|
R ' CERTIFICATE OF LIABILITY INSURANCE
<br />J �0/26�2010
<br />114.
<br />ADDL SUBR POLICY EFF POLICY EXP
<br />POLICY NUMBER MMfDD MMIDDIYYYY
<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 ADDMNIWIMISRFDPReeli es) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an a do s ent. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s)
<br />PRODUCER 1 -8 7 - 6.000 rf_
<br />T
<br />Aon Risk Services Southwest, Inc.
<br />CLE" - ? -��
<br />1330 Post Oak Boulevard, Suite 900
<br />Houston, TX 77056 -3089
<br />4361000
<br />E FAX
<br />No Ext: A/C No:
<br />E-MAIL -
<br />ADDRESS:
<br />PRODUCER -
<br />CUS7 MERID M
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />INSURED
<br />Clear Channel Outdoor, Inc.
<br />INSURER A: Insurance CO of The State of PA
<br />INSURER B:
<br />c/o 200 East Besse Rd.
<br />INSURER C:
<br />I VIED EXP (Any one person)
<br />INSURER D:
<br />PERSONAL & ADV INJURY
<br />San Antonio, TX 78209
<br />INSURER E :
<br />1 4
<br />INSURER F:-
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL SUBR POLICY EFF POLICY EXP
<br />POLICY NUMBER MMfDD MMIDDIYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />4361000
<br />11 /01 /1
<br />11/01/11
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 2 , 000'000
<br />I VIED EXP (Any one person)
<br />$ Excluded
<br />PERSONAL & ADV INJURY
<br />$ 2, 000, 000
<br />GENERAL AGGREGATE
<br />-$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />POLICY PRO LOC
<br />PRODUCTS - COMP /OP AGG
<br />$ 2,000,000
<br />, $
<br />A
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />CA3976708 (AOS)
<br />11 /01 /1
<br />11/01/111
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 2,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />{ Tr�'r
<br />M RO V �-% a
<br />- �., � ) �
<br />f
<br />�)
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />X
<br />HIRED AUTOS
<br />NON-OWNED AUTOS
<br />- v'
<br />/-
<br />,
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />-
<br />•A,SJ1SlIl1 ('`
<br />IV = �((17t�
<br />I
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DEDUCTIBLE
<br />$
<br />A
<br />RETENTION $
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ANY PROPRIETOR /PARTNER/EXECUTIVE
<br />OFFICER /MEMBER EXCLUDED? ❑
<br />NIA
<br />26149822 (AOS)
<br />11 /O1 /1
<br />11 /O1 /11
<br />X WCSTATU- CTH-
<br />TORY LIMITS ER
<br />$
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />(Mandatory in
<br />If yes, describe under
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT '
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: Santa Ana Agreement - Bus Shelters and Bus Benches City of Santa Ana, Santa Ana City Council, its officers, agents
<br />and employees are additional insured on the GL and Auto policy, but only to the extent of the liability assumed under
<br />written contract. Workers' Compensation coverage is evidenced for employees of the Named Insured only.
<br />CFRTIFICATF WAI nGO
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza - Ross Annex (M -85)
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />IISAQ�C
<br />nt,,,1 A.T,
<br />ACORD 25 2009/09 (9 1Udt$ -zua9 ACORD CORPORATION. All rights reserved.
<br />ACOR 98 ( ) The ACORD name and logo are registered marks of ACORD
<br />Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600
<br />
|