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Ramirez, Daniel 2a
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Ramirez, Daniel 2a
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Entry Properties
Last modified
5/28/2015 9:22:45 AM
Creation date
11/16/2004 4:52:43 PM
Metadata
Fields
Template:
Contracts
Company Name
Daniel Ramirez
Contract #
N-2003-096-01
Agency
Parks, Recreation, & Community Services
Expiration Date
6/30/2006
Insurance Exp Date
1/10/2007
Destruction Year
2010
Notes
Amends N-2003-096 Amended by N-2003-096-02
Document Relationships
Ramirez, Daniel 2
(Amends)
Path:
\Contracts / Agreements\ INACTIVE CONTRACTS (Originals Destroyed)\Q-R (INACTIVE)
Ramirez, Daniel 2b
(Amended By)
Path:
\Contracts / Agreements\ INACTIVE CONTRACTS (Originals Destroyed)\Q-R (INACTIVE)
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<br />. <br /> <br />lrpOM FIT',F3S Ar~D WE~LJ\lfSS ir"S~)R,\tJCE <br /> <br />(Tf-'U I MA R <br /> <br />9 2 '1 (16 1 -'l : r:: 8 S T I,,"' IJ, IJ., f:i ~:,> fJ 4 2 Cl >3 B ,;: <br /> <br />ACORD CERTIFICATE OF LIABILITY INSURANCE ) DATE (MMfDDlYYVY) <br />TM 031051/2006 <br />PRODUCER Phone: (BOO) 3ll5-8075 Fax: (858j519..()822 THIS CERTIFICATE IS ISSUEO AS A MAnER OF INFORMATION <br />FITNESS AND WELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIfiCATE <br />380 STEVENS AVENUE, SUITE 206 ~~~:R. THIS CERTIFICATE DOE~ :';>~:J:MEND. EX~~~ nO: <br />SOLANA BEACH CA 82075 <br /> INSURERS AFFORDING COVERAGE NAIC' <br /> ., lief 0026716 i------ <br /> -------- --- ----~-_._. <br />INSURED N- d-VO?;-rfi(p-O;;L INSURER ~: Zu!iCh American Insurance Company t--- -- <br />DANIEL RAMIREZ N -;).(;o3-v9~-O' INSURER B: <br />13901 FERNWOOD ._..~ <br />I~NSURER C <br />GARDEN GROVE CA 92843 IV -;).003-090 'NSURER-D~ - --[---- <br /> u_ -- <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LtSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMeD ABOVE FOR THE F'OLICYP[RIQD INDICATED, NOtWITHSTANDING <br />ANV REQUIREMENT, TERM OR CON DillON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlf"ICATE !MY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI~IONS OF SUCH <br />POL!CIES_ AGGREGATE LIMITS SHOWN MAV fil\VE BEEN REDUCED lJV PAlO CLA!MS. <br />H;;R ~~ .. -----.- <br />LTR INSR[] TVPi OF INSURANCE I POLICY NUMBER <br />~NERAL LIABILITY I <br />! X CO".,.,ERCIAl GENERALLIABIUTYI' <br />I CLNMS MADE [E OCCUR <br /> <br />~i"~~~ <br /> <br />~;~t:Y,=~N <br /> <br />LIMITS <br /> <br />EOL9012327-D1 <br /> <br />01/10/06 <br /> <br />01/10/07 <br /> <br />EACH OCCURRENCE <br />DAMAGE!o.RENi!D <br />PREMISE"StF.OGGu~"") <br />MED. [J(p (Anyone F"rson: <br /> <br />. <br />. <br /> <br />1,0~ <br />.~~ <br />2,~_~_ <br />1,000,000 <br />. ___ 3,~0~ <br />3,000,000 <br /> <br />A <br /> <br />f-- <br />f---~------ <br />GENl AGGREGATE LIMIT APPLIES PER: <br />f-c-, .~PRO ~ <br />X I POLlCY ! I JEer . 'LOC <br /> <br />PERSCNAl &ADV INJURY _ _~_ <br />GENERAL AGGREGATE $ <br /> <br />I <br /> <br />~~oou CT~_~COMP~'~~ ~~~. <br /> <br />. <br /> <br />AUTOMOBILE LlAEUl..rrY <br /> <br />8 . :::Y:~~DAUTOS <br /> <br />SCHEDULED AUTOS <br />HIREO AUTOS <br />I NON-OWNED AUTOS <br />- <br />- <br /> <br />COMBINED SINGLE LIMIT <br />(Eaaccide-nt) $ <br /> <br />J <br /> <br />BODILY INJUHV <br />'IIP!lfpar$Onl <br />BODILY INJURY <br />(P9l"oocid9tit) <br /> <br />s <br /> <br />. <br /> <br />GARAGE LIABiliTY <br />=] ANY AUTO <br /> <br />~e:SS I UMBRfL.U\ L.lA8tuTY <br />~. OCCUR 0 CLAIMS MADE <br /> <br />HI--, DEDUCTIBLE <br />RETENllON S <br /> <br />I <br />I <br /> <br />Pp:~~~I~AMAGE <br /> <br />. <br /> <br />AUTO ONl.. Y : EA ACCIDENT <br /> <br />. <br /> <br />OTHER THAN <br />AUTO ONLY <br /> <br />EA ACC S <br />AGG $ <br />. <br />. <br />~--- <br />. <br /> <br />'- <br /> <br />; EACH OCCURRENCE <br />, <br />~(;ATE <br /> <br />WORKERS COIIPENSATlON AND <br />EMPLOYERS' LIABIL(TY <br />I ""Wi PItOPRlETORIPAJlTNe~eUTIVE <br />OFl'lCl!l'lmEMIlEIt.EXCLUDEO? <br />,~,",duc:I'lIlIIUIIdW <br />ISPEClAlPROVISlOta_ <br /> <br />LjJ:(j / j I /-, <br />fVL '.7'+'. <br /> <br /> . <br />~!iT"'T\J-~L~ <br />TOPl_VLlMIT1; O~R - -- <br />E.L. EACH ACCIDENT . <br />E.L DISEASE-EA EMPLOYEE . -- <br />E_L DISEASE-POUCv. IM/T . <br /> <br />I OTHER: <br />I <br />i <br /> <br />I <br /> <br />. DESCRIPTION OF OPERATIONS/LOCATIONSNEJiICLESJEXCLUSIONS ADDED BY ENDORSEMENTI SPECIAl PROVISIONS <br /> <br />It is understood and agreed that thQ following eoUty Is added as an additional Insured but onty as respects the operations of the ~med insured <br />except that Uability resulUng from the additional insureds sole negligence. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLA TlON <br /> <br />Tho Cjty of Santa Ana <br />20 C'vlc Centeor PIau!. <br />santa Ana CA 92702 <br /> <br />SHOULD PJfV OF THE ABOVE DESCRIBED POL,CII:.S BE CANCELLE"Q BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURfR WILL MAIL 10 DAYS WRI-:-TEN <br />NOTlCF TO THE CERTWtCATF HOLDER NAMED TO THF LEFT <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />~~~ <br /> <br />Jeffrey E. Frick, CEO <br />@ACORDCORPORATION19Ba <br /> <br />Attention: FX: CARLA THOMPKINS 714-571~209 <br />ACORD 25 (2001108) Certificate # <br /> <br />37082 <br /> <br />I'::""', Y <br /> <br />
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