA1Y.NMZ Z Vs"d <br />Risk Management Analyst <br />
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