R.B. WELDING INC. 1 - 2011 - Laserfiche WebLink

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N -20'1 1 -058 i�C' R °® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYY`() L nnrl,�r�r... 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 SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the eertH)cate Holder Is an ADDITIONAL INSURED, the pollcy(laa) must be endorsed. If SUBROGATION IS WAIVED, sub)eet to the farms and conditions of the policy, certain policies may require an endorsement_ A statement on thle certlFlcete does not confer rlghta to the certiflcete holder in Ileu of such endoraement(B). PRODUCER 2'13 - 380040 2'13 - 380020 Theo Insurance Services, Inc. 3600 Wilshire BIVd. Ste. 974 Los Angeles, CA 900'1 O __ N n K on Park PRDNE -2�3- 380 -4040 aA,�`q):2'13- 380 -4020 woo'ess: INSURE s AFFOnomG covERwoE NAIL s wsuRERA: James Riv u a e n 'NSDRE° RB Welding, Inc. '155 E. Redondo Beach Blyd. Gardena, CA 90246 INSURER B: Pr eto 'a Insurance Com an INSURER C: INSURER D: EACH OCCURRENCE INSURER E: A INSURER F - 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 AFFO ROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. INSR TYPE OF INSURANCE ADD B BR POLICY NUMBER MWOD/YWY NMI E1CP LIMITS GENERAL I rABILITY ✓ EACH OCCURRENCE E � QQQ,QQQ A � COMMERCU\LGENERALLIABILITY PREMIBETO coca ante s 5Q 0 MED EXP IAny ono peraonl s Excluded CLIUMS -MADE O OCCUR pERSONALd ADV INJURY E � QQQ QQQ QQQ44992Q D9/20/2U70 U9/2D/2077 Z,SOO DedUCtiL)Ie __ GENERALAGOREGATE E2 O OO GEN'L AGGREGATE IJMIT APPLIES PER: PROpUCTS- COMP/OP AGG 5 2 QQQ QQQ POLICY PRO- LOC E B AUTOMOBILE LIABILITY COMBINEDI INGLE LI MIT 0 BODILY INJURY (Per person) 5 ANY AUTO AUTOS ED AVTOS VLED PICCA0002622 03/27/2077 03/27/2072 BODILY INJURY (Par ocaaen,) 5 ✓ NON -0WNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per ercldenl E E UNBRFlrs LIAB OCCUR EACH OCCURRENCE E AGGREGATE E E%CESB LIAB CLAIMS -MADE V APR! y t� f -,- �J i _ � � (. �A - �. � r� �' DED RETENTIONS E WORKERB CONPENBATION WC BTATU- 1 IOTH- AND EMPLOYERS• LIABILITY y f N 0.NY PROPRIETOR /PARTNER/E%ECIJTIVE OFFICERIMEMBER E%CLUDED9 � N / A _ � - . -. / QS.�LE$_ E.L. EACH ACCI°ENT 5 E.L DISEASE- EA EMPLOYE 5 (Mentlebryln NH) rf yea, tle3cnbo untler L$UT3 � ±, f// _._� ,_ ^. � _ � - _ E.L DISEASE - POLICY LIMIT - E OESCRIPTION OF OPERATIONS below _ DEBCRIPTON OF OPERATIONS / LOGTONB f VEHICLES (Attach ACORO 1p1, AtldlDonal Remerlaa Schetlula, Ir more apem V rnqul,etl) The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Additional Insureds. Waiver of subrogation applies. - Cancellation clause reverts to 10 days for non - payment of premium. L.AN�:CLLA I ILJN City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLCIES BE CANCELLED BEFORE Attn: Purchasin De artment THE EXPIRATION GATE THEREOF, NOTICE WILL BE DELNERED IN g P ACCORDANCE WITH THE POLICY PROVISIONS_ 20 Civic Center Plaze - Santa Ana, CA 9270'1 AUTHOR2ED REPREBENTATNE � © 7966 -2070 ACORD CORPORATION_ All rights reserved_ ACORD 25 (2010/05) Tha ACORD name and logo are rag[stared marks oT ACORD