Laserfiche WebLink
271069 <br />ACORN CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) <br /> 12/11/20'12 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER <br />. 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 ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br /> <br />Co <br />i <br />l Li <br />' NAME: <br />mmerc <br />a <br />nes -(8 <br />18) 464-9300 PHONE FAX <br /> A/C No . <br />Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 E-MAIL <br /> <br />' ADDRE <br />15303 Ventura Boulevard, 7th Floor <br /> INSURERS AFFORDING COVERAGE NAIL e <br />Sherman Oaks, CA 9403-3'197 Phil <br />d <br />l <br />hi ' <br /> a <br />e <br />p <br />a Indemnity Insurance Company <br />INSURERA: 18058 <br />INSURED <br />Di <br />S <br />i INSURER B : Philadelphia Insurance Company 23850 <br />scovery <br />c <br />ence Center <br /> INSURER c : Employers Compensation Ins Co 1'15'12 <br />2500 North Main Street <br /> INSURER D <br />Santa Ana, CA 92705 <br /> INSURER E <br /> INSURER F <br />JCC VtlIVW <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO <br />I <br />L <br />CY 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 />, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IN$R <br />LTR <br />TYPE OF IN6U RANGE VBR <br />POLICY NUMBER POLICY EFF <br /> <br />MM/DDKYYY POLICY E%P <br /> <br />MM/DD/YYYY <br /> <br />LIMITS <br />A GENERAL LIABILITY X PHPK953782 t2/'I 5/20'12 12/15/203 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY A A N <br /> P E T E E rra ce $ 300,000 <br /> CLAIMS-MADE ? OCCUR MED EXP (An one person) $ 5,000 <br /> PERSONAL B ADV INJURY $ 1 <br />000 <br />000 <br /> , <br />, <br /> GENERAL AGGREGATE $ 2 <br />000 <br />000 <br /> , <br />, <br /> GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS -COMP/OP AGG $ 2,000,000 <br /> X POLICY PRO LOC g <br />/.? AUT OMOBILE LIABILITY PHPK953782 t2/t 5/20'12 t2/t 5/2013 D <br />SINGLE LIMIT <br />e <br />d <br /> I <br />Ea s <br />ct <br />a 1,000,000 <br /> X ANY AUTO <br />ALL OWNED <br />CHE BODILY INJURY (Per parson) $ <br /> <br />AUTOS S <br />DULED <br />AUTOS <br />O <br />W <br />BODILY INJURY (Per accident) <br />$ <br /> X HIRED AUTOS X NED <br />AV <br />TOS PROPERTY DAMAGE $ <br /> era ant <br /> $ <br />B UMBRELLA LIAR X OCCUR PHLI6404496 12/15/2012 t2/?$/20t3 EACH OCCURRENCE $ 10,000.000 <br /> X E%CE33 LIAR CLAIMS-MADE AGGREGATE $ <br /> <br /> DED RETENTION $ $ <br /> <br />C WORKERS COMPENSATION X WC STATU- OTH- <br /> AND EMPLOYER3'LIABILITY ?./N EIG 1453813-00 04/0'1/12 04/01/13 <br /> ANY PROPRIETOWPARTNER/EXECUTIVE <br />OFFICER/MEMBEft EXCLU DED? ? <br />N / A E.L. EACH ACCIDENT $ 1,000.000 <br /> (Mantletory In NH) <br />If es <br />describe under E.L. DISEASE - EA EMPLOYE $ 1.000.000 <br /> , <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT <br />1.000,000 <br />$ <br /> <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Addltlonal Ramarka Schedule, I! more apace Is raqulred) <br />The City of Santa Ana, its officers, agents, employees, representatives antl volunteers are included as Additional Insureds for General Liability as required <br />by written contract. FORM <br />A? ?? <br />ROVE? <br />. <br />A <br />?,p <br />RcK <br />?VGLL/YIIV rY fir` - Ll?+' V <br />c,tstar` <br />Ci[y Of Santa Ana SHOULD ANY OF THE ABOVE D?SCf216ED POLICIES BE CANCELLED BEFORE <br />EI SalVad Or COmmUnliy Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />'1825 W Civic Cen[er Dr <br />Santa Ana CA 92703 AUTHORIZED REPRESENTATIVE '/r°"? <br />9? <br />The ACORD name and logo are registered marks of ACORD ©'1988-20'10 ACORD CORPORATION- All rin Flfa rnsnrvori <br />ACORD 25 (20'10/05)