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Last modified
12/1/2023 4:59:34 PM
Creation date
6/28/2023 2:43:01 PM
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Contracts
Company Name
AP TRITON, LLC
Contract #
N-2023-161
Agency
Finance & Management Services
Expiration Date
12/31/2023
Insurance Exp Date
1/1/1900
Destruction Year
2028
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EMS CONSULTING SERVICES I CITY OF SANTA ANA <br />APPENDIX E: TRITON CERTIFICATES OF INSURANCE & LITIGATION <br />AP Triton, LLC maintains liability insurance as shown in the following pages. Triton has no past <br />and/or pending litigation or unresolved lawsuits. Since AP Triton utilizes an entirely independent <br />pool of contractors, we are exempt from carrying Workers' Compensation insurance. Each of <br />our contractors carries their own liability insurance. <br />nc ad CERTIFICATE OF LIABILITY INSURANCE n3n�1;23 <br />MIS CERBFICATE IS ISSUED AS A NATTER OF WFORYATNW ONLYAND CONFERS NO RIGHTS UPON THE CFR IWATE HOLDER <br />MRS CHYDFMATE DOES NOT AFFWNATNELY OR NEGATNELY AMEiRJ, EXTBAt OR ALTER ME COVERAGE AFFORDED BY THE <br />MO ES BELDW_ MIS CERT Af TE OF WSURANCE DOES NOT CONSTRUTE A CONTRACT BETWEEN WE ISSU IG W SORER151, <br />ALRL10Rf2ED REPRESENTATNE OR PROOUCER, AND THE CEHTI TE HOLDER <br />N.VORTANT: N the oerCTicam hol,ler is an ADDTSIONAL WSURED, l e pafey561 nmst be endomed- N SUBROGATRWIS WANED, <br />subjeetto tl,e tome and oandSdons of l e policy, certain ,aUcies ma, oe,dre an endomeinnK A statement an this certificam does not <br />confer rights toile clUf.m holder in lieu of suoh endo,semenitzl. <br />moaoc� <br />CONTACT <br />USI INSURANCE SEWCES UOPHS <br />moxe (eml95TdT30 <br />Mx.xu. m[ <br />sax <br />lam. xaL <br />,IM515 <br />Tie HmRCN Service Center <br />n Bhpc1 <br />Wonic,TBhd <br />e+uo <br />San <br />San Anionic, T%T8251 <br />ixauemlvlwrewmwa cau9taW <br />peaRERa: Abn SpenaLly lreuaice Comp <br />171M <br />AP TRITON.l <br />IMR COFFEEN AVE STE 3170 <br />pummc: <br />SHERIDAN WY 82801S <br />ememe.: <br />T s ISTO CERTTYTPATT POUCIES CFINBLRMlCE LIST®BELOW MVE BEEN1SSLEDTOTIE INSIRUDNAAdEDABOVEFd2T!E �IHi1C0 <br />IADICATED.NT-NT STANCUGA RECUIRENffNT. TE2N W COMMON OFANY CIXURACT CR OD✓BL DWJh@iT Al[M RE:PECTTO W T <br />OEIMACATE MAY BE I3SUED OR NAY PHiINK THE INSURANCE AFFORCED BY ME POUCIES DESOSBED IBiEIN LS SIN.ECT TO ALL TF£ <br />TERMS,IXRUGIONS ANO CCIOf11RSOF SLCH POL{Ik;.0 IMY HAVE R®110E08Y PAIDCLNMS. <br />Aml <br />• <br />NU Baa <br />u ff <br />nm <br />QVZ/2023 <br />A <br />u_ialoe❑X arr R <br />C1Po220.53 <br />03✓=T11➢T1 <br />S1W,COC <br />ES.000 <br />rruoeua wvowRr <br />S1.DOD.DOC <br />ern.wugw,<uln vOus P9i: <br />�❑s �Lm <br />apaaiaaaRewre <br />320W,COC <br />aRpolai'd-ww.avAW <br />$1,OW,COC <br />MC6lEtYBMY <br />.Vn alfl0 <br />aG1FIXAID <br />wapwR <br />�� <br />BaW.v NYRalivOenml <br />CEH Va0 <br />GI.aME <br />NORIIERa CaI@p4ilae <br />avRella,EAf W9UI, <br />ne <br />aeo. <br />doodoo9baRl <br />eA <br />a:N <br />ei oaRnae-en ano+u <br />- rneenae-?cun uan <br />eEacPoilloRaim£RIfICx9ltauryaRe/ Y@a[lb µallow, mWmY Rai�RemmY, mqe� Waovp vmonwah mmml <br />Tlmse mild tome Vnsu=_tlY Opeieams <br />CERTIFICATE HOLDER CANCELLATION <br />FO(L INFORMATIONAL PURPOSES <br />tM COFPEEN AVESTE 3170 <br />SHFMDAN M 82801-5TT1 <br />fi11011LU ANY 6 THE ABOVE DESCRIBED PoUCIE$ BE CANCEIIID <br />BEFORETHEFXHRATIaN DATE THEREOF. NDTICEYA.L BE Dl].IVE1tE0 <br />W ACCORDANLE'MRITIEFOUCY PRgIISIONS. <br />aR¢d R£PREtpIPTiVE <br />J:�� ems° Gootrn�.. <br />01988-2015 ACORO CORPORATION. All rights reserved. <br />ACORD 25120161031 The ACOM name and logo are registered malts of ACORD <br />t AP TRITON 27 1 <br />
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