Laserfiche WebLink
AC4RDr,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDfYYYY) <br />2112/2009 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />RFP INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />5601 WEST SLAUSON AVE., SUITE 250 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />CULVER CITY, CA 90230 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Phone (310) 642-1933 Fax (310) 645-3150 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED ARC MID-CITIES <br />14208 TOWNE AVENUE <br />LOS ANGELES, CA 900fi1 <br />INSURER A: AIG -COMMERCE 8r INDI <br />INSURER B: <br />INSURER C: <br />INSURER D: <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 />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR D' <br />INSR <br />POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES Ea occun:nce $ <br /> CLAIMS MADE ~ OCCUR <br /> MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br /> <br /> GENERAL AGGREGATE <br /> $ <br /> GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ <br /> POLICY PRO LOC <br /> AUT OMOBILE LU181LnY <br /> COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO (Ea accident) <br /> <br /> ALL ODUNED AUTOS <br /> BODILY INJURY $ <br /> SCHEgULED AUTOS (Per person) <br /> C.- <br /> HIRED AUTOS <br /> <br />NON-OWNED AUTOS <br />RUVED E1 ~^r~ L, <br />1~-/ 1 ~~ BODILY INJURY <br />(Per accident) $ <br /> App <br /> <br />`` .~~ PROPERTY DAMAGE <br />$ <br /> (Per accident) <br /> GARAGE LUU31LnY ~`~ _ <br />t <br />SL <br />'"~- <br />S1 <br />1(: y <br />AUTO ONLY-EA ACCIDENT <br />$ <br /> ANY AUTO <br />: <br />-I, ra <br />e~ <br />t CI' <br />t <br />, <br />y iOfriBy <br />OTHER THAN EA ACC <br />$ <br /> an <br />A$s>$ AUTO ONLY: AGG $ <br /> EXCES5AIMBRELLA LUU3ILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE <br /> RETENTION $ $ <br /> WORKERS COMPENSATION ANO <br />EMPLOYERS' LIABILnY <br />3429138 <br />1 /27/2009 <br />1/27/2010 X TOR STA IUS OTH <br />A ANY PROPRIETOR/PARTNERlEXECUTIVE E.L EACH ACCIDENT $ 1,000 OOO <br /> OFFICER/MEMBER EXCLUDED? YES E <br />L DISEASE <br />EA EMP 1 <br />000 <br />000 <br /> If yes <br />describe under . <br />- <br />LOYEE $ <br />, <br />, <br /> , <br />SPECIAL PROVISIONS below E.L DISEASE -POLICY LIMIT $ 1,000 000 <br /> OTHER <br />~w~mr ~ run ur urtrwuvrv5 r LocATION5! VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECUU_ PROVISIONS <br />EMPLOYER'S LIABILITY LIMITS INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURENCE. <br />ENDORSEMENT ENTITILED WAIVER OF SUBROGATION EFFECTIVE 1/27/091S ATTACHED TO AND FORMS A PART OF THIS <br />POLICY. THIRD PARTY NAME: CLERK OF THE CITY COUNCIL, CITY OF SANTA ANA. <br />CERTIFICATE HOLDER Additional Insured CANCELLATIAN <br />CLERK OF THE CITY COUNCIL <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA M-30 <br />SANTA ANA, CA 92701-4058 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .3O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />AUTHORIZED REPRESENTATNE <br />ACORD 25 (2001108) ARCMI Cert# 3 Holder# 6 ©ACORD CORPO - TION 1988 <br />