Laserfiche WebLink
2501 12 <br />,a <br />R°a CERTIFICATE OF LIABILITY INSURANCE DA l'22013 <br />ke? <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 sndorsamentfsl. <br />PRODUCER <br />NUI <br />CONTACT Tracy Dolan <br />Wells Fargo Insurance Services USA, Inc. PHONE 916 589-8153 FA 877 611 <br />1971 <br /> . that . <br />C No : ' <br />CA DOI Lic. #OD08408 (916) 589-8000 E-MAIL tracy.dolan@wellsfargo.com <br />10940 White Rock Road <br />2nd floor <br />, INSURERS AFFORDING COVERAGE NAIC At <br />Rancho Cordova, CA 95670-6076 INSURER A: Valley Forge Insurance Company 20508 <br />INSURED INSURER e : National Fire Insurance Company of Hartford 20478 <br />Wittman Enterprises, LLC INSURER C: Continental Casually Company 20443 <br />PO Box 269110 lusueeR n Evanston Insurance Comoam, 3537R <br />Sacramento, CA 95826 <br />NUMBER: SAA hAlnw <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 TERMS <br />, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />62 <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFF <br />N DDMW POLJCY EXP <br />MMtDOMM <br />LINTS <br />A GENERAL LIABILITY 84034654035 7/1/2013 711/2014 <br />EACH OCCURRENCE <br />$ 2.000.000 <br /> X COMMERCIAL GENERAL LIABILITY LIABILITY <br />AE T EMA ED <br />MISES Lis REN urrence <br />PR <br /> <br />"'. $ 300.000 <br /> CLAIMS-MAOE IJ OCCUR MED EXP(Any one person) S 10,000 <br /> PERT 90µ4L s ADV INJURY 000 <br />000 <br />S 2 <br /> - . <br />. <br /> O <br />ENERALAGGREGATE ?S 4 <br />000 <br />000 <br /> , <br />. <br /> GEN% AGGREGATE LIMIT APPLIES PER PRODUCTS - OOMPIOP AGG S 4.000.000 <br /> X POLICY PR0. LOC l S <br />B AUT OMOBILE LIABILITY B4012487490 i <br />7!1/2013 711/2014 MBINEE <br />D <br />SINGLE LIMIT <br /> l D <br />I 1000000 <br /> X ANY AUTO BODILY INJURY (Par Person) $ <br /> ALL OWNED <br />AUTOS ASCHEDULED <br />UT OS <br />BODILY INJURY (Per acadent) <br />S <br /> % HIRED AUTOS % DOWNED PROPERTY DAMAGE S <br /> Pr do <br /> I $ <br />C X UMBRELLA LIAR % OCCUR 84034654083 711/2013 7/112014 <br />EACH OCCURRENCE <br /> <br />2.000.000 <br />$ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE 000 <br />000 <br />S 2 <br /> . <br />. <br /> DIED % RETENTIONS III= ( $ <br /> WORKERS COMPENSATION OTH- <br /> AND EMPLOYERS' LIABILITY f <br /> ANY PROPRIETORIPARTNER/E%ECUTNEQ <br />OFFICEWMEMBER EXCLUDED? <br />NIA;. <br /> <br />" <br />NT <br />7 <br />5 <br /> (Mandatory In NH) <br />If yes <br />descnbe under ! 01S?E <br />EMPLOYE 5 <br /> . <br />DESCRIPTION OF OPERATIONS bekw LICY LIMIT S <br />D Prof Liability l E0854157 07101/2013 07/01/2014 $1.000,,00CIS2.000,000 <br /> A? <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is requi <br />Certificate holder named additional insured per attached form. <br />'10 day notice applies if cancelled for non-payment of premium. r~ <br />f <br />IUU' <br />T. <br />O tr <br />?,P tp <br /> <br />CI O <br />? <br />' <br />rl <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED VCIES BE CANCELLED BEFORE <br />20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOT] WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISION <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />97 <br />The ACORD name and logo are registered marks of ACORD ®1988-2010 ACORD CORPORATION. All rlahts reserve, <br />AUUKU 20 (ZULU/UO)