Laserfiche WebLink
ACORD. CERTIFICA OF LIABILITY <br />INSURA 8 01 E DATE IMM'D0YYI <br />U3 <br />PRODUCER 626- 275 -3000 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Golden Pacific Insurance <br />Services, Inc. <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. Box 7045 <br />COMPANIES AFFORDING COVERAGE <br />COMPANY <br />A Atlantic Mutual Insurance Co. <br />Pasadena, CA 91109 -7045 <br />INSURED <br />�-L <br />COMPANY <br />�fl3 -ON// <br />Amrel Systems, LLC <br />B <br />American Reliance, Inc. <br />COMPANY <br />11801 Goldring Road <br />C <br />COMPANY <br />Arcadia CA 91006 <br />D <br />,,Qa�R�ic <br />... .... :n: o .., ..c. ....:.:......,.... ..,.. 'T: >o:, ,>.,:.. R o:..:,_:.< o o f :.:.>.k.... C:::. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW <br />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 <br />HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR <br />TYPE OF INSURANCE <br />POUCY NUMBER <br />POLICY EFFECTIVE <br />DATE IMWDD/YY) <br />POLICY EXPIRATION <br />DATE IMM /DD/YYI <br />LIMITS <br />A <br />GENERAL <br />UAMUTY <br />7610068210001 <br />8/03/03 <br />8/03/04 <br />GENERAL AGGREGATE <br />0 2000000 <br />X <br />PRODUCTS- COMP /OP AGG <br />F 2000000 <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE FX-1 OCCUR <br />PERSONAL a ADV INJURY <br />8 1000000 <br />EACH OCCURRENCE <br />1 1000000 <br />OWNER'S & CONTRACTOR'S PROT <br />FIRE DAMAGE (Any one fire) <br />$ 1000000 <br />MED EXP (My one person) <br />$ 10000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />$ <br />BODILY INJURY <br />(Per Person) <br />0 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per eccitlentl <br />0 <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />D <br />OTHER THAN AUTO ONLY: <br />ANY AUTO <br />EACH ACCIDENT <br />0 <br />AGGREGATE <br />F <br />A <br />EXCESS LIABILITY <br />7610068210001 <br />8/03/03 <br />8/03/04 <br />EACH OCCURRENCE <br />0 2000000 <br />X UMBRELLA FORM <br />AGGREGATE <br />$ 2000000 <br />0 <br />OTHER THAN UMBRELLA FORM <br />WOKKERS COMPENSATION AND <br />WC STATU- 7 TH- <br />ER <br />EMPLOYERS' LIABILITY <br />EL EACH ACCIDENT <br />0 <br />THE PROPflIEr0R/ INCL <br />PARTNERS/EXECUTIVE <br />EL DISEASE - POLICY LIMIT <br />0 <br />EL DISEASE - EA EMPLOYEE <br />0 <br />OFFICERS ARE, EXCL <br />OTHER <br />APP <br />1. <br />AS <br />ro FORD <br />DESCRIPTION OF OPERATIONSR.00ATIONSIVENICLES /SPECIAL ITEMS <br />Evidence of Insurance. ..� <br />See attached endorsement. <br />LEE SHAW <br />RAttorney <br />10 Da s NOC of non - a mem of remium. <br />yy��ii IILLA� ,. °i <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />Attn: Clerk of City Council <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />P.O. Box 1988 <br />BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY <br />Santa Ana, CA 92702 -1988 <br />OF ANY KIND UPON THE COMPANY. RB AGENTS OR REPRESENTATIVES. <br />AUTHOR¢ ENTA E <br />tu`!6...... ,..:: >:.; :.;:�...,,: :...... ;::ate W0000aw 61 <br />