|
,�cC RbP CERTIFICATE OF LIABILITY INSURANCE
<br />4,�,,,,/
<br />DATEIMA3/5/2611A4 i
<br />THIS CERTIFICATE IS [$SUED A$ 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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT:. If the certificate holder Is on ADDITIONAL INSURED, the policy(los) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does net carrier rights to the
<br />certificate holder In lieu of such endorsoment(s),
<br />PRODUCER
<br />Commercial Management Insurance Services Inc.
<br />CA License 0085855`
<br />22875 Savi Ranch Pkwy, Suite X
<br />Ycrba Linda CA 92887
<br />LIAME' Phyl].Sa Wilcox
<br />...................a..a.,.,»,w...,..............�..__._......�.
<br />PHONE (714)414-1167 NOt: (714) I14-1495..
<br />.7,....�.
<br />u4
<br />AlIggg. pwxlcoxQemia -ins . com
<br />AFFORDING COVERAGE 77
<br />HMIs
<br />�INSURERISI
<br />INSURERA.National Fire Ins.Co of
<br />0475
<br />INSURED
<br />;Lidgard & Associates Inc.
<br />2592 N Santiago Blvd
<br />IOrange__ CA. 92867
<br />INSURERatContinental Insurance Com art
<br />5289
<br />INsueRa:Continental Casualt Com an
<br />20443
<br />wsuRvRo.qallay Fore Ins CoM2any
<br />20508
<br />INsuREa e;
<br />P MI MIt $ 300,000
<br />NSURERF:
<br />X COMMERCIAL GENERAL LIABILITY
<br />�i3iirn"NrJ.ii�FilI�II_iy�nb®if.'f3h1<:Y4�t: -'.d9�11YIiAi2liiJRLta:i-
<br />THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE. SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTVATHSTANDING 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 COND17IONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIL} CLAIMS.
<br />MSRPOLICY
<br />LTR
<br />TYPEOFiNSURANCE
<br />POLICY NUMBER
<br />FF
<br />MM@
<br />ICY EXP
<br />D
<br />LIMITS
<br />GENERALLIAMUTr
<br />EACH OCCURRENCES 2,000,000
<br />P MI MIt $ 300,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />MEO EXP (AV we nelsa, S 10,000
<br />A
<br />7 WNSWADE XMOCCUR
<br />X
<br />B4022998395
<br />/4/2D14
<br />/4/2019
<br />PERSONAL a ADV INJURY 3 2,000,000
<br />GENERAL AGGREGATE $ 4,000,000
<br />GEN'LAGGREGATE DMTCAPPLIE$ PER:
<br />PRODUCTS-COMP.'OP AGO S 4,000,000
<br />S
<br />X POLICY PRO -LOC
<br />jFcT F7
<br />.t 1 DO DooANY
<br />BODILY INJURYiPer P=onf S
<br />AUTO
<br />NOMOMILEUMMUTY
<br />ALL 045MED SCHEnULED
<br />4022995431
<br />/4/2014
<br />l4f201S
<br />UODILY INJURY PRO -wd-4 5
<br />pa E DAMAGE. S
<br />P .t1eN
<br />HIREDAUTOSAUT $,
<br />nnftlat=icrlsl Bl bM2lknfi $
<br />X
<br />UMBRELLALIAS X tSCCUR
<br />EACH OCCURRENCE, $ 3,000,000
<br />AGGREGATE Is 3,000,000
<br />C
<br />EXCESS LM,e CLAIMU=TRADE
<br />Is
<br />DEO X RETENTION$ 10100.
<br />4022995526
<br />/4/2014
<br />/4,12018
<br />1D
<br />WORKERS COMPENSATION
<br />Y
<br />X 11MSTATU- I OTH+
<br />AND EMPLOYERS LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE T
<br />EL EACH ACCIDENT S 1 000 000
<br />EL DISEASE, EA EMPLOYE $ 1 000 Oo0
<br />OFPICEArY1n NIu EXCLUDED? L,v)
<br />OFFICEHA.fldAMM MNHk
<br />MIA
<br />C422995476
<br />%4/2014
<br />./4/2015
<br />E,L DISEASE - POLICY LIMIT $ 1,000,00
<br />If yyggsdasa>roa laldar
<br />DAVIT T[ON OF OP RATIONS #alwr
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AttWh ACORU iDt, AddIITonal Rrmarks SaiteduW, if nlom $PnR is roquindl
<br />THE CITY OF SANTA ANA, ITS OPFICERS, EMPLOYEES, AGEN'T'S, VOLUNTEERS AND REPRESENTATIVES ARE 14AWD AS
<br />ADDITIONAL INSUREDS WITH .RESPECTS TO GENERAL LIASLITY AS PER THE ATTACHED SB -146935-C (Ed.. 011/06) WHICH
<br />ALSO INCLUDES PRIMARY AND NON-CONTRIBUTORY WORDING.
<br />WAIVER OF SUBROGATION ONLY IF REQUIRED BY WRITTEN CONTRACT WITH RESPECT TO WORRLRS' COMPENSATION APPLIES
<br />IN FAVOR OF PER FORM G-19160-5 (Ed. 11/97) ATTACHED, 30 DAY NOTICE OF CANCELLATION EXCEPT 10 DAYS FOR NON
<br />PAYMENT OF PREMIUM.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOP, NOTICE WILL BE DELIVERED IN
<br />�$
<br />OLTX OF BANTA AMA CORDANOE WITH THE POLICY PROVISIONS-.
<br />20 CIVIC CENTER PLAZA, M-36 r(
<br />SANTA ANA, CA 92701 .� a`' -DENoaITEDREPRESENTATIVs
<br />.nMichael Wakoly/PHYLL .d i^'f"a�,-w-.c''".it°" "-•''r,.r/ �.,.-
<br />ACORD 25 (2010/08) 0'1958»2010 ACORD CORPORATION, All rights reserved.
<br />INS025 patcm)m The AOMDnorno and logo are registered marks of ACORD
<br />
|