TORRES, MARTIN 6A - 2004 - Laserfiche WebLink

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ACORD CERTIFICATE OF LIABILITY INSURANCE oaza/ TM. PRODUCER Plane: (800)395AW5 Fac (858)51&0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF FITNESS AND WELLNESS INSURANCE AGENCY INFORMATION 380 STEVENS AVENUE, SUITE 205 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SOLANA BEACH CA 92075 ki INSURERS AFFORDING COVERAGE I NAIC # INSURE2.. t) ?5 INSURER A: Zuncn JMIIBrICan lasumnce wm u X POLICY PRO- LOC CIO MARTIN TIORRES 12692 RANCHERO WAY GARDEN GROVE CA 92843 N -a o 03 - o `F> -6� A -°ZDO✓ - 11/7 INSURER B: FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER C: INSURER. ITS AGENTS OR REPRESENTATIVES. INSURER D: P.O. Box 1988 M -23 Santa Ana CA 92702 INSURER E: `.+ COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. wool TYPE OF INSURANCE POLICY NUMBER sallcrufEtmE PaucY nvw Nn UNITS Lin $ 1,000, GENERAL LIABILITY 6763733-00 01/24/07 0112U08 EACH OCCURRENCE oMIAGETo BeNrso E 100,000 X COMMERCIAL GENERAL LIABIU AnEM18ES (Ea.mu«wal CLAIMS MAD OCCUR MED. EXP (A,1Y one person) $ 2,500 PERSONAL &ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 3,000,000 GENL AGGREGATE UMITAPPUES PEI PRODUCTSCOMP/OP AGG. S 3,000,000 X POLICY PRO- LOC DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT The City of Santa Ana, its Officers, FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE employees, agents and representatives. INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 7j24� P.O. Box 1988 M -23 Santa Ana CA 92702 `.+ Attention: AUTOMOBILE LIABILITY n 0 wrnen 0Dn0ATInM 1QRR C COMBINED SINGLE LIMIT (Ea accMe,I) $ ANY AUTO BODILY INJURY (Per person) E ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Pw aodd�) S PROPERTY DAMAGE (Per acaderd) E GARAGE IJABAJTI• AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ ANY AUTO r ( $ EACH OCCURRENCE $ EXCESS I UMBRELLA LIABILITY OCCUR CLAIMS MADE AGGREGATE Y FEE] DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' UABILnY WG BTPTII ioRY uMis OT1ffA E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ QUVOeOT E.L. DISEASE - POLICY LIMIT $ OTHER: DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS The City of Santa Ana, Its officers, employees, agents, and representatives are added as an additional Insured but only as respects the operations of the named insured except that liability resulting from the additional insureds sole negligence. Additional Insured Endorsement is Effective: 02127107 , wr,nu CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT The City of Santa Ana, its Officers, FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE employees, agents and representatives. INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 7j24� P.O. Box 1988 M -23 Santa Ana CA 92702 `.+ Attention: Jeffrey E. Frick, n 0 wrnen 0Dn0ATInM 1QRR C ACORD 25 (2001108) Certificate 9 53653 ^�� ^� --