Laserfiche WebLink
•/ • DATE f!AhtittYYYYYJ <br />CERTIFICATE OF LIABILITY INSURANCE 8/21/2009 <br />PFW-01 czR (949) 851 -8804 SAX: (949')651 -8842 THFS CERTIFICATE 15 ISSUED AS A mATTER OF INFORMATION <br />GSM Insurance Sarvicee ONLY AND CONFERS, NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Lie. #OD15612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW._ <br />30 Corporate Park $307 <br />Irving CA 92 606 INSURERS AFFORDING COVERAGE NAIL <br />INSUM --11A Nsul=a.lus Inn CO <br />C---- , Inc. Insu, a,r —reat Divide Ins Co <br />500 S. Jefferson INSURSaG: <br />INSUFit.•R d: <br />11?lacent�a CA 92870 IN$J RE <br />COVERAGES <br />1;1EPOLlCIES OFI.NSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOPNJTMTANUING <br />AN•f REOUIREMENT, 'GERM OR CONDITION OF ANY CaSIRAGT ON OTHER 00CUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />141AY PERTAOV, TFE INSUJFRANCE AFFORDED BY THE POLICIES OESCRIBE_O iHEREW IS SUBJECT TO ALL THE TERMS, EXCLUSIONS A,14DCONDITONS OF 9 UCH <br />1100' -IE$. AWREW, E LIMITS SFfOwN MAY HAVE KEN REMCED BY PAID CLAIMS, <br />MtBR <br />. .'' <br />.. LIMITS iTR. YSR Ty 0EI SU"H2 POLICYNUMER YI 4XA <br />a TxrtALLUBILm FACAVCCtIA11 Knr $ 1,000,000 <br />TSA1ktdE 4d Rc^tTTfb <br />X 003tM01L.e1. r,ENERn�L 'LIAUa.rrr ' _k'Nt,1ISk3 ae� ocltny%gl .. S if0 OQ0 <br />R CLAM srE OCCuR item 0200181-12 8/23/2009 8/23/207.0 gj�q�tAv" in <br />PERSONAL & iCN INJlX / <br />__ ._. _ _ cFn rtALctaecaA S 2.000, 00,0 <br />r,�wl A1jGFW -JA, TrLIWTA.. r.IESrR M0ducr5 casiP�.13PAGD t 2 ODO X00 <br />X f Pa0r,e I LOC I _ <br />_ _ <br />AuiCitOait.EClAam•IfTY COMBNdED SINGLE :ILIITm i 1,000,0040 <br />X Auv A11 TQ <br />D AI.I,OWJ!:DPi+ -0G 0200182 -12 8/23/2009 B/23/2010 ROnILYlNJ4HY <br />S ^T ULIL�L'AUT{iS (ForForwni S <br />X NIRfr;1 ti:Ti3K 'Put fJS.Ji1i!` .. _....._ <br />it ION- OWTt�I AiTrn.. IpeT.urcitienll <br />came i Coll Dori. t...r11<�v� "• . <br />L v pkOPE 1TY'"'AGS <br />1 4 00 tpm aoldeA <br />I <br />RARASC LtADYITY AUTO ONLY• kA ACCIL ;6Nr 5 <br />1 ANY MITO : . EA �RLL'.. S _...... __._ <br />i OtHER T!iA,k <br />AVtOONLY. ACC, S <br />_EXCEWWWRELrLAV}A}7HJ7Y p „�..�•^^` - ~ -� \til}'CIlUS'. C+,1CI16CCUi6iEFk:E b <br />,rY GtA:M3A6tLK I ��SCi. � AGGREGATE <br />I <br />3 <br />I ( DEDUCTIBLE <br />8 <br />AND MPL(7YERS *LIA0aJ7Y <br />YON <br />X SN3YaiI1diS9l _ . _ EH _ . <br />Awt opnEToNrARTNEfyuE- cAmvE: r-LL" RAC ICCur S 11000,000 <br />c�fl�E'sa exta.uc>E;nr <br />(ht,mlabrjlPNM 1523397 -1D `8/23/2009 8/23/2010 ELMAEM19- rA@A9TLOYE s 11D00 ODO <br />___.ev.:; PF{ONXRlCW3 bebr D15FAFF• POt TCYr ulrr a 1 0 0 DOO <br />A MVERContractors ECpO 02aaisi -12 8/23/2009 8/2312010 ZacdiDoourrntwa a L'000,000 <br />Yollut-ion R4oxso4 e S 2,000,000 <br />s <br />i <br />Dt:Bt:Wp'TtIIN OF OFiW1T16N5 f LOCA,TIOpkSf V6HiCLEg! EXCL11Y7ONS AIX38DKY kttUONYEiTE.'VT'R 5PLCIAL pR'JWlia•ONS <br />Tho VoTT•wral liability poltoy includai the City, of 9antn Ana, itF1 officlare, employesa, agenta,voluatears and <br />raprasantativos as acieu tiolial insured with regard tb work partormed by os on behalf of tho xam" Inaurad wf uru rimcpirod <br />hY writtan contract.*Nxoopt 10 days for nonpaynart of premium. <br />SNDULD ANY OMMADOVE oatcFusen MXk.1IgS RECANCELL oaePine THE E%PatAnoh <br />City Of Santa Axis WETNEREDF ,NEWLM.0 INSURER %ILL*M)OM TAIL 30 _ DAYS WRrITEN <br />1)opartnant of Public Works NOTICE 10THECEk11FdCATE HOLDER NAMED TOTIQ LEFT. <br />it�)��gii�%Q�i <br />0 a2 Civic Canter Plaza, ?aG?PL�IX6� { bf�E�Gj €')A�(VG�47#961CX�li»C'35�16�FA E <br />M -21 <br />Santa Ana, CA 92702 <br />AW90f 2EO REPReSONTATIYE <br />.ioy False /JLF <br />ACORD 25 (2009101) 0 7488 -2008 ACORD CORPORATION. All rights reserved. <br />INS025gwwiI The AGURD name and logo are registered marks of ACORD <br />