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ALAMTFL-02 KRRFMFR
<br />A� �* CERTIFICATE OF LIABILITY INSURANCE
<br />D03/012019AM l
<br />oa/oa/zols
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND 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 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsements).
<br />PRODUCER N%pcT Kristy Bremer
<br />Hub lDlBfna00nal Northwest LLC PHONE FA% ---
<br />999 West Riverside Avenue, Suite 510 '.. IreC, No, Eel: (509) 319-2909 IAIC, No):
<br />_
<br />Spokane, WA 99201 � DD RIEss: Kristy.Bremer@hubinternational.com
<br />! _.. INSURERISI AFFORDING COVERAGE NAICIf
<br />INSURER A .American Zurich Insurance Company 40142 _
<br />INSURED
<br />CA 0INSURER 8: American Guarantee & Liability Insurance Company
<br />126247
<br />16535_
<br />Cj
<br />Alamon Inc. A-- ow� INSURER C:Zurich American Insurance Company
<br />__
<br />315 W. Idaho INSURER D:
<br />Kalispell, MT 59901 E -
<br />INSURERS:
<br />INSURER F:
<br />COVERAGES (`FRTIFICATF NI IMRFR• eeamm�u wweee.
<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
<br />--''-T_ADDL- --
<br />PAID CLAIMS.
<br />ILTR", TYPE OF INSURANCE
<br />IINSD WVD POLICY NUMBER
<br />0 WVD
<br />POLICY EFF
<br />/DD
<br />._.
<br />POLICYE%P --
<br />MMIDOr/YYY LIMITS
<br />A I X
<br />COMMERCIAL GENERAL LABILITY
<br />I
<br />EACH OCCURRENCE $ 1,000,006
<br />CLAIMS -MADE X ! OCCUR
<br />X X GLA023005303
<br />12I31I2018
<br />12I31/2019 300,000
<br />SES EREcwEnence $
<br />X
<br />STOP GAP/EMPL LLIAB
<br />REM
<br />10,000
<br />MED E%P (Any one Gerson) ; $
<br />PERSONALS ADV INJURY �$ 1,000,000
<br />- 2,000,000
<br />GENERAL AGGREGATE $
<br />- --
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />��� gp-
<br />POLICY X] JEL'T LOD
<br />- . PRODUCTS-COMP/OPAGG I $ 2,000,000
<br />OTHER:
<br />!STOP GAP '-$ 1,000,000
<br />A AUTOMOBILE LIABILITY _
<br />1 COMBINEDSINGLELIMIT E $ 1,000,006
<br />X ANY auto ___ X X GLA023005303 12/31I2018:
<br />-
<br />12I3112019j BODILY INJURY tPer Gerson) I$
<br />OWNED SCHEDULED
<br />- '
<br />AUTOS ONLY AUTOS
<br />^BODILY INJURY (Per=sdenU 1 s
<br />WNED
<br />_X__ AUTOS ONLY X AUTOONIV
<br />IPpOPER DAMAGE
<br />- _(Per acaU $
<br />I
<br />S
<br />B UMBRELLA LAB X ( OCCUR
<br />EACH OCCURRENCE $ 10,000,000
<br />X EXCESS LL1B "'. CLAIMS -MADE; AUC664394400 12/31/2018
<br />I
<br />1213112019: 10,000,000
<br />I AGGREGATE S
<br />DED 1 X ; RETENTIONS 10,0001
<br />C
<br />EMPLOYERS'
<br />X I
<br />AND LIABILIIT'
<br />ANY WCO23005403 - 12/3112016.
<br />PROPRIETORIPARTNERIEXECUTIVE YN"IN/A
<br />STATUTE FOR
<br />12/3 7I2019
<br />E.L. EACHACCIDENT $
<br />OFFICER/MEEMBER EXCLUDED?
<br />i an ,myin H)
<br />.1,000,000
<br />' 1,000,000
<br />If yes, desoBbe unm,r
<br />E.L. DISEASE - EA EMPLOYEE $
<br />'- ----
<br />DESCRIPTIONOFOPERATIONS balm
<br />F.L. DISEASE -POLICY LIMIT _$ 1,000,000
<br />DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES ACORD101,A&IIUomTRemarks SebeEuN,me beaMcheEN more space isrequlmo)
<br />AS RESPECTS CELL TOWER SITE - STADIUM AREEMENT A-1999.205, TOWER SIVIE #411604
<br />ADDITIONAL INSURED STATUS TO THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS
<br />AND REPRENSENTATIVES WITH REGARD TO
<br />LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIONS AND USES PERFOMRED BY OR ON BEHALF OF THE NAME INSURED PER THE
<br />ACTUAL INSURANCE POLICY FORMS ATTACHED TO THIS INSURANCE CERTIFICATE.
<br />INSURANCE IS PRIMARY AND NON-CONTRIBUTORY - APPLIES SEPARATELY TO EACH INSURED
<br />N
<br />- 30 DAYS NOTICE OF �Ei TION GIVEN TO THE
<br />CITY OF SANA ANA.
<br />�V
<br />f
<br />•1
<br />SHOULD ANY OF THE ABOVE
<br />.D[SI5R@B�b"11OkiCIG,} CANCELLED BEFORE
<br />CITY OF SANTA ANA THE EXPIRATION DATATHEREOF '§jjC;3 __WILL BE DELIVERED IN
<br />PURCHASING DIVISION ACCORDANCE WITH THE POLICY PR@Yf>@I l
<br />20 CIVIC CENTER PLAZA l
<br />SANTA ANA, CA 92701 AUTHORRED REPRESENTATIVES
<br />AUUKU 25(2U16/U3) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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