ARELLANO ASSOCIATES -2013 - Laserfiche WebLink

Home Browse Search

ACC1R®� CERTIFICATE OF LIABILITY INSURANCE Ill DATEtmmmom ) 3/28/2013 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 CERTIFICAT ? 4 R.9 -; 1: 21 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). y; 3 ` PRODUCER Wood Gutmann & Bogart Lic #0679263 15901 Red Hill Ave., Suite 100 ^r q AHONN Eu -7 4-824-8327 A/C No E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC H Tustin CA 92780 INSURER Aflartford Accident and /26/2013 /26/2014 INSURED ARELL -1 INSURER B INSURERC:Amco Insurance CQmpaoy Arellano Associates INSURER D: i wi Mutual Ins GenovevaArellano 5851 Pine Ave Ste A RENTED PREMSES TO occurrence $1,000,000 Chino Hills CA 9170945 INSURERS: NSURER F: COVERAGES 'CERTIFICATE NUMBER: 1455909375 REVISION NUMBER: 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 LTR TYPE OF INSURANCE ADDL INSR BR MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EKE MM/DOIYYYY LIMITS C GENERAL LIABILITY CP7806098272 /26/2013 /26/2014 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY RENTED PREMSES TO occurrence $1,000,000 CLAIMS -MADE El OCCUR MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 $ POLICY PRO LOC JFGT D AUTOMOBILE LIABILITY ACP7806098272 /26/2013 /26/2014 Ea accident 1,000000 BODILY INJURY (Par person) $ ANYAUTO BODILY INJURY (Per accident) $ ALL OWNED X SCHEDULED AUTOS PROPERTY DAMAGE Per accident $ X NOWOWNED HIRED AUTOS X AUTOS $ C UMBRELLA LIAB X OCCUR ACP7806098272 /2612013 /26/2014 EACH OCCURRENCE $2,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED 'X I RETENTION$O $ A WORKERS COMPENSATION 72WECDQ0297 /27/2013 /27/2014 X WC STATU- OTH- TORY UMUS ER AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? F-1 N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yyes, describe under DESCRIPTION OF OPERATIONS below B C Errors & Ommissions Valuable Papers & Records PHSD736305 CP7806098272 /8/2012 /26/2013 /8/2013 /26/2014 2,000,000 1Clalm 2,000,000 /Agg 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Job: Warner Avenue Widening Project Job No: N- 2012 -011 Certificate holder is named as additional insured on the General Liability per attached PB6003 04 11. Primary and Non - Contributory applies on the General Liability, endorsement to follow from company. APPROVED AS TO FORSA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE LBUrB S t StteEdy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Assistant City Attorney Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE r ACORD 25 (2010105) (D 19BB -2010 ACORU CORPORA] ION. All rights reserved. The ACORD name and logo are registered marks of ACORD