Laserfiche WebLink
/4t,,VrVq' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDWYYY) <br />05/25/2011 <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 ACONT.RACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certtficate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. if SUBROGATION IS WANED, subject to <br />the terms and conditions of the poHM certain polldes may require an endorsement. A statement on this certificate does not confer rights to the <br />certNlcate holder In lieu of such endorsement(s). <br />PRODUCER CONTACT <br />NAME: <br />Insurance Office of America, Inc. PHONE No E : 619.574:6220 Ne):619.574.628,8 <br />DBA IOA Insurance Services E <br />ADDRESS: <br />1775 Hancock Street, Ste. 180 CUSIMKID S. <br />San Diego, CA 92110 MISURER(S) AFFORDING COVERAGE NAIL It <br />INSURED INSURER A: United Specialty Ins Co 12537 <br />ANR Industries, Inc INSURI:R.B <br />10702 Hathaway Drive #1 INSURER C.: <br />Santa Fe Springs, CA 90670 INSUItMD: <br /> INSURER E : I <br /> INSURER F <br />COVERAGES CERTIFICATE NUMBER- 11/12 GL Cert REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF. INSURANCE LISTED BELOW HAVE-BEEN ISSUED. TO THE INSURED NAM ED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY RE.OUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH R€$PECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 8.YTHE 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 />Lam . TYPE OFINSt)RANCE *M `yyp POLICYNUMBER LWrS <br /> GENERAL LIABILITY TWCG410013 9 0511.9!2011 0511 WO1.2 EACH. bcb_FwNcE s 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea bcanrence = 50 , <br /> CLAM/SMADE L" I OCCUR M:.D EXP (Any one person). <br />A .PER'SONAL& ADV.INJURY t 1 000 ... <br /> GENERAL AGGREGATE $ 2,000-,00( <br /> GENL AGGREGATE LIMY APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,, 000, <br /> P%ICV 2&LOC _ <br /> AM TOMOBLE LIABILITY C(*OINED SINGLE LIMIT <br />ert) <br />'( <br />a eca = <br /> E <br />d <br /> ANY AUTO <br />t BODILY INJURY (Per person) $ <br /> ALL ovo <br />o AUTOS BODILY INJURY (Per. accident) $ <br /> SCHEDULED AUTOS <br /> <br />HIRED AUTOS <br /> <br />Q <br /> <br />?O <br />PROPERTY DAMAGE <br />(Per accident) <br />_ <br /> NON-OYVNED AUTOS t <br />+ $ <br /> Q? <br />Y $ <br /> UMBRELLA U18 . bccm <br />H EACH OCCURRENCE t <br /> EXCESS LIAR CLAINIS-WDE t RG <br />6y AGGREGATE $ <br /> I?oucTlaLE Crry? a ?.?H <br />`a^ V% <br />t? OC <br />r <br /> RETENTION t ? <br />t ?`" $ <br /> %VR <br />AND ICIMSCOMP6NSAT10N <br />EMPLOYEWL1 S&M YIN wcS S 71 lU <br />T ?R IMIT R <br /> ANY PROPRIETOR/PARTNER/EXECLMVE: D <br />OFFPQB'WhEM <br />EREX <br />L <br />9 NIA I E L. EACH ACCIDENT $ <br /> .C <br />UDE0 <br />B <br />(M&W wV in NHI E.L DISEASE - EA EM'LOY I; <br /> It.Yes describe under. <br />DESCRIPTION OF OPERATIONS belpw <br />.El. DISEASE -POLICY LIMIT <br />11 <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES pwith ACORD 101, Addi6oMlal Remarks ScMdulo, W rr re spade Is regWred) <br />he City of Santa, it officers, employees, agents and volunteers are named as.addi.tion <br />insured. Primary and non-contributory wording applies. s30 Days notice for -nonpayment <br />f premium <br />CERTIFICATE HOLDER 'GANCFI'l OTIAN <br /> SHOULD 'ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br />The City of Santa Ana AUTHORED REPRESENTATIVE <br />20 Civic Center Plaza <br />Sa to Ana, CA 92702 Barr Nordstrom ENDEP <br />O 1988-2009 ACORD. CORPORATION. Ali rights reserved. <br />ACORO 25(2008/09) The ACORD hame and logo are registered marks of ACORD