120 WATER, INC. - Laserfiche WebLink

Home Browse Search

AC RV CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6125I2025 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 INSURER($), 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 NAME: Mane a pint LLC Accretive Global Risk Advisors, LLC PHONE FAx dba Libertate Insurance Services E•MA1L E Alc No): 20 N.Orange Avenue, Suite 500 ADDRESS, qqb.tequesta.certs(cDaIq.com Orlando, FL 32801 INSURERS AFFORDING COVERAGE NAIC# www,libertateins.com INSURER A: Key Risk Insurance CompanyiQ885 INSURED Managepoint, LLC INSURERB: 9119 Otis Avenue INSURERC: Indianapolis IN 46216 INSURERD; INSURER E I INSURER F COVERAGES CERTIFICATE NUMBER: 85922418 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. INBR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MMIDDJYYYY MM1DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCUGE TO RENTED $ bA CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ JECT 0 LOC PRODUCTS-COMPlOPAGO $ OTHER: $ AUTOMOBILE LIABILITY COMBINED&NGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident AUTOS ONLY AUTOS ( ) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accldenl $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB Ed.CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION KEYPE000003501 12/1/2024 12/1/2025 IPER OTH- AND EMPLOYERS'LIABILITY Y 1 N ✓ STATUTE ER ANYPROPRIETORIPARTNEP4EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFJOERIMEMBEREXCLl1DEp7 N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 O00 Ir yes,describe under DESCRIPTION OF OPERATIONS below E.L,DISEASE-POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Addillonal Remarks Schedule,may be attached if more space is required) THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER, Coverage provided in all states(except in monopolistic slates)for all leased employees but not subcontractors of: PEO Client:120Water, Inc. Effective 12/01/2020 Waiver of Subrogation In favor of City of Santa Ana APPROVED By Yu Tran L 7:27 am,Jun 26,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Water Services Quality Coordinator ACCORDANCE WITH THE POLICY PROVISIONS. 215 S Center St Santa Ana CA 92703 AUTHORIZED REPRESENTATIVE Paul R.Hughes ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 059229 t0 I Master WITH $NOS I Pam summers L 6/25/2025 10:52:01 AM (EDT) I page I of 1 rt This ceificate cancels and supersedes ALL previounly issued certificates.