|
Cliel 1258425
<br />305COMPUMGM
<br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE
<br />DATE {MMIDDIYYYY)
<br />211412014
<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 CONSTITUTFA C�NTCT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERI-I r,t�A - "?EMI-11 `.. ` `t
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endol A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s). i_;
<br />PRODUCER,
<br />Aide Radilla
<br />BB&T Insurance Services
<br />PH°NE 714 578-7050 FAx 877 297 9245
<br />AMCA Lo, Ext :INC, No
<br />of Orange Count
<br />g y
<br />ADDRESS: aradllla@bbandt,com
<br />Drive Suite 100
<br />Lann,
<br />CA 92831
<br />Fullerton, CA
<br />Ful
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICff
<br />INSURERA; Atlantic Specialty Insurance Co
<br />27154
<br />_
<br />INSURED
<br />Compulink Mgmt Center Inc
<br />INSURER B
<br />dba Laserfiche
<br />INSURER C :
<br />3545 N, Long Beach Blvd. #110
<br />INSURER D :
<br />Long Beach, CA 90807
<br />INSURERE:
<br />_
<br />INSURER F :
<br />COVERAGES 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 CONTRACTOR 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />S
<br />D
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EX?
<br />MM1DDlYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />7110103310007
<br />2/13/2014
<br />0211312018
<br />EACH
<br />$1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />gqOCCURR6NOE
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />MED EXP Any one person)
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGO
<br />$ 2,000,000
<br />POLICY PRO LOC
<br />JECT
<br />A
<br />AUTOMOBILE
<br />_
<br />LIABILITY
<br />7110103310007
<br />02J13/2014
<br />02/13/201
<br />O eBINEDSINGLE LIMIT
<br />1,000,000
<br />BODILY INJURY (Her parson)
<br />$ a
<br />ANY AUTO
<br />X
<br />ALL OWNED SCHEOULEb
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />A
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />7110103310007
<br />0211312014
<br />02/13/2015
<br />EACH OCCURRENCE
<br />s20,000,000
<br />AGGREGATE
<br />$20 000 000
<br />REXCESS
<br />LIAB
<br />CLAIMS -MADE
<br />LED�RFT�ENTICN $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYTORY
<br />ANY PROPRIETORIPARTNERlEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED? �
<br />NIA
<br />4060200720008
<br />1l01I2014
<br />01/011201
<br />X WCSTATU- OTH-
<br />LIMITS ER__
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />A
<br />Technology
<br />7110103310007
<br />0211312014
<br />02/131201
<br />Limit: $5,000,000
<br />E & O
<br />Ded. $50,000
<br />Retro Date: 0211312004
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is re u. edl
<br />Evidence of Insurance. OVED T FORM
<br />3
<br />.lase San al
<br />S for Assistant City
<br />ER
<br />City of Santa Ana
<br />20 Civic Center Plaza M-42
<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 />&)Z
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) 1 of 1
<br />#S118631421M11863111
<br />The ACORD name and logo are registered marks of ACORD
<br />AFRAD
<br />
|