BURKE, WILLIAMS & SORENSEN (2) - Laserfiche WebLink

Home Browse Search

A aRV CERTIFICATE OF LIABILITY INSURANCE 07/23//2024 Y) DATE (M024 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 CONTACT Kasey Litz NAME: Stanton and Associates Inc. a'C' o Ext : (805) 413-1498 a/c, No : (805) 435-3737 ISU Stanton & Associates E-MAIL kasey@isustanton.com ADDRESS: y� INSURER(S) AFFORDING COVERAGE NAIC # 3625 Thousand Oaks Blvd #292 Westlake Village CA 91362 INSURERA: HARTFORD FIRE INSURANCE CO. 19682 INSURED INSURER B : Trumbull Ins. Co. 27120 Burke, Williams & Sorensen, LLP INSURER C : Hartford Casualty Ins Co 29424 444 S. Flower St., Suite 2400 INSURER D : Sentinel Insurance Company Ltd 11000 INSURER E : Los Angeles CA 90071 INSURERF: COVERAGES CERTIFICATE NUMBER: 24-25 City 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FX OCCUR PREM SES Ea occurrDence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 A 72UUNBD3RBC 08/01/2024 08/01/2025 LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO- FXLOC MOTHER PRODUCTS-COMP/OPAGG $ 2,000,000 $ : AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 72UENCG7716 08/01/2024 08/01/2025 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ C EXCESS LIAB CLAIMS -MADE 72XHUBF3DCB 08/01/2024 08/01/2025 DED I X1 RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A 72WEAB2915 08/01/2024 08/01/2025 ER /� STATUTE EORH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are hereby named as additional insured. Hartford CGL policy form HG0001 includes Additional Insured status, Primary and Non -Contributory wording, and Waiver of Subrogation where required by written contracts. IH 0303 - 30 Day NOC applies CG2026 —Additional Insured — Designated Person or Organization WC 990394 — 30-Day Notice of Cancellation to Certificate Holders WC040306 — WC Waiver of Subrogation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 l "4 '71 (' © 1988-2015ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD