|
CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DDIYYYY)
<br />05/0612024
<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, ANDTHE 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 />PRODUCER
<br />McGrlff Insurance Services, LLC
<br />5400 SW Meadows Road, Suite 240
<br />Lake Oswego, OR 97035
<br />Digitall
<br />INSURED - - - - -/ - — L)y /--%I
<br />Greyhound Lines, Inc. �/
<br />PO Box 660632
<br />Dallas, TX 75266-036 Date.
<br />Acevedo na•n,q
<br />COVERAGES
<br />CERTIf ICATE NUMBER:TVR5245U
<br />503-943-6621
<br />REVISION NUMBER:
<br />NAIC p
<br />17324
<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 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 />OF INSURANCE
<br />ADDLTYPE
<br />INSD
<br />WVD SUER
<br />POLICY NUMBER
<br />MMIOUY�
<br />MMIOOIY YY
<br />LIMnS
<br />'A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />GL-RRG-001023-01
<br />12/31/2023
<br />12/31/2024
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />CLAWS -MADE FxIOCCUR
<br />DAMAGE To PREMISES Ee oc. ante
<br />$ 5,000,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL B AOV INJURY
<br />$ 10,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 10,000,000
<br />POLICY JECT LOC
<br />PRODUCTS-COMP/OP AGG
<br />$ 10,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />AL-RRG-001023-01(ADS)
<br />12/31/2023
<br />12/31/2024
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />10,000.000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />1X
<br />BODILY INJURY (Per acodent)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Peraccidant
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DIED I I RETENTION$
<br />J $
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOWPARTNEWEXECUTIVE
<br />62790879 AOS)
<br />62790880 CA)
<br />04/01/2024
<br />04/01/2025
<br />PER OTH-
<br />X STATUTE
<br />E.L. EACH ACCIDENT
<br />$ 3,000,000
<br />OFFICEMMEMBER EXCLUDED? ❑
<br />(Mandatory in NH)
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 3,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 3,000,000
<br />B
<br />Auto Liability
<br />AL7281073 AOS/NY)
<br />04/Oi/2024
<br />04/01/2025
<br />Combined Single Limit
<br />10,000,000
<br />C
<br />AL7281072 MA)
<br />$
<br />$
<br />$
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Addhional Remarks Schedule, maybe atlached if more space is required)
<br />Contractual Liability coverage is included under the General Liability policy. RE: Leased Location: The Depot at Santa Ana; 1000 East Santa Ana Boulevard, Santa Ana,
<br />CA. City of Santa Ana, its agents, officers, employees and volunteers are included as Additional Insured in accordance with the policy provisions of the General Liability
<br />policy. General Liability policy evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the
<br />policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the Workers' Compensation policy. Should
<br />General Liability policy be cancelled before the expiration date thereof, the policy provisions will govern how notice of cancellation may be delivered to certificate holders in
<br />accordance with the policy provisions.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana, CA 92701
<br />USA
<br />SHOULD ANY OF THE ABOVE DESCRI
<br />THE EXPIRATION DATE THEREOI
<br />ACCORDANCE WITH THE POLICY PRC
<br />AUTHORIZED REPRESENTATIVE
<br />,g RiekMaMgemDeLDivieipn 5-
<br />o REVIEWED& APPROVED BY:
<br />A--p "441
<br />Risk Management Specialist _
<br />ACORD 25 (2016/03)
<br />Pane 1 of 1
<br />The ACORD name and logo are registered marks of ACORD
<br />All rinint. remn•ed
<br />ACORD 25 (2016/03)
<br />Pane 1 of 1
<br />The ACORD name and logo are registered marks of ACORD
<br />All rinint. remn•ed
<br />
|