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STAMEN, TED 1 - 2004
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STAMEN, TED 1 - 2004
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Last modified
3/26/2024 2:35:37 PM
Creation date
1/25/2005 12:01:34 PM
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Contracts
Company Name
Stamen, Ted
Contract #
N-2004-135
Agency
Parks, Recreation, & Community Services
Insurance Exp Date
4/10/2005
Destruction Year
2010
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3: 10/25/2004 Time: 11:21 AM To: @ 19494542429 <br />Prom: /ArmstrongRobitaille Page: 002-DOS <br />ACORD- CERTIFICATE OF LIABILITY INSURANCE 10/26/�MIDD;YY) <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Armstrong/Robltallle Bus&lnsSv ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />fi80 Lan sdorf Drive #100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PO Box 34009 <br />Fullerton, CA 92834-9409 INSURERS AFFORDING COVERAGE <br />INSURED INSURBRA: Herfford <br />TED STAMEN, ISA CERIFIED ARBORIST & <br />INSURER 6 <br />23052 ALICIA PARKWAY #H425 _ <br />INSURER ': <br />MISSION VIEJO, CA 92692 <br />INSURER D: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THP. INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED O <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUIm <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSR <br />TYPE OF INSURANCE <br />POWCV NVMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />A <br />GENERAL LIABILITY <br />72SBAGO4974 <br />04/10iM <br />04/10M5 <br />EACH OCCURRENCE <br />$1000000 <br />MRHDAMAUE(Ar.yonefire) <br />$300000 <br />X CoMMERCIALGHNERALLIAEILITY <br />CLAIMS MADE ❑ OCCUR <br />MED EKP (Ar. one penor.) <br />$10000 <br />PERSONAL&ADVINJURY <br />$1000 OO <br />GBNBRALAGGRBGATE <br />$2 000 <br />GBN'LAGGREOATE <br />LIMD'APVLIPS PER: <br />PRODUCTS -COMP/0PAGG <br />$2000000 <br />POLICY <br />PRO- LOT <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />72SBAGO4974 <br />,M <br />04/1 O/W <br />,K <br />04/1 OM5 <br />COMBINED SINGLE LIMIT <br />6+=—;� ''O <br />$1,000,0W <br />IhODILY INJURY <br />(Per pe—.1 <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X <br />BODILY INJURY <br />(Pn eoa1Mo1) <br />$ <br />HIRED AUTOS <br />NONIDWNED AUTOS <br />X <br />PROPERTYDAMAGE <br />(Per ttv;dcnp <br />$ <br />GARAGE LIABILITY <br />AUTOONLY-EAACCIDENT <br />$ <br />OTHERTHAN CW ACC <br />$ <br />ANl'AUTO <br />$ <br />AUTO ONLY: AGO <br />EXCESSUABILITY <br />EACH UOCURRBNCH <br />$ <br />OCCUR ❑ CLAIMS MADE <br />AGGREGATE <br />b <br />$ <br />DEDUCTIBLB <br />3 <br />RETHNI'ION $ <br />WORKERS COMPENSATION AND <br />WCSTATUSI -JfH- <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />$ <br />E.L.DISRASE-EAEMPLOYEE <br />$ <br />H.L.DISHASH -POLICY LIMIT <br />b <br />OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS)V EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPFCIAL PROVISIONS <br />Cancellation clause is completed as follows: except in the event of Non -Payment when a 10 <br />day notice will be provided. <br />The City of Santa, 0s officers, agents, employees, representatives end <br />volunteers are added as Additional Insured per endoreement attached. This <br />(See Attached Descriptions) <br />City of Santa Ana Parks, <br />Parks, Recreation & Community <br />Services Agency/ Dolores Ramos <br />888 W. Santa Ana Blvd. Suite 200 <br />200 P.O. Box 1988 M-23 <br />SHOULD ANYOPTH EABOW DESCRIBED PCIJCIES BE CANCELLED BEFORETHE EXPIRATION <br />DATETHEREOP, THEISSUING INSURER WILLMA113O—DAYS WRBTEN <br />NO ICETOTHE CERTIFICATE HOLDERNAMEDTOTHELEPT. B <br />ACORD 25-S (7/n 1 of 3 #5255065/M255063 q TLA D ACORD CORPORATION 199E <br />l <br />
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