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AMERI52 OP ID: WC <br />CERTIFICATE OF LIABILITY' INSURANCE <br />FDATE (MMMD <br />10121/2015 <br />THIS CERTIFICATE 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 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 <br />Orr and Associates Ins. Serv. <br />CALK#0E63493 PH(951)506-5$59 <br />28780 Single Oak Drive #255 <br />Temecula, CA 92590 <br />CONTACT <br />NAME: <br />PHONE AIC,No, Ext. A1C Na: <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIIC 4 <br />COMMERCIAL GENERAL LIABILITY <br />INSURER A: ASSOCIATED INDUSTRIES INS CO 23140 <br />INSURED American Wrecking Inc <br />2459 Lee Ave. <br />South EI Monte, CA 91733 <br />INSURER B: LIBERTY MUTUAL FIRE INSURANCE 23035 <br />INSURER C : RSUI INDEMNITY COMPANY 22314 <br />INSURER D : WESTCHESTER SURPLUS LINES INS. 10172 <br />INSURER E: TRAVELERS PROP CASUALTY CO OF 25674 <br />CLAIMS -MADE ® OCCUR <br />INSURER F : <br />X <br />COVERAGES CERTIFICATE NUMBER:. REVISION NUMBER: <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 ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM'S, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />...IND <br />INTRR <br />TYPE OF INSURANCE.... <br />ADDL <br />U <br />D. <br />POLICY NUMBER <br />MMIDBR IDYYYY <br />(MM1DDfYYYY) <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE... $ 1,000,00 <br />CLAIMS -MADE ® OCCUR <br />X <br />X <br />AES1034672 <br />04/2812015 <br />04128/2015 <br />PREMISES Ea ocTrrence $ 50,000 <br />MED EXP (Any one. person) $ 5,000 <br />PERSONAL&ADV INJURY $ 1,000,00 <br />AGGREGATE, LIMIT APPLIES PER: <br />POLICY I L 11PRC- LOG <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'L <br />PRODUCTS - COMPFOP AGO $ 2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />MINGLE LIMIT <br />Ea accadent $ 1,000,04 <br />B <br />X <br />ANY AUTO <br />AS2-Z91.457618-015 <br />09101/2015 <br />09101/2016 <br />BODILY INJURY (Per person) $ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />NON -OWNER <br />HIRED AUTOSAUTOS <br />PROPERTY DAMAGE $ <br />Per accident <br />$ <br />UMBRELLA. LIARX OCCUR <br />EACH OCCURRENCE $.... 10,000,000 <br />C <br />X <br />EXCESS LIAR CLAIMS -MADE <br />NHA237858 <br />04/2812015 <br />04/2812016 <br />AGGREGATE $ 10,000,000 <br />$ <br />DED RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS" LIABILITY YIN <br />ANY PROPRIET7RiPARTNER/EXECUTIVEE.L. <br />OFFICERWEMBBER EXCLUDED? ❑N1A. <br />PER OTH-. <br />STATUTE ER <br />EACH ACCIDENT $ <br />- <br />E.L. DISEASE- EA EMPLOYE:. <br />(Mandatory in NH) <br />If yes, describe under <br />OE.SCRIPTfON OF OPERATIONS below <br />E.L. DISEASE- POLICY LIMIT $ <br />D <br />Po11ut'ion Liabilit <br />627562048001 <br />0211812015 <br />02118/2016 <br />'GA1POL LI 5,000,00 <br />E <br />PROPERTY *SEE NOTE <br />QT6609A147581TIL <br />0412812015 <br />0412812016 <br />',SEE NOTES <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEBICL.ES (ACORD 101., Additional Remarks Schedule, may be attached if more space is required) <br />CITY OF SANTA ANA ITS OFFICERS, AGENTS, EMPLOYEES CONSULTANTS, SPECIAL <br />COUNSEL AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED PER ATTACHED <br />ENDORSEMENT FORMS. <br />r <br />« 1�IB�F I-ILl"wI 1:9V I�I� <br />/�,E\fl 'W :_) BY ' � ✓ l � , EU1( tl II //)I <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2014101) <br />1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE, ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF„ NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA M-93 <br />AUTHORIZED REPRESENTATIVE <br />SANTA ANA, CA 92702 <br />ACORD 25 (2014101) <br />1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />