110 PERCENT, INC. - Laserfiche WebLink

Home Browse Search

AC"R ® CERTIFICATE OF LIABILITY INSURANCE °ATE'MMID°"YYY' 04/01/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS}, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Toby Moser StateFarm Toby Moser PHONE 303-4944554 FAX AIC No Ext: AIC No): A4 1295 South Broadway Suite A E-MAI�ss toby.moser.le25@statefarrn.00m INSURER(S)AFFORDING COVERAGE NAIC# Boulder CO 803056769 INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER B: 110%INC INSURER C: PC BOX 538 1 INSURER D: INSURER E SALIDA CO 812010538 1INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR TYPE OF INSURANCE OD UB E P IN ADD WVD POLICY NUMBER MMlDDfYYYY MMIODIYYYY LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 DAMAGE TO RENTED $ 300,000 CLAIMS-MADE �OCCUR PREMISE a ccurrence MED EXP(Any one person) S 5,000 A Y Y 96-ES-P901-7 09/01/2024 09/01/2025 PERSONAL&ADV INJURY s 2,001 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 4,000,000 PRO- ��11 POLJCY JECT /7 LOC PRODUCTS-COMPIOPAGG S 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMTT Ea accident S ANY AUTO BODILY INJURY(Per person s OWNED SCHEDULED AUTOS ONLY AUTOS BODILY tNJURY(Per accident) s HIRED NON-OWNED AUTOS ONLY AUTOS ONLY Per accident S S UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR HCLAIMS-MADE AGGREGATE S DEC) RETENTION $ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE YIN E-L,EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N!A - (Mandatory in NH) E,L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ U raI-I %Tran 1,guyen Ng yen w34so 070o- APPROVED By Tu Tran Nguyen at 2:32 pm,Jun 11,2025 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is regw Description of Services: 110%to provide consulting services to the City of Santa Ana Parks and Recreation Department for the development of a financial sustainability strategy. "The City of Santa Ana, its officers,employees,agents,and representatives are named as additional insured on this policy pursuant to written contract, agreement,or memorandum Of understanding," CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 This form was system-generated on 04101/2025 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1001485 2005 155279 205 01.19-2023