Laserfiche WebLink
mw <br />7 48 <br />A? R° CERTIFICATE OF LIABILITY INSURANCE R154 DATE (MMIDDNYYY) <br />D09 ATE 2010 <br />THIS CERTIFICATEIS 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 D i C9f55T1kNTEEC "TRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDE . <br />IMPORTANT: if the certificate holder is an ADDLTIQNALINSURED, the_policy i s must be endorsed. If SUBROGATIONIS WAIVED, subject to <br />the terms and conditions of the policy, certain p " inay require an! error $ A Statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). ..: = I'-= <br />PRODUCER <br />USAA INSURANCE AGENCY INC/PHS of FAX <br />`°' 888 242-1430 (A>c.Ne): 1877) 905-045 <br />812846 P:(888)242-1430 F:(877)905-0457 <br />PO BOX 33015 A' f <br />ADDRESS: <br /> <br />SAN ANTONIO TX 78265 PRODUCER <br />C_UT -RID x: <br /> INSURER(S) AFFORDING COVERAGE NAIC a <br />INSURED INSURER A: Hartford Casualty Ins CO <br />KNOWLEDGE & INTELLIGENCE PROGRAM INSURER B: Hartford Accident & Indemnity C <br />PROFESSIONALS, INC <br />4401 ATLANTIC AVE STE 200 <br /> <br />INSURER C <br />LONG BEACH CA 9 0 8 0 7 INSURER D <br /> INSURER E : <br /> INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 TO 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 />L R TYPE OF INSURANCE INSR WV POLICY NUMBER 1MM/DD/YYYYI 1MM1DD1YYYYI UMITS <br /> GENERAL UAO&FrY EACH OCCURRENCE S 1 00c) O C O, <br /> COMMERCIAL GENERAL LIABILITY PREMISES ( occurrro?nee) . 5 300, 000 <br /> CLAIMS-MADE 7 OCCUR MED EXP (Any one porsonl 1 I S 10, 000 <br />A X General Liab X 65 SBM PWIS30 10/22/2010 10/22/2011 PERSONAL & ADV INJURY 1$ 1, 000,000 <br /> GENERAL AGGREGATE S 2, 0 0 0, 0 0 0 <br /> GEN'L AGGRF .?E LIMIT A P S PER: PRODUCTS - COMPIOP AGG 1 5 2 000,000 <br /> I <br />POLICY ?J PJEcT RO- X LOC i 5 <br /> AVT OMOBRE UABIUTY COMBINED SINGLE LIMIT I n <br />$ <br /> (£a accident) <br />11 000, 0 0 0 <br /> ANYAUTO BODILY INJURY (Per person) j S <br /> ALL OWNED AUTOS <br />BODILY INJURY (Por aeeitlent) <br />S <br />A SCHEDULED AUTOS <br />65 SBM PWZ 830 <br />10/22/2010 <br />10/22/20I1 <br />PROPERTY DAMAGE <br /> X HIRED AUTOS (Par accident) <br /> X NON-OWNED AUTOS <br /> <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE <br /> EXCESS LIAB H CLAIMS-MADE AGGREGATE <br /> DEDUCTIBLE j S <br /> RETENTION i $ <br /> WORKERS COMPENSATION <br />' WC STATU- OTH-' <br />X <br /> AND EMPLOYERS' UABIUTY TQRY IL MIT$ <br /> Y / N <br />ANY PROPRIETOR/PARTNERIEXECUTIVE[^] <br />N/A E.L. EACH ACCIDENT S 1, 0 0 0, 0 0 0 <br />B <br />OFFICERNEM anda oq In NHJ EXCLUDED ? <br />W <br />65 WEC J02464 <br />04/22/203.C <br />04/22/2011 <br />E.L. DISEASE - EA EMPLOYE S 1 , 0 0 0 , 0 0 0 <br /> If yes, describe undo <br />DESCRIPTION OF OPERATIONS below <br />I <br />I <br />E.L. DISEAS 1 0 0 0 0 0 0 <br /> <br /> <br />i A <br />prl? j%D <br />7/ <br />DESCRIPTION OF OPER477ONS / LOCATIONS / VEHICLES IAnach ACORD 101, AddVanal Ramarks Schodu b, II mac space k reOarredl <br />Those usual Lo the Insured's Operations. <br />A TwK CRp??tWAiTE <br />? <br />L.trS I II" lt-R I C ri LJLUtM t-ANC.ti-LA I IvIV - -• - <br />City of Santa Ana <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AU7HORZED REPRESENTATIVE <br /> <br />0 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD