BELL BUILDING MAINTENANCE COMPANY 1B - 2012

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1% OP ID: HF '4 RO CERTIFI6ATE OF LIABILITY INSIotANCE DAT01 /09 /1YYYYJ 01!09!12 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 endorsements • CONTACT PRODUCER 951- 676 -3365 NAME: Heidi Farmani United Agencies, Inc. (M) 9$1- 676 3020 PHONE 951- 676 -3365 ac CA License #0252636 (A/C,.ti, NoL:_95.1.676 -3020 27403 Ynez Rd., Ste. 110 E -MAIL hfarmani uniteda encies.com ADDRESS: 9.,_- -- Temecula, CA 92591 PRODUCER Ryan E. Hollander c�smµEx.iOwl" LLB -1 INSURED Bell Building Maintenance Co. INSURERA:Preserver Insurance Company 15586 Mrs. Yang Chanhee INSURERs:Century Surety Company _ T136951 5170 Sepulveda Blvd., ##180 INSURERC: Sherman Oaks, CA 91403 - -- - - - -- _.._... ._.._. — �..._. INSURER D: .___- .�_ ..... .... _._ -.- ._...... .. _ .T_. INSURER E: n INSURER F: ('OVFRArFS r:FRTIFIC:ATF NIIMRFR• RFVISICIN IJI IURF:D- 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. INSR :ADDLWUEIT -•' —_ ___... - - - -- POLI Y EF LTR TYPE OF INSURANCE POLICY NUMBER MMID Z`G 'XP MM /DDIYYYY ) LIMITS - - '_ -- GENERAL LIABILITY I EACH OCCURRENCE i 1,000,00 B X COMMERCIAL GENERAL LIABILITY X X CCP742906 01110!12 01H0113 15A MVu: 10KENIED ce ! S _100,001. C-AIMS-MADE X OCCUR ! MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY I $ 1,000,00 GENERAL AGGREGATE _ $ _ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMPIOP AGG $ 1,000,00 PRO- X POLICY . LOC I -` $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ?,= fT. +? it - ( @� +i i �- : s a - 'r Ea accident) ( ) I -i ANY AUTO BODILY INJURY (Per person) Is ALL OWNED AUTOS —•- •' - -- BODILY INJURY (Per accident) •-- S SCHEDULED AUTOS �_ -~ - PROPERTY DAMAGE — I HIRED AUTOS (Per accident) +S S NON - OWNED AUTOS UMBRELLA LIAe OCCUR EACH OCCURRENCE $ j EXCESS LIAR CLAIMS -MADE t AGGREGATE ffi I DEDUCTIBLE " --- S -. -.._. .._ RETENTION S S WORKERS COMPENSATION WC STATU- OTH- X AND EMPLOYERS' LIABILITY YIN ! R _ $ 1,000,00 A ANti PRCnRIE- CR%PAR'NER,EXECU -IVE , WCC 0004991 05/02/11 05102/12 E.L. EACH ACCIDENT C= FICERIMEMeER EXCL'JOECI NIA _ ......- ' (Mandatory in NH) E E. L DISEASE - EA EMPLOYE OOO 1 , 00 yes oescrIbe unoe' UESCRiPTION OF OPERATIONS below _ .0 IE.L DISEASE - POLICY LIMIT .. ,.- Ii 1,000,00 i DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedute, H more space Certificate holder, its oficers, agents, and employees are named as is required) additional insured in regards to General Liability where required by contract; subject to actual policy terms and conditions. R-A City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 CITYOFS 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 REP R ES ENTATIV E DD ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD &A-C)