Laserfiche WebLink
Page 1 of 1 ~~Y~l ICL~t+e ~f ~~ZSI~Y[~~'lCQ <br />Sparta Program <br />Name Insured: Named Additional insured: <br />Adlerhorst International, Inc. SANTA ANA (SPARTA) Bordereau <br />3951 Vernon Ave 20 Civic Center Plaza PO Box 1988 <br />Riverside, CA 92509 ~ _ ~~Q,j ' ~ ~~ Santa Ana GA 92701 <br />Certificate # SSA03-0019 <br />Coverage SPARTA INSURANCE PROGRAM: Commercial General Liability -Hazard 1 <br />Contract Value: $16,000.00 <br />Coverage Period: 2/1/2004 to 2/]/2045 <br />Insurance Carrier: Essex Insurance Company <br />Master Policy: 3CM4480 <br />Master Policy Effective Date:l 1/15/2003 to expiration <br />Limits $2,OOD,000 General Aggregate / $],000,040 Each occurrence 1 $1,000,000 Products/Completed operations / <br />~ 1,000,000 Personal & Advertising Injury/$50,000 Fire Damage J Medical Payments Excluded <br />Deductibles $540 BI & PD Per Claimant Including Loss Adjustment Expense <br />$750.00 Premium (Fully Earned) <br />$23.44 Taxes {Fully Earned) <br />$50.00 Certif-cate Fee (Fully Warned) <br />TRIA <br />$823.44 Total Amount <br />Terms & 1. No Cancellations Allowed. Premium, taxes and fees are fully earned at inception. <br />Conditions 2. Operations and Rating Based: Training K-9 & police ofricers on city property. tNo Public Exposure). <br />3. Department: Santa Ana Police Department <br />4. Additional Insured(s): Not Applicable <br />5. NO PROFESSIONAL LIABILITY COVERAGE PROVIDED. <br />6. NO PUBLIC EXPOSURE WORKING WITHIN THE CITY OF SANTA ANA DEPARTMENTS AND THEIR <br />EMPLOYEES ONLY. <br />7. NO COVERAGE PROVIDED FOR ANIMAL MORTALITY OR DOG BITES. <br />Exclusions Asbestos, Assault & Battery, Employer Related Practices, Subsidence, Independent Contractors, Pollution, Cross <br />Suit, Lead or Silica Dust, Mold or Bio-organic Growth o~ Ivlildew, Punitive Damages, Animal, Breach of Contract, <br />Y2K Electronic Data, Medical Payments, War or Terrorism. <br />The insurance provided under this policy is limited to your work performed on behalf of the entity named as <br />"Additional Named Insured" above and doesn't extend itself to any other work performed by you or your <br />organization. Coverage is limited to the description of operations and rating bases listed in "Terms & Conditions" <br />item 2. <br />The Terrorise Risk Insurance Act of 2002, requires us to offer you a quote for terrorism coverage. This Quotation is <br />separate and not included in your coverage premium. This coverage must be accepted or rejected by you and the <br />attached form returned to us prior to binding. <br />Per the Master policy, a copy is available by written request to: Municipality Insurance Services, Inc. 1920 East 17th <br />St Suite J 36, Santa Ana, CA 92705 <br />Carol Frost /President <br />Municipality Insurance Services, Inc. <br />..:~i_ . . <br />1920 East 17th St Suite 136 Santa Ana, CA 92705 (800) 420-0555 {714) 550-5040 fax (714) 550-5044 License# OC04849 <br />