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­"1 OP ID: HF <br />'`'�._°.. RO CERTIFI�ITE OF LIABILITY INSUkANCE DATE 01109D/YYYY) <br />01109!12 <br />THIS CERTIFICATE IS ISSUED AS 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(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 not confer rights to the <br />certificate holder in lieu of such endorsement(s), <br />CONTACT <br />PRODUCER <br />951- 676 -3365 NAME: Heidi Farmani <br />United Agencies, Inc. (M) PHONE Fax <br />CA License #0252636 951- 676 -3020 t�,.N9 xc :951- 676 -3365 lwc Nol: -951- 676 -3020 <br />27403 Ynez Rd., Ste. 110 E-MAIL - -- <br />Temecula, CA 92591 ADDRESS: hfarmani@ugiltedagencies.com <br />PRODUCER <br />Ryan E. Hollander 9USTOMER-IDCL60ELLB -1 <br />INSURI AFFORDING COVERAGE NAIC # <br />INSURED Bell Building Maintenance Co. INSURER A: Preserver Insurance Company 15586 <br />Mrs. Yang Chanhee INSURER B:Century Sure an Y Com F _ X36951 <br />5170 Sepulveda Blvd., #180 <br />- INSURER C : ' <br />Sherman Oaks, CA 91403 - - - - -- - -..__. INSURER D: <br />D : <br />- - - - -- — - -- -- <br />^ INSURER E : _ <br />INSURER F: <br />COVERAGES CERTIFICATE NUMRER- RFVISIr NI NIIMRFR- <br />[HIS IS TIC 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, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR TYPE OF INSURANCE .ADDL SU POLICY NUMBER <br />_ __— <br />MMID YD/YYYY MM DDlYYYY LIMITS <br />_ <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />; $ 1,000,00 <br />B X COI:7MERCIAL GENERAL LIABILITY X X CCP742906 <br />01110!12 <br />AMA GE TO RENTED <br />01/10/13 pREMISESL z Q_crurrence <br />$ 100,00 <br />- AIMSAIADE X OCCUR <br />! MED EXP (Any one person) <br />$ _ 5,00 <br />PERSONAL _& ADV INJURY <br />$ 1,000,00 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEN1 AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMPIOP AGG <br />$ 1,000,00 <br />X POLICY PRO- . LpC I <br />- <br />$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />$ <br />,`.. . <br />(Ea accident) <br />ANY AUTO - <br />BODILY INJURY (Per Person) <br />$ <br />ALL OWNED AUTOS ' <br />SCHEDULED AUTOS �' > <br />BODILY INJURY (Per accidern) <br />—. <br />I $ <br />_..._._ <br />H;REO AUTOS - <br />j <br />PROPERTY DAMAGE <br />(Per accident) <br />j $ <br />NGN- OV,'NEC AUTOS <br />$ <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE <br />$ <br />I EXCESS LIAB CLAIMS -MADE <br />AGGREGATE <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />g <br />WORKERS COMPENSATION <br />NIC STATU- OTH- <br />X <br />AND EMPLOYERS' LIABILITY YIN <br />T ER. -' <br />- <br />$ — 1,000,00 <br />-. <br />A ANY PRC7RiE- 'CR;PAR- NER!EXECU -IVE WCC 0004991 05102111 06/02/12 E.L. EACH ACCIDENT <br />�, �FFICERWE MEER EXCLJDEC'� I NIA <br />i !Mandatory in NH) <br />! E (DISEASE- EA EMPLOYEE <br />$ 1,000,00 <br />yes Jescnbe unde, <br />)ESCRIPTION OF OPERATIONS below <br />I EL DISEASE - POLICY LIMIT <br />- <br />$ 1,000,00 <br />i <br />DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (Altach ACORD 101, Additional Remarks Schedule, if more apace is required) <br />Certificate holder, its oficers, agents, and employees are named as <br />additional insured in regards to General Liability where required by <br />contract, subject to actual policy terms and conditions. <br />V CR 1 117 11 Ak I C 11ULUCK UANGELLATIQN <br />CITYOFS <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATNE <br />©1988.2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />I .' <br />