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PROBOLSKY RESEARCH - 2011
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PROBOLSKY RESEARCH - 2011
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Last modified
10/21/2013 11:29:29 AM
Creation date
10/5/2011 12:06:45 PM
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Contracts
Company Name
PROBOLSKY RESEARCH
Contract #
N-2011-113
Agency
CITY MANAGER'S OFFICE
Expiration Date
12/6/2011
Insurance Exp Date
6/6/2012
Destruction Year
2016
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CERTIFICATE OF LIABILITY INSURANCE OPID MS <br />CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATNELY 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 />REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />e ee ea e o er s an a po cy es mus a en ores , su ec o <br />the terms antl conditlons of the policy, certain po]ICles may require an entlorsen)ent. A statement Dn this certlflcate does not confer rlghts to the <br />cenlflcate holder In Ileu of such endorsement(s). <br />PRODUCER NAME- <br />Fraemaa & Yearce xas. - COCSA <br />Lic. #0559854 c Ne Eat : AIC, No <br />1216 N. Tustin Street ADDRESS: <br />OraaQe CA 92967 CUSTOMER IO *: PROBO-1 _ <br />ahone:714-558-1334 Fax:714-629-1330 WSUAER(S)APFORDINOCOVERAOE NAICs <br />INSURED WSURERA: American casual ey eo orAaaciing 20427 <br />PSObOlakyyH R®aBerCh LLC - WguRER B : ConGinantai casually coogany 20443 <br />1A601 DoveO$treet, $uii:e 195 IN8URER C: <br />NeWNort Heach CA 92660 IN8URER D: <br />INSURER E : <br />COVF12Cr?FR CFQ TIRI["ATC IUIiMOCO• a??ne„?u u„u sees. <br />THIS IS TO CERTIF S O CE STED B O VE BEE ISSUED TO THE 1 URED NAMED <br />INDICATED. NOTWI7HSTANDINO 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 />LTR TYPE OF INSURANCE INSR WV POLICY NUMBER MMIOD MM/DDA'YY17 LIMITS <br />GENERAL LIABILITY EACJ-I000IdtRENCE $ 1 , 000 , 000 <br />A 'X COb?v+ERCIAl GENERAL LLAHIITIY B 1073363845 06/06/11 06/06/12 PREa115ES IEa oecurrenee) s 300,000 <br /> <br />cLwMS?0.IADE ?X occuR >?o EJW (Ant one Personl $ 10 , 000 <br />]? PERSOIJP)_&ADVINJURY S 1,000,000 <br />' GFNERPL AGGREGATE $ 2, 0 0 0? O O Q <br />GF1J'L AGGREGATE LIhtTT APPLIES PER: PRODUCTS-COLSP/OP AGG $2,000,000 <br />POLICY J?ECo-T LOC $ <br /> AUTOMOBILE LIABILIK .COMBINED SINGLE LIMIT <br /> <br />ANY A1ST0 <br />(Ea ecdOent) $ 1 ? 000 , 000 <br /> <br />ALL OWNED AUTOS BODILY INA_RiY (POr per50n) $ <br /> <br />SCt?DULEO AUTOS BODILY INJURY (Per eCCldtnt) $ <br /> PROPERTY OV?MAGE $ <br />8 X MIRED AUTOS 8 1073378815 06/06/11 06/06/12 (Per ecclCerl7 <br /> X Nor?owNEO ADTOS $ <br /> <br /> UMBRELLA LIAB OCCI.Gi ? EACH OCCURRFJ.'CE $ <br /> EXCESS LU1H CWMSMPDE n ? AGGREGATE <br /> <br />DEDUCTIBLE ???0 V ? <br />7jY 5 <br /> RETENTION $ $ <br /> WORKERS COMPENSATION <br />AND EI.IPLOYER8' LIAHILTf \. / N <br />{'* ?? <br />? <br />ttOrney <br />A <br />TORY LII.tITS ER <br /> ANY PROPRIETO1tIPPRTNER/EJrECUTIVE <br />OFFICER/Nlc'?BER EJCCLLIDED't O /A ?` <br />G\t <br />tarp <br />Et_ EAICH/YCCIOENT <br />$ <br /> (Mandatory In NH) Ar35\S 7 <br /> <br />II s <br />tlesviDe <br />n0er / <br />/ E.L. DI6EASE - EA EMPLOYEE $ <br /> , <br />u <br />oE?scRIPnGN cF oPF?anTlolvs eaow \/r! E L DISEASE -POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONB / LOCATONS /VEHICLES (Attsch ACORD tei, Atltlttlonal R?marke Sehadu[a, H meta apata Ia reaulred) <br />CERTISxCATE HOLDER x$ *Ta*•**FD A3 ADD2TSONAL SN$URffiD A3 RSQU'x RED HY WRxTTEN <br />CONTRACT. <br />CERTIFICATE HOLDER CANCELLATION <br />C2TY002 SHOULD ANY OP THE ABOVE DCBCRIBCD POLIGIEB BE CANCELLED BEPORE <br />THE EXPIRATION DATE THEREOP, NOTICE-WILL BE DELNERED IN <br />ACCORDANCE WITH THE POLICY PROVI810N8. <br />AUn1OR1ZED REPREBEMATVE <br />CSTY OF SANTA ANA <br />20 CSV2C CENTER PLACE <br />ANTA ANA CA 92701 <br />®1988-2009 ACORD CORPORATION. All rlghts reserved. <br />A?cvrzu zo (zODa/Da) The ACORD-name antl logo are reglsterod marks of ACORD
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