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SOUTHLAND CAR COUNTERS 5 -2005
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SOUTHLAND CAR COUNTERS 5 -2005
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Entry Properties
Last modified
1/3/2012 2:09:48 PM
Creation date
10/6/2005 2:45:29 PM
Metadata
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Template:
Contracts
Company Name
Southland Car Counters (Field Data Services)
Contract #
A-2005-114
Agency
Public Works
Expiration Date
6/6/2006
Insurance Exp Date
9/30/2007
Destruction Year
2011
Notes
Amended by A-2005-114-01
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AL`ORD CERTIFICATE OF LIABILITY INSURANCE OP ID DaTE (MM/ODIYYYY) <br />NATIO-5 O5 07 07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Freeman 6 Pearce Ins . - COCIA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />LiC. #0559854 HOLDER. THIS CERTIFICATE DOES NOT AMEND <br />EXTEND OR <br />1216 N. Tustin Street , <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Orange CA 92867 <br />Phone: 714-558-1334 Fax:714-626-1330 INSURERS AFFORDING COVERAGE ~NAIC# <br />INSURED <br />National Data & Surveying A•D~ ~-rry, <br />INSURER A' Colden [a93e/PCeilesa xna Co ~' 10$36 <br />SerV1Ce4 Ino. <br />DBA: SOUTHLAND CAR COUNTERS A-zoos-uy-or INSURER B' <br />DBA: FIELD DATA SERVICES INSURER C: <br />8370 Wilshire Blvd Ste 209 <br /> <br />Beverly Hills CA 96211 INSURER D: <br /> INSURER E. <br />CO <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 />MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IB SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IRSR <br /> <br />LTR <br />NSR TYPE OF INSURANCE <br />POLICY NUMBER <br />~qTE MM/OD/ri <br />DATE MM ~DlYY _ _ <br />I LIMITS <br /> !GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A X X COMMERCIAL GENERAL LIABILITY CBP9888381 09/30/06 09/30/07 PREMISES Ea occurence $ 1DD, DDO <br /> CLAIMS MADE '.~ OCCUR <br /> MED EXP (Any one Person) 8 1 D r D D D <br /> I <br />f FERSONHL3ADVIIJJURY 1$1,000,000 <br /> GENERAL AGGREGATE $2, QODrQDO <br /> GEN'L AGGREGATE LIMIT APPLIES PER'. <br />PRO <br />' PRODUCTS -COMP/OP AGG $ 2 , 000 , D D D <br /> ' <br />- LOC <br />POLICY <br />JECT <br /> AU TOMOBILE LIABILITY <br /> oQ INGLE LIMIT <br />e S <br /> ANY AUTO E <br />accitle <br /> ALL OWNED AUTOS ~b)~ ~E°~~ ~~' ~~~ .~~~~q~s <br /> SCHEDULED AUTOS /A~.L PFi~~rl®~13 C~Fi6B '(GATES ~ ~ IP oPersloN~J)URY $ <br /> HIRED AUTOS ' <br /> BODILY INS JURY $ <br /> <br />t NON-OWNED AUTOS ' (Per accidenq <br /> ( <br />i ~ PROPERTY DAMAGE <br />(Par accidenq $ <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANV AUTO <br />OTHER THAN EA ACC <br />$ <br /> AUTO ONLY. qGG $ <br /> E%CESSlUMBRELLA LIABILITY EACH OCCURRENCE $SrQDD~OQO <br />A X OCCUR CLAIMS MADE CU 8070943 09/30/06 09/30/07 AGGREGATE $SrOOO, ODD <br /> $ <br /> I DEDUCTIBLE 8 <br /> ' RETENTION $ $ <br /> WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY - - <br />TORY LIMITS ER I <br /> ANY PROPRIETORIPARTNERlEXECUTIVE ~ E.L. EACH ACCIDENT '. $ <br /> OFFICERIMEMBER EXCLUOED9 <br />It ye; describe under c. L. DISEASE - EA EMPLOYEE( $ <br />i SPECIAL PROVISIONS below E. L. DISEASE-POLICY LIMIT $ <br />OTHER <br /> <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT( SPECIAL PROVISIONS <br />*CANCELLATION - EXCEPT 10 DAYS NOTICE FOR NON PAYMENT OF PREMIUM. <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS & VOLUNTEERS, __ , <br />PRIMARY WORDING PER FORM CGODOI 10/O1 & NAMED AS ADDITIONAL INSURED q,.,,, „°,=Y <br />PER FORM GECG602 9/04 BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS <br />CONTRACT ARE CONCERNED.RE: TRAFFIC DATA COLLECTION <br />ctrc I o-wn I L: n~LUtH; CANCELLATION <br />SANTO 13 SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O * DAYS WRITTEN <br />CITY GF SANTA ANA, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br />PUBLIC WORKS AGENCY <br /> <br />Attn: Shahir Gobran IMPOSE NO OBLIGATION OR LIABILITY OF ANV KIND UPON THE INSURER, ITS AGENTS OR <br />20 CIVIC CENTER M-93 REPRESENTATIVES. <br />SANTA ANA CA 92702 12ED RE7RE5EIJT?TI'(E <br /> - - <br />ACORD 25 (2001!08) ©ACORD CORPORATION 1988 <br />
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