Laserfiche WebLink
! 'XI I <br />A -z61() -k3 -2 - <br />.:. _:1� Fii rn':I?: :. sl `�[.. .,_.Ira' .T -a..rh E. ','a'rY_= :.G�n-r „•4 ., <br />. R a CERTIFICATE OF LIABILITY INSURANCE GATE )iIMHID YYYY) <br />L � <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 polley(les) must be endorsed. It 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 Hsu of such endorsements . <br />PRODUCER <br />Joseph D Walters <br />2706 South Park Road <br />Bethel Park, PA 15102 <br />CONTACT -I <br />NAME: _,__ ____ <br />PHONE FAX <br />412�831-8222 - _ A No: __ __ <br />EMAIL <br />ADDRESS'— <br />— __- <br />lNSURER S AFFORDING COVERAGE NA.IC R <br />INSURER A: PEERLESS_ INSURANCE COMPANY 24198 <br />INSURED HYDROBLAST & ICP & COMMERCIAL STEAM <br />INSURER S <br />CLEANING <br />Steve Amman & Rodney Ward <br />INSURER C ; Qei <br />INSURER D : . { - <br />--- — -- <br />726 W. Angus Ave. Suite G <br />Orange, CA 92868-1300 <br />— — - -- - - f Ft <br />INSURER E : <br />INSURERF: ` <br />THIS IS TO 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 TC 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Z <br />INSR , ----!A�6L <br />LTR TYPE OF INSURANCE I R <br />SUBR, POLICY EFF <br />! POLICY NUMBER M!G YY <br />POLICY ERP : ; <br />MMIDDIY YY LIMITS '"'" •""" <br />A _ GENERAL LIABILITY X CBP9708503 04/07r10 <br />04107l11 EACH OCCURRENCE_ s ':'•= ,.J 000 <br />_ COMMERCIA_ GENERAL UABIGTY <br />1000 <br />PREMISE' �F —5 100 <br />. CLAIMS-MAOE [� OCCUR j <br />,„.... <br />MCD EXP (AA ORe p5i5wi) _ $ 'O__.. <br />PERSONA' d ADV JURY S 'I �Q0 QOQ <br />.._ ._..-. _---- ___ ----- —— ...._.- <br />GENERAL AGGREGATE S 2, DOD ODD_ <br />GENL AGGREGATE LMIT APPLIES_ PER <br />PRODUCTS - COMP/OP AGG S 2,000,000 <br />POLICY �O. ! LOC I <br />is <br />AUTOMOBILE <br />LIABILITY COMBINED SINGLE LE L <br />Ea a ) S -- <br />ANY ACTC 6001LY INJURYIPer pesnr)n <br />Jj _ <br />Amos NEU ^ SCHEDULED APPROVED S TO "ORM j RODILYAJURY(Per accident $ <br />NON -OWNED"• - "' " <br />-•`�- <br />' <br />HIREG.A'Ln0g PROPERTY DAMAGE. <br />_- AUTOS 1Per eccldenl)_ 9 .,- •, ____._�_ <br />UMBRELLA LIA6 ; <br />._.._- <br />OCCUR <br />' <br />I <br />JOSEPH W. FLET <br />HER <br />.ACH OL CURRE\CF S <br />�- S <br />EXCESS uaB <br />[ I AIMS.MADE l'. <br />CITY ATTOR <br />Y <br />AGGREGATE- <br />--��-.�'. <br />V _. <br />DED <br />$ <br />WORKERS GOMPENSATION <br />WC STATU- OTH. <br />AND EMPLOYERS'11ASILITY YIN <br />APIY PROPRIET02;ARTNER/EXECUTIVE �— <br />I <br />m�r " <br />,OFFICERIVEMSEREXCLUDED' <br />-. L'..TORYLIMrra] -ER_. <br />EACH ACCIDENT <br />f <br />j <br />E.L. DISEASE - EA EMPLOYEE <br />....-.A. E:.-__..'---- .._. <br />_.. _. <br />_ <br />�NfAj <br />i {Mandatory In NH) <br />If yyes, describe umi�r <br />I j <br />I <br />DF.SCPoPTiC'J OF OPERATIONS hebvr <br />E.L. DISEASE -POLICY LIMIT <br />Y <br />I <br />DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace 1s raquiradt <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED <br />ON GENERAL LIABILITY (SEE ATTACHED CG2010). INSURANCE IS PRIMARY AND NON-CONTRIBUTORY ON GENERAL LIABILITY <br />(SEE ATTACHED CG0704). A 30 DAY NOTICE OF CANCELLATION WILL APPLY EXCEPT FOR NON-PAYMENT WHICH IS 10 DAYS. <br />CITY OF SANTA ANA, ITS OFFICERS <br />EMPLOYEES, <br />AGENTS AND REPRESENTATIVES <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRAMON DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />c) . —0 - t'ji k <br />1w tyoe-LUIlu fkt,VKIJ UUKI'VKAIILlN. All lights reserved. <br />ACORD 25 (201W05) The ACORD name and logo are registered marks of ACORD <br />