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SKIDMORE, CHERYL - 2004
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SKIDMORE, CHERYL - 2004
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Last modified
1/3/2012 2:08:35 PM
Creation date
6/7/2004 4:02:17 PM
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Template:
Contracts
Company Name
Cheryl Skidmore
Contract #
N-2004-059
Agency
Parks, Recreation, & Community Services
Expiration Date
2/6/2004
Insurance Exp Date
8/31/2008
Destruction Year
2009
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<br /> ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP ID RD I DATE (UMlDDIYYYY) <br /> SKJ:DM 1 03/03/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION <br />Cheval Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Lie. OC94257 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. O. Box 2933 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br />Fullerton CA 92837 <br />Phone: 714-447-9191 Fax: 714-525-9191 INSURERS AFFORDING COVERAGE NAlC.. <br />INSURED Cheryl Skidmore A1- rRCO<I-o~f/- INSURER A: American Bankers <br /> INSURER B: <br /> Kids Can Do ~astics 03 INSURER c: <br /> dba Fun With orses <br /> 187 E. Wilson St. ----.- -.------ <br /> Costa Mesa CA 92627 INSURER D: <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmoNS OF SUCH <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE U/NDDIYY1 D'k%TIMMlDONV)" LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE 11.000.000 <br /> L- <br />A X ~ 3MMERCIAL GENERAL LIABILITY SL1103177 08/31/07 08/31/08 I PREMiSES lea occunnc:e) $ 50 .000 <br /> f--- ClAIMS MADE ~ OCCUR MED EXP (Any one person) I 5,000 <br /> PERSONAL & AI:N INJURY $1.000.000 <br /> GENERAL AGGREGATE $2,000.000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS.CDM~PAGG $ 2,000.000 <br /> Xl POLICY n ~8T n LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE UI'IIT <br /> - . <br /> ANY AUTO NONE (b accident) <br /> - <br /> ALL OWNED AUTOS BDOIL Y INJURY <br /> - . <br /> SCHEDULED AUTOS (Per""......,) <br /> - <br /> - HIRED AUTOS BODILY INJURY <br /> . <br /> NON-OWNED AUTOS (Per accident) <br /> -- <br /> - PROPERTY DAMAGE . <br /> (Per Kcldlnt' <br /> GARAGE LIABILITY AUTO ONlY. EA ACCIDENT . <br /> R ANY AUTO NONE OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG . <br /> EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ <br /> tJ OCCUR D CLAlIiIS MADE . <br /> NONE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE I <br /> .- <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I TORY" uMiT's I IO~. <br /> EMPLOYERS LIABILITY NONE <br /> M1Y PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT $ <br /> OFFICERlMEMBER EXCLUDED? EL. DISEASE . I!A EMPLOYEE $ <br /> It yes., describe under <br /> SPECIAL PROVISIONS below E.L DISEASE. POUCY UMIT . <br /> OTHER <br /> NONE <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Certificate holder is additional insured as sponsor of recreational program <br />but only insofar as insured operations in connection with said insured. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> CITY SA SMOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />Community Development Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />M 25 Attn: Deborah <br />;po Box 1988 IMPOSE NO OBliGATION DR .1} ILfTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br />Santa Ana CA 92702 REPRESENTATIVES. <br /> AUTHORIZED REPRESENT} I~ ~ces <br /> Cheval Insur <br />ACORD 25 (2001108) 4 ;/2... @ACORD CORPORATION 1988 <br /> // /~/--Ci.- \ <br /> <br />./' <br /> <br />y <br /> <br />
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