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BELLB -1 OP ID: SO
<br />�RO CERTIFICATE OF LIABILITY INSURANCE OATE(MMlDD/YYYY]
<br />x2/07113
<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 poHcy(les) 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 endorsements .
<br />PRODUCER Phone: 951 -676 -3365
<br />NAME: Stacy OrtIZ
<br />United Agencies, Inc. (M) Fax:951 -676 -3020
<br />PHONE 951 -676 -3365 ,FAAic,.NO);_951- 676 -3020
<br />-
<br />CA License #0252636
<br />27403 Ynez Rd., Ste. 110
<br />AWN - _... _
<br />ADDRESS: sorUz@unitedagencies.com
<br />- - -- - - - -- - -- _ --
<br />Temecula, C A 92591
<br />Ryan E. a, C Hollander
<br />- __. —_.... INSURERS) AFFORDING COVERAGE __ -- NAIC 0 .
<br />EACH OCCURRENCE $ 1,000,00
<br />INSURERA :Century .Surety Company 136951
<br />.NSURED Bell Building Maintenance Co.
<br />INSURERB:Topa Insurance Services
<br />Mrs. Yang Chanhee
<br />INSURERC:Preserver Insurance Company 15586
<br />5170 Sepulveda Blvd., #180
<br />_ —.- -. ___ -- . .
<br />Sherman Oaks, CA 91403
<br />INSURERD:
<br />PRODUCTS- COMPIOP AGG _S _1,000,00
<br />INSURER E
<br />$
<br />INSURER F:
<br />____.�.�. �� ... .�... �.._
<br />oR /Ielnu tJ111lAQCQ•
<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 D
<br />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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />sU�� - - - -- ._. ___.. ..— POLICY EFF POLICY EXP
<br />ILTR TYPE OF INSURANCE POLICY NUMBER MM /DDIYYYY MWDD L
<br />LIMITS
<br />GENERAL LIABILITY I E
<br />EACH OCCURRENCE $ 1,000,00
<br />A X COMMERCIAL GENERAL LIABILITY X XCCP780594 01110113 01!10114 D
<br />DAMAGE'rb RED €O
<br />PREMISE_S_(Eaoca,rrencP1-_S _. 100,00
<br />CLAIMS-MADE X OCCUR L
<br />LMED EXP (Any one person) $ _ _ 5,00
<br />PERSONAL B ADV INJURY $ 1,000,00
<br />.... GENERAL AGGREGATE I$ 2,000,00
<br />GEN L AGGREGATE LIMIT APPLIES PER: P
<br />PRODUCTS- COMPIOP AGG _S _1,000,00
<br />PUUCY PRO- LOC -
<br />$
<br />COMBINED SINGLE LIMIT
<br />AUTOMOBILE LIABILITY j '.. [
<br />[_(Es accidence
<br />I I
<br />I B
<br />BODILY INJURY (Per person) _
<br />ANY AUTO I
<br />_ _ $
<br />ALL OWNED SCHEDULED - B
<br />BODILY INJURY (Per acudenp $
<br />.AUTOS AUTOS -
<br />-- P
<br />- -"
<br />HIRED AUTOS AUTOS '� I
<br />_ (Per accident]... ... _.. —_ -.. ... - --..
<br />I $
<br />UMBRELLA LIAB X _OCCUR E
<br />EACH OCCURRENCE i5 5,000,00
<br />B X $
<br />$
<br />L E
<br />DED X RETENTIONS $
<br />$
<br />WORKERS C
<br />i.T.9ALLLMS$.. ER. _
<br />OFFICERIMEMBER E
<br />E._L. DISEASE _EA E_ MPLO_Y_EEI $ 1x000,00
<br />(Mandatory in NH) -
<br />If yes, des; rice under 1
<br />1,000,00(
<br />D
<br />I
<br />I
<br />I
<br />DESCRIPTION OF OPERATIONS t LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Certificate holderr its officers, employees, agents, and representatives are
<br />named as additional insured in regards to General Liability where required n
<br />n�
<br />by written contract, with primary and non -
<br />20 T
<br />CERTIFICATE HOLDER CANCELLATION 1-1 At�O
<br />CITYOFS A,55Iska
<br />SHOULD ANY OF THE ABOVE DESCR ED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />©1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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