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TOM MALLOY dba TRENCH SHORING 1 - 2004
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TOM MALLOY dba TRENCH SHORING 1 - 2004
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Last modified
1/3/2012 2:00:31 PM
Creation date
11/17/2004 12:26:52 PM
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Contracts
Company Name
Tom Malloy Corporation dba Trench Shoring Company
Contract #
N-2004-071
Agency
Public Works
Expiration Date
12/31/2004
Insurance Exp Date
11/1/2004
Destruction Year
2009
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<br />,ACORDN CERTIFICATE OF LIABILITY INSURANCE CSR KL I DATE (MM/ODIYYYY) <br />TRENC-1 06/08/04 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Wood-Gutmann Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0679263 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />14192 Franklin Ave., Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tustin CA 92780-7044 <br />.Phone:714-505-7000 Fax:714-573-1770 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Hartford Fire Insurance <br /> INSURER B: Fireman's Fund Insurance Co. <br /> Tom Malloy Co~oration INSURER C: state Compensation Ins Fund <br /> DBA: Trench Shoring Company <br /> 636 Rosecrans INSURER D: <br /> Los Angeles CA 90059 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 AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER ),~~~1J~rJ~~E ¡r>ç¡~~ÇEYI~~~~}~~N LIMITS <br /> DATE MM/DDIYY <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> - <br />A X COMMERCIAL GENERAL LIABILITY 72 CE SOA2 655 11/01/03 11/01/04 PREMISES (Ea occurence) $ 300,000 <br /> l CLAIMS MADE ŒJ OCCUR MED EXP (Anyone person) $ excluded <br /> - PERSONAL & ADV INJURY $1,000,000 <br /> - GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 <br /> I .nPRO- h <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> f-- $1,000,000 <br />B ANY AUTO MZA80240920 11/01/03 11/01/04 (Ea accident) <br /> I--- <br /> ¿ ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS (Per person) <br /> f-- <br /> X HIRED AUTOS BODILY INJURY <br /> - $ <br /> ~ NON-OWNED AUTOS (Per accident) <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY 1ifi:~At~~ ~,I; " 0/ / AUTO ONLY, EA ACCIDENT $ <br /> ~ ANY AUTO /3 OTHER THAN EAACC $ <br /> t,...' '-'" ..". ~~. I AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY V // EACH OCCURRENCE $ <br /> =:J OCCUR D CLAIMS MADE ' , <br /> ,/ AGGREGATE $ <br /> $ <br /> ~ DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X I TORY lIMITŠ I IUË~' <br />C EMPLOYERS' LIABILITY 166356603 12/09/03 12/09/04 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1000000 <br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1000000 <br /> If yes, describe under $ 1000000 <br /> SPECIAL PROVISIONS below E,L DISEASE. POLICY LIMIT <br /> OTHER <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />*10 Days notice of cancellation for non payment of premium, Certificate <br />holder named as additional insured per attached Exhibit B titled "Additional <br />Insured endorsement for Commercial General Liability Policy". <br /> <br />SANTA07 <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br /> <br />Donald L, Wood <br /> <br /> <br />ACORD 25 (2001/08) <br /> <br />J4ú;¡-- <br />
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