Laserfiche WebLink
rrancine H. Villareal Villareal <br />A� " CERTIFICATE OF LIABILITY INSURANCE <br />oAM01124/2022o n <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 />MARSH USA INC <br />1717 Arch Street <br />Philadelphia, PA 19103 <br />Attn: Philadelphia.oeds@nnarsh.win I Fax:(212) 9490380 <br />CONTACT Marsh � U.S.Operations <br />PHONE jFAX <br />Mc Me Ertl. BG6-966-0864 _ _-.1.(AAIcNoI_ <br />E-MAIL PNladi Na.Certs@nershcon <br />ADDRESS' b <br />— <br />INSURER S AFFORDING COVERAGE <br />NAICR <br />INSURER A: Indian Harbor Insurance Company <br />36940 <br />CN1 I8025105-ALL-STAND-22-23 <br />INSUREDAlliedUniversal Topics, LLC <br />(See Attached for Additional Named I nsureds) <br />INSURER B : Greenwich Insurance Company <br />22322 <br />INSURER 6 : XL Insurance Anni <br />24554 <br />INSURER o : National Fire & Marine Insurance Company <br />20079 <br />161 Washington Street, Suite 600 <br />Conshohocken. PA 19426 <br />INSURER E :NIA <br />N/A <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: CLE-00644TT72-26 REVISION NUMBER: 12 <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 CR 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 />LTR <br />TYPE OFINSUMNCE <br />ADOLSURR <br />POLICY NUMBER <br />POLICY EFF <br />MMDO <br />POLICY E%P <br />MIDD <br />LIMITS <br />A <br />X <br />OONMERCIAL GENERAL LIABILITY <br />RES943799402 <br />011012022 <br />01/012023 <br />EACH OCCURRENCE <br />$ 30p00,000 <br />CLAWS -MADE ',� OCCUR <br />DAMAGE O R <br />PREMISES Ea ocanene <br />$ _- 30.000p00 <br />X <br />MED EX? (Any one person) <br />$ <br />CONTRACTUAL LIABILITY <br />X <br />SIR$1,750,000 <br />PERSONAL SADV INJURY <br />$ 30.000,000 <br />GEN•L AGGREGATE LIMIT APPLIES PER: <br />GENERAI-AGGREGATE <br />$ 40,000,000 <br />PRODUCTS-COMPIOP AGO <br />$ 40,000,000 <br />O. <br />X POLICY JJEECT rx I LOG <br />$ <br />OTHER: <br />B <br />AUTOMOBILELNaIUTY <br />'RAD943781805 <br />01/012022 <br />01/012023 <br />SINGLE LIMIT <br />Eaacdeat <br />$ 5,000,000 <br />BODILY INJURY (Per person) <br />$ <br />X ANYAUTO <br />- <br />BODILY INJURY(Peracciden0 <br />$ <br />AOWNED <br />UTOS ONLY SCHEDULED <br />AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Pm accident <br />$ <br />$ <br />UMBRELLALIAS I X <br />OCCUR <br />42XSF10W9009 <br />01/p1/2022 <br />01/012023 <br />EACH OCCURRENCE <br />$ 10,OOD,000 <br />X <br />AGGREGATE <br />$ 10,WD,000 <br />EXCESSUAB <br />CWMS-MADE <br />Excess Of General Lability, <br />DEO RETENTION $ <br />Auto Liability, and Workers Camp <br />S <br />C <br />C <br />WORKERS COMPENSATION <br />ANDENPLOYERS'LIABILITY YIN <br />ANYFROPRIETORIPARTNEWEXECUTIVE <br />OFFICERNi EMBEREXCLUOEO] <br />(Mandatary in NiE.L. <br />N/A <br />RWD3001203-06(AOS) <br />RWR300120406(WI) <br />011p12022 <br />0MV2023 <br />011012023 <br />g PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENTIII <br />10p000p <br />DISEASE -EA EMPLOYEE <br />$ 1.000.000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 1 00,000 <br />it yea, describe under <br />DESCRIPTION OF OPERATIONS below <br />A <br />Professional Liability <br />RESM799402 <br />01/012022 <br />01/0112023 <br />Limit <br />2.000,000 <br />SIR <br />1,750.000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remade Schedule, maybe artachad If more space Is mqulmd) <br />The City of Santa Ana, its aficars, employees, agents, volunteers and representatives ale induced as addtional insured where required by vmtten contrad with respect to General Liablity and Auto Lability <br />UaDlity coverage shall be primary and non-contributory where required by written banned. Waiver of subrogation is applicabe where required by written contract. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />Ride MvwgglRtt )iwisian <br />a� REvtD 6 APPROVED Br. H r, tI <br />01988-2016 ACORD C % -ia FliI ,r„t Z V:.K A"t <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD '�' Risk Management Analyst <br />