PERFORMANCE EXCELLENCE PARTNERS, INC. 4B - 2011

Home Browse Search

OP ID: BA CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD/YYW) 10113111 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 BY 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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT RODUCER 909-435-0230 NAME: ,awyer Cook Insurance 909-798-7971 PHONE (A/C, No): 200 California St., Ste 260 (Alt, No, Ext); ledlands, CA 92374 E-MAIL ADDRESS: Tic Sammons N-2011-043-002 PRODUCER cusTgM_eH tl? a:PERFO-7 INSURER(S) AFFORDING COVERAGE NAIC # NSURED Performance Excellence Partner INSURER A: Travelers 136161 Tami Berg INSURER B :Travelers 136161 20911 Cabrillo Lane INSURER C : Philadelphia Insurance Huntington Beach, CA 92646 INSURER 0 INSURER E : _ INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S A15DLI$UBR' POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INS' Wvn POLICY NUMBER fMMIDDIYYYYI MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 4 X COMMERCIAL GENERAL LIABILITY X 1680-5A432002 09/27/11 09/27/12 ! PREM SES. Ea occurrence) $ 300+00 CLAIMS-MADE X OCCUR RTj~ MED EXP (Any one person) $ 5+00 ASS` rV0 ~Q PERSONAL & ADV INJURY $ 1,000,00 (GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. s- K PRODUCTS - COMP/OP AGG $ 2,000+00 POLICY PRO- LOC CJ L. QR('i $ AUTOMOBILE LIABILITY 'L 1ty AttO COMBINED SINGLE LIMIT $ 1,000,00 tan/ (Ea accident) ANY AUTO ~$15 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ A X HIRED AUTOS 680-5A432002 09/27/11 09/27/12 (Per accident) X NON-OWNED AUTOS 680-5A432002 $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X ' WC STATU- OTH AND EMPLOYERS' LIABILITY i TORY LIMITS ER B ANY PROPRIETORIPARTNERIEXECUTIVE Y SUB-6A123682 09127/11 09/27/12 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? NIA • 1,000,00( (Mandatory in NH) E_ .L. DISEASE - EA EMPLOYEE, $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 C Professional Liab PHSD662866 09/27/11 09/27/12 (Aggregate 1,000,00 ,Each Clm 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) .Ity of Santa Ana is named as additional insured per attached CG D1 06 04 94 tndd Primary Wording per attached CG DO 37 04 05. CERTIFICATE HOLDER CANCELLATION CITYOFS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD