|
??1 JOSIT?U-1 OP ID: SW
<br />'`'?,°? °? CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br />05/30/'12
<br />THIS CERTi FICATE 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 A CONTRACT BETWEEN THE FSSUIN6 INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(/es) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and eonditlone of the policy, certain pollctes mey require an endorsement. A statement on this certificate does not con/er rights to the
<br />PRODUCER 925-868-7050 TA T
<br />CCI Flnanciel S Ins. Solutions NAME:
<br />License #0381824 925-688-8275 P NE
<br />o-
<br />P. O. BOX 5078 A /' ? (?I 2 -tAAtL
<br />San Ramon, CA 94563-7328 ' ?/ V - ADDRESS:
<br />David M. Diamond © ? INSURER 6 AFFORDING COYERAOE NAIC N
<br />INSURER A :Peerless Insurance Company
<br />INSURED EHS International, InD. INSURER B :Golden Eaele Insurance Corp. 90$36
<br />26741 Portola Parkway Preferred Employers Ins. Co.
<br />Suite 9E#823 IN6VRERC: 90900
<br />Foothill Ranch, CA 928'10-'1783 INauRER D , Atlmlral Insurancs Company
<br />COVERAGES CERTIFICATE NUMBER: REVISION NuMwFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISS UEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
<br />,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR TYPE OF INSURANCE POLICY NUMBER M D MM/DD LIMITS
<br /> GENERAL LIABILITY
<br />EACH OCCV RRENCE
<br />$ 9,000,00
<br />A J( COR/MERCWL GENERAL LIABILITY X (iBP9599O92 00/O t/12 0B/O'I /'I3 PREMISES Ee oaa,rrancc $ 900,000
<br /> CLAIMS-1.1ADE ? OCCUR LIED EXP (My one parson) $ 5,000
<br /> PERSONAL SAOV INJURY $ 9,OOD,000
<br />
<br /> GENERAL AGGREGATE $ 2
<br />OOD
<br />000
<br /> ,
<br />,
<br /> GENLAGGREGATE LIMB APPLIES PER: PRODUCTS-COl.1 PAJP AGG S 9,000,000
<br /> X POLICY PRO- LOC S
<br /> AUT OMOBILE LIABILITY B T
<br />Fe aWOent
<br />f ,000,000
<br />A _ ANY AUTO
<br />L CBP8598092 OB/O'I/?2 05/0'1/13 BODILY INJURY (Per person) $
<br /> A
<br />L OWNED
<br />AUTOS SCHEDVLED
<br />AUTOS
<br />BODILY INJVRY (Per acGtlenl) ----'
<br />$
<br /> )t HIRED AUTOS X NON?OWNED
<br />AUTOS
<br />-
<br />Par accW enl $
<br /> $
<br /> J( UTAaRELLA UAB OCCVR EACH OCCURRENCE $ 2,000,00
<br />B E%CESS LIAB CLAIRIS-RV?DE CVB7389'18 OB/0 "I/?2 06/01/13 AGGREGATE $ 2,000,ODO
<br /> OED X RETEMION $
<br /> WORKERS COMPENSATION
<br />ANO EMPLOYERS' LIABILITY Y / N
<br />_ w'c" X WC ST TU- 0TH-
<br />C OFFICEWRIREA1aERFJ(?CIUDE?p?ECVTIVEr? N)A KN918028-10 08/01/'I2 05/Ot/'I3 E.L FACHACCIDENT $ x,000,000
<br /> (Man Wtory In NH) I-I
<br />H es tlesrn'be und E.L DISEASE-EA EMPLOYE $ ?,000,DOO
<br /> er
<br />DESCRIPTION OF OPE
<br />T
<br />O
<br />
<br />RA
<br />I
<br />NS beforr E.L DISEASE-POLICY LIMn $ 9,000,000
<br />p Prof Liability Eoooooot4wTO 02/92/92 02112!93 Ea Occur f,ooo,oo
<br /> Aggre??t,? ?,ooo,ooo
<br /> O -?"'
<br />DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (Atlech ACORO f01, Additlonsl Ramarka Schedule, 11 more apsc 1
<br />The City of Santa Ana, Its oHlcers, agents, volunteers and employees are ???
<br />named as Additional Insured with respect to General Llablllty ae required byA?
<br />i
<br />t
<br />'
<br />wr
<br />t
<br />en contract per the attached. Insure d
<br />s General Llablllty coverage Is
<br />Primary and Non-Contributory.
<br />?'tt'ti
<br />ttars?°71
<br />?osePt?
<br />itY A
<br />Eart G
<br />Assis
<br />?n a..iarvccus? r wrv
<br />CITYSA5
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Briza MOraIOB THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />- City of Santa Ana
<br />Risk Management, M2$ AUTHORIZED REPRESENTATIVE
<br />20 CIVIC Center Plaza
<br />Santa Ana, CA 92709 ????, ,y?,4 ?! '
<br />{ ? ._.._
<br />__ _ _ ®79t18-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2070/05) ? The ACORD name and logo are registered marks of ACORD
|