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PADILLA, DENNYS DIAZ (3)
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PADILLA, DENNYS DIAZ (3)
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Last modified
8/29/2024 8:19:59 AM
Creation date
6/3/2024 2:13:48 PM
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Contracts
Company Name
PADILLA, DENNYS DIAZ
Contract #
N-2024-180
Agency
Parks, Recreation, & Community Services
Expiration Date
6/30/2025
Insurance Exp Date
9/1/2025
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WDD <br />ac`oiro® CERTIFICATE OF LIABILITY INSURANCE DATE (MOBI03120/2023r VYY) <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 BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE <br />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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endomement(s). <br />NAME: <br />Maguire Insurance Agency, Inc. FWI PHONI <br />1 Bala Piz Ste 100 <br />Bela Cynwyd, PA 19004-1401 (A/c, N <br />610.61].]900 E-MAIL <br />Digitally s ane INSURER(S) AFFORDING COVERAGE <br />INSURED r' p Angie <br />7 43 F Diaz �JJ Y g <br />]143 Fulton Way 1 <br />Stanton. CA 90680 _ Acevedo <br />INSURER E: <br />REVISION <br />THIS IS TO CERTIFY THAT THE POLICIES JF'.ISURANCE L BE S THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMEt r. -cRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS <br />OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADDL <br />SUBR <br />POLICY ER, <br />POLICY UP <br />LTR <br />TYPE OF INSURANCE <br />INSp <br />MD <br />POLICY NUMBER <br />(MWDD/YYYY) <br />(MMIDDIYYYY) <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />PHPK2457612-001 <br />09101/2023 <br />09/1/2024 <br />EACH OCCURRENCE <br />$11000,000 <br />CLAIMS -MADE �% OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$100JMo <br />X <br />MED EXP(Any one person) <br />$2,500 <br />PROFESSIONAL LIABILITY <br />PERSONAL B ADV INJURY <br />$1,000,000 <br />GEN'L <br />GENERAL AGGREGATE <br />$3,000,000 <br />AGGREGATE LIMIT APPLIES PER <br />POLICY ElPROJECT ❑ LOC <br />X <br />PRODUCTS - COMP/OPAGG <br />$3,000,000 <br />8 <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />OWNED AUTOS SCHEDULED AUTOS <br />ONLY <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS NON -OWNED <br />PROPERTY DAMAGE <br />ONLY AUTOS ONLY <br />(Peracadem) <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED <br />RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />PER <br />OTHER <br />AND EMPLOYERS' LIABILITY YIN <br />STATUTE <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />NIA <br />OFFICERIMEMBER EXCLUDED? <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required) <br />It is understood and agreed that the following entity is added as an additional insured but only with respects) to the operators of the named insured except that liability resulting from me additional insured's sole <br />negligence. <br />CERTIFICATE HOLDER CANCELLATION <br />Risk Management Division <br />20 Civic Center Plz <br />Santa Ana, CA 927014058 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH <br />THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />'l <br />V 4 <br />"MlvugonentEltMipn <br />REMEMEC&APPROVEDBY: <br />1 <br />I e <br />A+� Adw�cA <br />" Risk Management Spedalist <br />Of <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />
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