|
MEKOPRI-01 ALORRAINE
<br />, i. o CERTIFICATE OF LIABILITY INSURANCE
<br />��
<br />DAT12012024 Y)
<br />sno/zoza
<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, 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.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsemen s .
<br />PRODUCER
<br />COMNTAE:CT
<br />PHONE FAX
<br />(A/C, No, Eat): (323) 400-6705 (A/C, No):
<br />PIASC Insurance Services, Inc.
<br />5800 S. Eastern Avenue
<br />Suite 400
<br />EDURIESs: info@piascins.com
<br />Los Angeles, CA 90040
<br />INSURE S AFFORDING COVERAGE
<br />NAICN
<br />INSURER A: Hanover Insurance Company
<br />22292
<br />INSURED
<br />INSURER B: Alimerica Financial Benefit
<br />41840
<br />Mekong Printing, Inc.
<br />Hoan Truong
<br />INSURER C:Employers Preferred Ins. Co.
<br />10346
<br />2421 W. First Street
<br />INSURER D :
<br />INSURER E :
<br />Santa Ana, CA 92703
<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 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 />LTRfYYYI
<br />TYPE OF INSURANCE
<br />ADDINSO
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE N OCCUR
<br />GL BROADEN ENDT
<br />X
<br />ZH3914586513
<br />5/1912024
<br />5/19/2025
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES fE. cermnence
<br />100,000
<br />$
<br />X
<br />MED EXP (Any oneperson)
<br />$ 10,000
<br />PERSONAL &ACV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />'R' LOC
<br />X POLICY JE
<br />OTHER:
<br />GENERALAGGREGATE
<br />21000,000
<br />PRODUCTS - COMPIOP AGG
<br />Included
<br />Emp. Ben.
<br />$ 1,000,000
<br />IS
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />XO
<br />ONLY AO0V
<br />AW3914743413
<br />5119/2024
<br />5/1912025
<br />EO BIN DSINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per person
<br />$
<br />BODILY INJURY Per accident)
<br />$
<br />eAROS Oaccdenl AMAGE
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />UH3909155012
<br />5119/2024
<br />511912025
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />DIED X I RETENTION$ 0
<br />C
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE �
<br />(Mandatary in NX) EXCLUDED?
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />EIG287806905
<br />7/1/2024
<br />711/2025
<br />X PER OTH-
<br />SAT ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />A
<br />Printers E&O
<br />ZH3914586513
<br />5119/2024
<br />5119/2025
<br />Ded: $1000
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 1D1, AUdiUonal Remarks Schedule, ma be attached if more space is required)
<br />The City of Santa Ana, it's officers, employees, agents and representative are namewas Additional Insured in regards to General Liability per COMMERCIAL
<br />GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS, with respects to services provided and/or performed by the Named
<br />Insured as required by written contract, per the attached endorsement.
<br />The City of Santa Ana
<br />Attn: Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />ACORD 25 (2016/03)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PRC
<br />AUTHORIZED REPRESENTATIVE
<br />lih(eMnuemodD(ulelon
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|