BARBOZA & ASSOCIATES - Laserfiche WebLink

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE DATIE (MM/DDIYYYY) 1 ll 19/202.1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Seeman Holtz Property & Casualty - NIS 530 E Los Angeles Ave # 1 15-500 Moorpark, Ca 93021 CONIAGI NAME: Evidence of Insurance Dept. NE FAX AIC, No, Ext : 866.647.4222 (AIC, No); 818.568.1014 ADDRESS: Caeoi@-seemanholtzpc.com INSiURER(S) AFFORDING COVERAGE NAIC # INSURER A: California Automobile Insurance Company 38342 INSURED CARLA BARBOZA BARBOZA & ASSOCIATES 660 SOUTH FIGUEROA STREET SUITE 162.0 LOS ANGELES CA 90017 INSURER B : INSURER C : INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE IINSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO - POLICY PRO LOC PRODUCTS - COMPIOP AGO $ $ OTHER: AUTOMOBILE LIABILITY cum D(Ea accident) SINGLE LlIV77— $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A AUTOWNEDOSONLY AUTOSULED � AUTOS BA040000063344 11/12/2021 11/12/2022 BODILY INJURY (Per accident) $ HIRED NON-OWNIED AUTOS ONLY AUTOS ONLY rMUFLN I Y JAMAUE$ (Per accident) $ UMBRELLA LIIAB OCCUR EACH OCCURRENCE $ EXCESS LIMB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ER ........................................................................................................................................... E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNIERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under (DESCRIPTION( OF OPERATIONS below E.L. DISEASE - POLICY (LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,. Additional Remarks Schedule,may be attached if more space is required) 1999BMW 328 WBABK7339XET67345 I Iwill! GLai VJa ill CITY OF SANTAANA 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE -Mw4gowd DMS16" - i" RE"u'1 f"�J8+2Cr{'SVEOHNr f0'di 01988-2015ACORD II T Rd, M.'aa—tC ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I"