Laserfiche WebLink
ME <br />163167 <br />,acoR CERTIFICATE OF LIABILITY INSURANCE D/DD/YYYY) <br />o4n /12/2 z/2o 11 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYLD <br />IAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY. OR N (3ATtVEL11 AM D; r.XTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. . <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the, p6licy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certalrt;policies may require.an-An-dorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER CONTACT <br />NAME: Rocco Leon <br />John 0. Bronson Co. / #0425149 PHONE 916-480-4134 <br />3636 American River Drive Suite 200 E-MAIL A/C No): 916-480-4134 <br />Sacramento, CA 95864 ADDRESS: rleon@'ohnobronson.com <br />916-974-7800 INSURER(S) AFFORDING COVERAGE NAIL # <br />INSURED <br />Ware Disposal Company Inc. <br />INSURER A: Financial Pacific Ins. Co. (Sacramento, CA) <br />INSURER B : Starr Indemnit & Liability Co.(WFI LA, CA) <br />(See below for additional named insureds, if any) <br />1035 E. 4th Street <br />Santa Ana, CA 92701 (( (/ <br />"l T of <br />INSURER C : Princeton Excess & Surplus(WFI Los Angeles,CA) <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADDL SUBR <br />LTR TYPE OF INSURANCE IN POLICY NUMBER MOLICYMIDD EFF MM ICY/YYYY LIMITS <br />GENERAL <br />LIABILITY <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE a OCCUR <br />182323A <br />2/28/2011 <br />2/28/2012 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 50,000 <br />MED EXP An one arson) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />X POLICY PRO- LOC <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS No <br />AUTOS <br />182323A <br />2/28/201 1 <br />2/28/2012 <br />COMBINED L I <br />Ea accident <br />1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS <br />SISCSEL00004111 <br />(Lead Excess) <br />2/28/2011 <br />2/28/2012 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />-MADE <br />DED RETENTION $ <br />AGGREGATE <br />$ 5,000,000 <br />WORKERS COMPENSATION <br />$ <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N <br />OFFICERIMEMBER EXCLUDED? ❑ N / A <br />(Mandatory in NH) <br />WC STA IU- OTH- <br />TQRY TR <br />E.L. EACH ACCIDENT $ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - EA EMPLOYE $ <br />E.L. DISEASE -POLICY LIMIT $ <br />Excess Liability - 2nd Layer 66A3F0000031100 <br />C <br />2/28/2011 2/28/2012 <br />$5,000,000 Each Occurrence/$5,000,000 Agg <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />RE: Work performed by the insured for certificate holder per written contract <br />.,y <br />City of Santa Ana; its officers, employees, agents, volunteers and representative <br />Inter <br />Interests: <br />Forms: CG2010 021 OR <br />CERTIFICATE HOLDER CANCELLATION *30 Day Notice of Cancellation/10 Dav for Non-Pav/Non-Rnto* <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana Public Works Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA, M-21 ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />