ALL CITY NURSERY-2012 - Laserfiche WebLink

Home Browse Search

~ Policy Number: Date Entered: 10/4/2012 ACORD@ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYVVY) ~ 10/4/2012 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 CONTACT MARYAM REZVANI INSURANCE AGENCY NAME: ~gN~nFYt\. (949)348-9794 (L~"No\: ~9) 716-9292 27281 LAS RAMBLAS # 100 E-MAIL !"-.. .....,\ c= Mission Viejo, CA 92691 ADDRESS: """-.) INSURERISI AFFORDING COVERAGE: "::;) NAlC # INSURER A: Farmers Insurance '. ~ INSURED All City Nursery INSURER B : rv INSURER C: W 3131 S Standard Ave., INSURER 0: ". :::::',;> "" Santa Ana, CA 92705 ... "" ,.." INSU RER E : .,J' INSU RER F : ~'::.~~-j :,';;,. ':-I COVERAGES CERTIFICATE NUMBER: REVISION Ne:M~R: ~ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABO~FOR TAt: 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 TYPE OF INSURANCE ADuL I~; (&~~g~~\ (&3Mg~~\ LIMITS LTR IN"'R POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A [Z jMMERCIAL GENERAL LIABILITY X 605139202 0/03/2012 0/03/2013 ~~~~~~J'i'E~~~~~~ence' $150,000 ~ CLAIMS-MADE [Z] OCCUR MED EXP (Anyone person) $5,000 ~ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 I-- GEN'L AGGREn LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $1,000,000 n POLICY p,rg. n LOC $ AUTOMOBILE LIABILITY fE~~~~~~~t~INGLE LIMIT l: I-- ANY AUTO BODILY INJURY (Per person) $ I-- ALL OWNED - SCHEDULED BODILY INJURY (Per accident) $ I-- AUTOS - AUTOS lOR i\ NON-OWNED .\PPRUVi:..U ^ " rf"} ip~7~c?c~d~gAMAGE $ HIRED AUTOS AUTOS Fl.~ I-- - ----, J $ UMBRELLA LIAB H OCCUR "...__~~_ro ~-~~t-~ .~/2. EACH OCCURRENCE $ I-- EXCESS L1AB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ L.lUra SLtt S-':Cl $ WORKERS COMPENSATION t" '::-'-,lSldl L '"-_ J I T~8~T ~Ys I IOl~- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ ~~~~~rp"ir~~ ~~gPERATIONS below E.L. DISEASE. POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, il more space Is required) City of Santa Ana, its officers, employees, agents, volunteers and representatives are also named as additonal insured. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clerk of the City Council ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza (M-30) POBox 1988 AUTHORIZED REPRESENTATIVE -Mr; Santa Ana, CA 92702-1988 F~ I ACORD 25 (2010/05) @ 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Plus software. www.FormsBoss.com; Impressive Publishing 800-208-1977