ECHAN, BARBARA A. 2A - 2009 - Laserfiche WebLink

Home Browse Search

AQED TM CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDM) j SEP 1 09 ER E..L.M.L.M. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE BROKERS, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. BOX 2668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR EL S EGUNDO CA 902445-5- 1768 E. GRAND AVE 210 CA LIC OD28706 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EL PHONE: 310-322-1301 INSURERS AFFORDING COVERAGE Agency Lic#: OD28706 — NAIC # INSURED INSURER A: Lloyds of London BARBARA ECHAN INSURER B 3056 MADERIA AVE - COSTA MESA CA 92626 INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH INS LT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YV POLICY EXPIRATION LIMBS GATE MM/DDIY GENERAL LIABILITY NOT INCL COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE DAMAGE 70 RENTED - $ $ CLAIMS MADE '.� PR MI •�rce1 __- MED. EXP (Any One Person) g - OCCUR PERSONAL 8 ADV INJURY $ -- GENERALAGGREGATE$ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. �$ POLICY �— AUTOMOBILE LIABILITY NOT INCL ANY AUTO COMBINED SINGLE LIMIT (Ea accident; $ ALL OWNED AUTOS -------- INJURY ---1 SCHEDULEDAUTOSson) re, g HIRED AUTOS — BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE $ "3 --- GARAGE LIABILITY NOT INCL AUTO ONLY - EA ACQ.917ENT, $ ANY AUTO OTHER THAN EA ACC . _ $ AUTO ONLY: AGG $ , EXCESS / UMBERELLA LIABILITY j NOT INCL OCCUR L I CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ ----.— --__--...--_------ $ ey DEDUCTIBLE RETENTION $ ' $ V �r $ WORKERS COMPENSATION AND NOT INCL EMPLOYERS' LIABILITY I WC STATU-0�7, R M 7 ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/M.MBER EXCLUDED? - E.L. EACH ACCIDENT �$ It yea, describe under E.L. DISEASE -EA EMPLOYEE$ SPECIAL PROVISIONS below OTHER: PROFESSIONAL LIABILITY E.L. DISEASE -POLICY LIMIT $ 0510-001224038 MAY 1 09 A (CLAIMS MADE FORM) MAY 1 10 i$1,000,000 / $1,000,000 LIMITS/// DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE IS FOR PROOF OF PROFESSIONAL LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND EXTEND COVERAGE PROVIDED BY THE ABOVE MENTIONED POLICY. CERTIFICATE TO THE REFERENCED OR HOLDER IS NOT ADDED AS AN ADDITIONAL INSURED POLICY. ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED POLICY REMAIN IN FULL EFFECT. 05/01/2007 RETROACTIVE DATE.*10 DAYS NOTICE OF CANCELLATION IN FORCE AND THE EVENT OF CANCELLATION FOR NON-PAYMENT./// Gtti I IFICATE HOLDER j ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 20 CIVIC CENTER PLAZA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 - SANTA ANA, CA 92702-1988 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention: APPROVED AS TO F RM - _-_------ ACORD 25 (2001/08) Certificat # 4126 Frederick J. Fisher 0607799 B 'N MIN I FfvI N Chief A IlttAftf City Attorney