|
~ ~~ c~-- C`jj
<br />.yt,ux~,~ CERTIFICATE OF LIABILITY INSURANCE 3~i9i2
<br />oY'
<br />o
<br />PRO
<br />DUCER (866) 544-8273 FAX: (866) 544-3486 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Elizabeth Souther Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />29395 Agoura Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Suite #202
<br />A ours Hills CA 91301 INSURERS AFFORDING COVERAGE NA1C #
<br />INSURED pacific Building Care Inc, PBC Janico INSURER A: Fi.rSt MEITCU Insurance 10657
<br />Ine,PBC Solution One Ine, PBC A&D Building INSURERB:Hartford Casualt 29424
<br />Maintenance DBA A&D Bldg Maint INSURERCAmerican Alternative Ins 19720
<br />3080-B Airway Avenue
<br /> INSURER D
<br />COSta Me98 CA 92626
<br /> INSURERE~
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I
<br />NDICATED. NOTWITHSTANDING A
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT -MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE
<br />ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
<br />EXCL
<br />S
<br />,
<br />U
<br />IONS ANp CONDITIONS OF SUCH POLICIES-
<br />A IM T H Y H V N R U Y PAI IM .
<br />1NSR ADD'
<br />TYPE OF INSURANCE
<br />POLICY NUMBER POLICY EFFECTIVE
<br />DATE MM1DDlYY POUCYEXPIRATION
<br />DATE MMlODlYY
<br />LIMITS
<br /> GENERAL LIABILITY EACH CURRENCE $ 1 , 000 , 000
<br />
<br />A X COMMERCIAL GENERAL LIABILITY ~MAGE TO RENTED e S 50 , 000
<br /> X CLAIMS MADE ~X occuR Ft~IINIO16o35-2 3/17/2009 3/17/2010 MEDEXP one rson S 5,000
<br /> X Errors 6 Omissions
<br /> PERSON ADVIN RY S 1,000,000
<br /> X Vicarious Crim Acts 2
<br /> N R A R ATE S
<br />,000,000
<br /> GEN'LAGGREGATELIMITAPPLIESPER~ PRO TS- OMPgP $ Z,000,OOO
<br /> X POLICY JECT LOC
<br /> AU TOMOBILE LIABILITY
<br />
<br />X
<br />ANY AUTO COMBINED SINGLE LIMIT
<br />(Ee acadenq
<br />$ 1, 000 , 000
<br />
<br />B ALL OWNEDAUiOS AaUENIE1966 3/25/2009 3/25/2010
<br />
<br />SCHEDULED AUTOS BODILVINJURY
<br />(Per person)
<br />$
<br /> X HIRED AUTOS
<br />
<br />X BODILY INJURY S
<br /> NON-0VMIEDAUTOS ~,r~1
<br />" ~,-~y~,l~,,,
<br />v (PeraccWeM)
<br /> X $1,000 Dod Comp (
<br />e
<br />y v
<br />~
<br />
<br />X
<br />$2 000 Ded Coll
<br />(~~, ~ ~7 pROPERTYDAMAGE
<br />(Pereceidem)
<br />$
<br /> GARAGE LUIBIUTY r~
<br />~ AUTO ONLY - EA ACGDENT $
<br /> ANY AUTO ~
<br />( - ~-~
<br />/
<br /> / She
<br />)-- 'dy OTHER THAN $
<br /> ~;L AUTO ONLY- A G $
<br /> E%CESSIUMBRELLALIABILITY (;1Ly
<br />
<br />~ anL H N S S,000,OOO
<br /> X OCCUR ~ CLAIMS MADE AS~
<br /> A GREGATE S
<br /> $
<br />C DEDUCTIBLE 82A2UH000082600 10/1/2006 10/1/2009
<br /> $
<br /> X RET NTI N 10 000
<br /> S
<br /> WORKERS COMPENSATION AND STATU- OT
<br />H-
<br /> EMPLOYERS' LIABILITY R
<br />T ~ V iS16,
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFK;ERlMEMBER EXCLUDED? E.L. EACH ACCIDENT S
<br />
<br /> If yes, desaibe untler E L. Ol EA - - EA EMPLOYE S
<br /> P I PR VISI N below
<br /> . pIS ASE -POLICY LIMIT S
<br />B OTHER guainess Personal 44LtUNi1z1791 3/25/2009 3/25/2010
<br /> Limit $930,000
<br /> Property
<br /> D¢duatible $1, 000
<br />DESCRIPTION OF OPERATONSA-OCATIONSNEHICLESIE%CLUSIONS ADDED BY ENDORSEMENTISPECIAL PRGVISIONS
<br />RE: Job 10088 The Depot of Santa Ana
<br />The City of Santa Ana (20 Civic Center Plaza, Santa Ana, CA 92701), its officora, employees, aganta and
<br />represontativea are named as Additional Insured, but only as respects General Liability arising out of the
<br />operations
<br />of the Named Insured psr Porm CG 20 10 07 04 attached.
<br />CFullerton@santa-ans. org SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />The Ca.ty of Santa And EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL a4e1(1)Sio)6~p~(~( MAIL I
<br />Th® Depot of Santa Ana 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />Attn: Carolyn Fullerton ~~~~~~~~~~~~~~~~~~~~~~~~~
<br />1000 E. Santa Ana Blvd. #108 ~~~~~~~~~
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Bruce Monteith%JEANIE ~ '~'-- ~?`c?'-' ~ ~
<br />ACORD ZS (2001!08) ®AGORD CORPORATION 1988
<br />INenoa,.,...e. ,w_
<br />Parts 1 n/~
<br />I
<br />i
<br />
|