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MADISON MATERIALS 1 - 2005
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MADISON MATERIALS 1 - 2005
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Last modified
1/3/2012 2:33:58 PM
Creation date
12/21/2005 1:04:36 PM
Metadata
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Template:
Contracts
Company Name
Madison Materials
Contract #
A-2005-243
Agency
Public Works
Council Approval Date
10/3/2005
Expiration Date
6/30/2008
Insurance Exp Date
2/28/2008
Destruction Year
2013
Notes
Amended by A-2006-078
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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID P DATE (MM/DD/YYYY) <br />WARED-1 02 28 07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Select Programs Ins. Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Ste. 712 <br />Ocean Blvd. <br />249 E ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br />, <br />. <br />Long Beach CA 90802 <br />Phone: 562.216.9016 Fax:562.216.9026 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED A <br />~ ~ ~~ INSURER A: Amen Can Int'1 $ eClalt <br />~ <br />1'S~ <br /> INSURER B: COIDmerCe br Ind115t <br />-~~ O <br />Madison Mater1a13 <br />~ INSURER C: &wrest National Insurance Co. <br />n , (IJ <br />V <br />P.O. BOX 8206 <br />8 <br />92 INSURER D: <br />65 <br />Newport Seach CA <br /> INSURER E: <br />COVERAGES <br />7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW RHSTANDING <br />ANY REQUIREMENT, TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED eY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POULY NUMBER 0 TE MMIFDEDIYY E PDATE EMIDD/Y(N UMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 , OOO ~ OOO <br />A X X COMMERCIAL GENERAL LIABILITY EG2223762 02/28/07 02/26/08 PREMISESIEaoccurence) $300,000 <br /> CLAIMS MADE OCCUR MEO EXP (Any one person) $lO, OOO <br /> PERSONALSADVINJURY $1,000,000 <br /> GENERAL AGGREGATE $ 2 , OOO r OOO <br /> GEN'L AGGREGATE LIMRAPPLIES PER: PRODUCTS-COMPlOP AGG $l, OOO, OOO <br /> POLICY PE a LOC <br /> 4UTOMOBILE LIABILITY <br />COMBINED SINGLE LIMB <br /> <br />000 <br />000 <br />$1 <br />$ }( ANY AUTO 6531476 0128 ~07 02~29~08 (Ea accidenq , <br />, <br /> ALLOW NED AUTOS <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />lPar person) $ <br /> HIRED AUTOS BODILY INJURY <br /> NON-0WNED AUTOS (Per accitlant) $ <br /> PROPERTY DAMAGE $ <br /> (Per acdtlenU <br /> GAR AGE UABILD-Y AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: pGG $ <br /> EXLESSNMBRELLA DABILITY EACH OCCURRENCE $ 4 r Q OO r OOO <br />(' ]( ]{ OCCUR ~CLAIMSMADE 7167000037071 02/28/07 02/28/06 AGGREGATE $grOpOrOpO <br /> $ <br /> DEDUCTIBLE $ <br /> ]( RETENTION $NOIle $ <br /> WORKERS COMPENSATION AND <br />' - <br />TORY LIMITS ER <br /> EMPLOVERS <br />UABIUTY <br />ANV PROPRIETOR/PARTNER(EXECUTIVE ~ „ ~ <br />~ <br />t <br />el E.L. EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? _ ~ E.L. DISEASE -EA EMPLOYE <br />- $ <br /> Hyes, tlescdbe untler - - - - <br /> SPECIALPROVISIONSbelaw E. L. DISEASE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLE51 E%CLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br />*10 Days Notice of Cancellation if Cancelled for Non-Payment of Premium. The <br />Certificate Holder is included as Additional Insured per attached Additional <br />Insured Endorsement for Commercial General Liability policy. <br />CERTIFICATE HOLDER CANCELLATION <br />L.s~,r~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATO <br /> DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL *3O DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAIUIRE TO DO SO SHALL <br />City of Santa Ana <br /> <br />Attn: Teri Cable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />20 C1V].C Center Plaza REPRESENTATIVES. <br />Santa Ana CA 92702 AUTHORI~DREPRE NTA <br /> Mare Ber n <br />AcoRD 2s (z0ovo8) ~/ '"•L~~~" ©ACORD CORPORATION 19 <br />
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