Laserfiche WebLink
<br />ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDlVYI <br />10/05/2001 <br />~RODUCER (727)530-0684 FAX (727)536-9985 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Jack Rice Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />13080 S. Belcher Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Largo, FL 33773 INSURERS AFFORDING COVERAGE <br />INSURED Axlom Internatlonal INSURER A: Transportation Insurance Company <br />Axiom Services, Inc. dba INSURER 8: Transcontinental Insurance Company <br />1805 Drew Street INSURER c: <br />Clearwater, FL 33765 INSURER 0: <br />I INSURER E: <br /> <br />COVERAGES <br /> <br />LIMITS <br /> <br />$ <br />FIRE DAMAGE (Anyone fire) S <br />MED EXP (Anyone person) S <br />PERSONAL & ADV INJURY S <br />GENERAL AGGREGATE $ <br />PRODUCTS. COMPIOP AGG $ <br /> <br />05/10/2000 05/10/2003 <br /> <br />COMBINED SINGLE LIMIT <br />(fa accident) <br /> <br />BODILY INJURY <br />(Perperlon) <br /> <br />BODILY INJURY <br />(Peraocident) <br /> <br />- <br /> <br />PROPERTY DAMAGE <br />(Peraceldenl) <br /> <br />. <br /> <br />~GE LIABILITY <br />I ANY AUTO <br /> <br />EXCESS UABILlTY <br />:rOCCUR D CLAIMS MADE <br /> <br />I DEDUCTIBLE <br />I RETENTION $ <br />~RSCOMPEN8AnoNAND <br />EMPLOYERS' UABIUrY <br /> <br />APPROVED AS IV <br />~ aL. W-." <br />.>I.4'T , <br />L UTa Sheedy <br />a City AttOrn Y <br />Deputy <br /> <br />EACH OCCURRENCE $ <br />AGGREGATE S <br />$ <br />$ <br />$ <br /> <br />AUTO ONLY. EA ACCIDENT $ <br />EA ACe s <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />AGG $ <br /> <br />I T~:m:mfsT <br />E.L. EACH ACCIDENT <br />E.l. DISEASE. EA EMPLOYE <br />E.L. DISEASE - POLICY LIMIT <br /> <br />r1C224472783 <br /> <br />01/02/2001 01/02/2002 <br /> <br />IU~,\'- <br />$ <br />$ <br />$ <br /> <br />B <br /> <br />OTHER <br /> <br />1 000,000 <br />100,000 <br />10,00 <br />1 OOO,OO( <br />2,OOO.00( <br />2,000,00( <br /> <br />$ <br /> <br />1 OOO,OO( <br /> <br />$ <br /> <br />$ <br /> <br />S <br /> <br />100 ,00( <br />100 ,OO( <br />500,OO( <br /> <br />~ OF OPERATIONSILOCATtONSlVEHICLESJEXCLUSIONS ADDED BY ENDORSEMENTISPECIAl PROVISIONS <br />e: ProJect: CAPO Conversion <br />he City of Santa Ana, its officers, employees, agents volunteers and representatives are additional <br />nsured with respects to general liability and defense of suits arising from the operations and uses <br />Ierformed by or on behal f of the named insured. "See Attachment" <br />* Except 10 Days for Non-Payment <br /> <br />CERTIFICATE HOLDER I I ADDrnoNAL 'NSURED, INSURER LETTER <br /> <br />CANCELLATION <br /> <br />City of Santa Ana <br />Public Works Agency <br />Attn: Taig Higgins <br />20 Civic Center Plaza M-36 <br />Santa Ana, CA 92701 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~ MAIL <br />*30 DAYS WRITTEN NonCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />~X <br />XXXXX <br /> <br />d7?(J)~ <br /> <br />.. <br /> <br />AUTHORIZED REPRESENTATIVE <br />Sandi Vernacchio/FLN <br /> <br />@ACORD CORPORATION 1988 <br /> <br />ACORD 25-8 (7/97) <br />