Laserfiche WebLink
A -~~08 -~o/~ -G'~~ <br />~ ~.~~~ <br />CERTIFICATE OF LIABILITY INSURANCE OPID ffi <br />q( <br />~(~ DATE (MMIDD/YYYY) <br />` <br />/ 49/Oi/10 <br />THIS CERTIFlCATE IS 133UED A3 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 THI= COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 133UING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />e ce c o er s an po s mu e e orse , su ect o <br />the terms and conditions of the policy, certain po9cies may require an endorssment. A statement on this cerUtlcate does not conferrights to the <br />certltlCate holder In Ileu oT such endorsements). <br />PRODUCER <br />B <br />t <br />i <br />i <br />G NAME: ,.. . <br />--- <br />u <br />w <br />n <br />nsurance <br />roup <br />Suite 914 cArc,NO,Exci: WC,-+e): <br />60 Cutter Mill Road AnDRESb: <br />Great Neck NY 11021-3104 cuaTOMEROi: CON30-2 <br />Phone:516-966-4200 Fax:516-466-4213 NbunER(a)AFFORDNGCOVERAGE NAlcr <br />(NwRED lNbURERA: patlonel union risti ine. co. 19945 <br />United Testing Corporation INwRERe <br />AIG <br />dba United Ins <br />ection : <br />p <br />and Testing INwRERC: Admiral insurance Compan 24856 <br />22620 Goldencreest Drive <br />Suite 114 <br />INSUaER D <br />Moreno Valley CA 92553 INbuRER E: <br /> INbURER F <br />COVERAGES CERTIFlCATE NUMBER: REVISION NUMBER: <br />THIS I5 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, TERMORCONDITION OF ANY CONTRACT OR OTHERDOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUEDCR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OFSUCHPOLICIES, LIMITS SHOWN MAY HAVE BEEN REWJCED BY PAID CLAIMS. <br />LTR TYPEOFINSURANCE INbR POLICY NUMBER I(6HNIpp/YYYY) (MNIppIyYY1~ LIMITS <br /> GENERAL LWBILITY EACH OCCURAENCE S S , OOO , 000 <br />A X COMMERCIAL GENERAL LIABILITY 4022676 07/01/10 07/01/11 PREMISES (Eanccurrenee) S SOO,000 <br /> CLAIMS~MADE ~ OCCUR MED EXP {Any ane person) ; 10 , 000 <br /> X PERSONAL 8 ADV INJURY S 1, OOO , OO0 <br /> GENERAL AGGREGATE S 2 , 000, OOO <br /> T <br />IM <br />APPLIES PER: <br />GENL AGGREGATE L <br />I PRODUCTS • COMPlOP AGG S Z , OOO , O 0 O <br /> __ <br />Pp <br />R <br />p <br />POLICY X JECT LOC ; <br /> AUT OMOBILE LJABIUTY Ma IN <br />`O <br />E~; INGIE LIMIT i 1 <br />000 <br />000 <br /> e <br />d , <br />, <br />A X arrvAUTO <br />LL OW <br />D <br />OS 3853974 o~/oi/io <br />j 07/bi/u BODILY INJURY (Per person) ; <br /> A <br />NE <br />AUT 80gILY INJURY (Per eccideM) S <br /> TOS <br /> SCHEDULED AU PROPERTY DAMAGE <br /> <br />HIRED AUTOS <br />(Per aacklent) S <br /> NON-0V~/NED AUTOS b <br /> t <br />B X occuR BE2275709 oT/oi/io oT/oi/11 EACH OCCURRENCE s5, 000, 000 <br /> EXCESbLIAB CLAIMSa.1ADE AGGREGATE ., b5, 000,000 <br /> DEDUCrreLE s <br /> X RETENTION s 10000 5 <br />B <br />AND <br />EMPLOYER!' LIABILITY 07/01/10 07/01/11 TORY LIMITS ER <br /> y ~ N <br />ANV PROPRIETOR/PARTNERIF~CECUTNE ^ <br />F <br />I <br />E <br />C <br />I A <br />I <br />E.L EACH ACCIDENT <br />S 1000000 <br /> O <br />F <br />CERlM <br />MBER EX <br />LUDEDT <br />M <br />d <br />t <br />I <br />NH <br />0 <br />0000 <br /> ( <br />en <br />e <br />ory <br />n <br />) E.L. DISEASE -EA EHPLOYEE S 1 <br />0 <br /> If yes, describe under <br />DESCRIPTION OF OPERATIONS bebw <br />E.L. DISEASE -POLICY LIMIT <br />S 1000000 <br />C Professional I.iab E000001416201 oT/oi/io oT/oi/11 Ea Claim 2,000,000 <br /> re ate 2 000 000 <br />DESCRIPTION OF OPERATION! !LOCATIONS !VEHICLE! (AtMh ACORD 701, Addltlenel Remertu behedWe, If men apes k ngWnd) <br />The City of Santa Ana its officers, employees, agents <br />volunteers and <br />, <br />representatives are additional insureds <br />APPROVED AS TO FOR <br />CERTIFICATE HOLDER r „„ CANCELLATION <br />Laura Stitt Sheedyi°' <br />Assistant City Attorney <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />bHOUIJ) ANY OF THE ABOVE DEbCRIBED POLICIEb BE CANCELLED BEFORE <br />THE E7fPIW-TION DATE THEREOF, NOTICE WILL BE OELAIERED N <br />ACCORDANCE Wrni THE POLICY PROVIbIONb. <br />reserved. <br />ACORD 25 (2009109) The ACORD name and Iogo are registered marks of ACORD <br />