|
.qce D CERTIFICATE OF LIABILITY INSURANCE DATEVI IDDNWY)
<br />02/25/2415
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain POIiCies may mgUlre an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endomement(s).
<br />PRODUCER
<br />CONTACT Slabs, Bill
<br />NAME
<br />SL Insurance Associates Inc
<br />..m.__ __-
<br />PHONE E 40$ 776 -$600 � JAL No7: ooa >T6 -BS02
<br />275 Tennant Ave, Suite 207
<br />aoosESS: bill @slinsure,com
<br />Morgan Hill, CA 95037
<br />MED eXP(Anyone person) 1 s 10,000
<br />INaUREftfa AF EGUIVIOCOVERAOE NAIC#
<br />._.. ....._ _.. .._....
<br />INSURERA: National Faro Inavranae Co of Bax[ford 524298
<br />INSURED 949- 542 -7995
<br />INSURERS: Hartford Casualty ins. Cc 37478
<br />Pacific Services Inc
<br />-- ......._...__..
<br />INSURER C
<br />nibs: Pacific Datacom
<br />.._�. ........ .._.- ._.. _...__�_. _.__._.._
<br />927 Calle Negocio Ste L
<br />INSURERD:
<br />San Clemente, CA 92673
<br />INSURER E:
<br />INSURER F:
<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
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />20 Civic Center Plaza
<br />INS
<br />R _.... ..__._._— _�__....._.._.__._�__. ADOL UBR _— .._.._.._.... . —.—. POLICY EFF POLIOYEXP
<br />LTR� TYPE OF INSURANCE NSR MD POLICY NUMBER MMIDD(YYY I MMIDOIYYYY
<br />LIMITS
<br />GENERAL LIABILITY I
<br />EACH OCCURRENCE $ 2, 000, 000
<br />a COMMERCIAL GENERAL LIABILITY s z B 4031343323 of /2c;2oss 43tao /zc ;e
<br />DAMAGE OR�If`1% �-
<br />PREMISES(Eao.k n 300,000
<br />t.._ /
<br />_$
<br />I J CLAIMS-MADE I V OCGUR _
<br />MED eXP(Anyone person) 1 s 10,000
<br />PERSONAL &ADV INJURY 1S 2 0_00,000
<br />._.. ....._ _.. .._....
<br />GENERALAGGREGATE is 4,000,000..
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />'PRODUCTS COMPlOP AGO S 4,000,000
<br />,._.
<br />Vj _ POLICY PRO- LOC
<br />s
<br />AUTOMOBILE
<br />LIABILITY
<br />CAMDINED SINGLE LIMI
<br />Ee aacident --------- }}}��r--- ---444���- -- 1,000,000
<br />A
<br />ANY AUTO s B 40313433323 a, /xo /ss>s o ; /xo /2s;e
<br />BODILY INJURY (Per parson)
<br />_
<br />All OWNED , SCHEDULED
<br />-'
<br />rBOD7LY INJURY (Par acc dent} $
<br />I_
<br />AUTOS -
<br />NON -0OWNED
<br />PROPERTYDARAGE S
<br />, HIRED AUTOS AUTOS I
<br />LPgr accldenlJ.,_ .
<br />UMBRELLA DAB � OCCUR
<br />FACNOCCURRENCE $
<br />1
<br />. EXCESS DAR CIAIM& -MADE
<br />_ _....
<br />AGGREGATE ,. $
<br />DED RETENTION$
<br />$
<br />WORKERS COMPENSATION I
<br />`, 4VOSTATU OIH-
<br />ANDEMPLOYERS'UABILnY YIN I
<br />a ANY PROPRIETORIPARTNER(EXECOTIVE
<br />OFFICERYMEMBER EXCLUDED' C NIA) i57WECES7871 /os
<br />EL EADhI ADGIDENT
<br />-'
<br />$ 1,000,000
<br />'- "- ---
<br />oifoafmxb' or /seat
<br />(Mandatory inNIV
<br />DSEASE, EA EMPLOYEE
<br />S 1,000,000
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />-EL
<br />IE DISEASE - POLICY LIMIT
<br />,$ 1, D00, 000
<br />I
<br />DESCRIPTION OF OPERATIONS! LOCATIONS t VEHICLES (Anacb ACORD JOY, Additional Remarks emomla, If mom space is romlred)
<br />As it pertains to its California operations, and where required by contract
<br />for any and all locations for
<br />that contract, the following is named as additional insured interest.
<br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Ca. 92701, its Officers, employees, agents,
<br />volunteers and representatives with regard to Liability and defense of suits arising from the operations
<br />and uses performed by or on behalf of the named insured.
<br />CERTIFICATE HOLDER CANCELLATION
<br />O 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) 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 SE DELIVERED IN
<br />The City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE mm
<br />O 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD �����
<br />
|