CORDOBA CORPORATION 2A - Laserfiche WebLink

Home Browse Search

Client#: 1259431 305CORDOCOR ACORD,. CERTIFICATE OF LIABILITY INSURANCED TE(MM011YM 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. 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(ies) 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). PRODUCER BB&T Insurance Services of Orange County 680 Langsdorf Drive Suite 100 CONTACT NAME: Christy Mata HON o Ext :714 578-7370 No): ADDRESS: CMata@BBandT.com rKUMULK Fullerton, CA 92831 CUSTOMER ID #: 72SBACP3130 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Cordoba Corporation 1401 N. Broadway Los Angeles, CA 90012 INSURER A: Hartford Casualty Insurance Com 24 294 INSURER B: Everest National Insurance Co 10120 INSURER C, Property 8r Casualty Ins Co of H 34690 INSURER D : INSURER E: INSURER F: MED EXP (Any one person) $10,000 COVERAGES CERTIFICATE NUMBER: REVISION NLIMRER- 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. INSIR LTRN TYPE OF INSURANCE ADDL U POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X 72SBACP3130 1/20/2011 01/2012012 EACH OCCURRENCE $1 000 000 -DAPREMISES X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GEO R occurrence $300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 X POLICY 7 PRO LOC $ C AUTOMOBILELIABILITY X ANY AUTO 72UECUS9769 01/20/2011 01/20/2012 COMBINED SINGLE LIMIT (Ea accident) $1 000 000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON -OWNED AUTOS $ $ A UMBRELLA LIAB X OCCUR 72SBACP3130 1/20/2011 01/20/2012 EACH OCCURRENCE s5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE s5,000,000 DEDUCTIBLE X RETENTION 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA CA20011117111 1/20/2011 01/20/201 X WC STATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Per form SS0008 04/05 pages 11-13 of 24 attached, the following are named as Additional Insureds, as respects to General Liability, as required by written contract. (See Attached Descriptions) City of Santa Ana Transportation & Traffic Engineer Public Works Agency M-93 Attn: David Biondolillo; 20 Civic Center Plaza ACORD 25 (2009109) 1 of 2 #S6218762/M6217385 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4j� t91at5ts-ZUU9 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXMCN