Laserfiche WebLink
A� V CERTIFICATE OF LIABILITY INSURANCE <br />DA 4/5/2012 <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 pollcy(les) must be endorsed, If SUBROGATION 13 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 <br />Joseph D Walters Agency, Inc. <br />2706 S. Park Road <br />COeT <br />FAX <br />P"oNNo,E (412) 831-8222 IAX <br />EMAIL <br />ADD E <br />Bethel Park, PA 15102 <br />INSURERS AFFORDING COVERAGE NNC A <br />INSURER A: PEERLESS INSURANCE COMPANY 24198 <br />INSURED HYDROBLAST & ICP <br />Steve Amman <br />INSURER B : <br />726 W. Angus Ave. Suite G <br />INSURER C <br />Orange, CA 928681300 <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER' REVISION NUMBER - <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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL;SUBRi <br />INSR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP ' <br />LIMITS <br />A <br />GENERAL LIABILITY <br />Y <br />CBP9708503 <br />04/07/2012 <br />04107/2013 <br />EACH OCCURRENCE <br />$ 1000000 <br />GENERAL LIABILITY <br />CLAIMS -MADE V OCCUR <br />E TO RENTED <br />DAMAGCOMMERCIAL <br />PREMI$,FS (Ea occurrenr <br />MED EXP Any oneperson) <br />$ 100000 <br />$ 5000 <br />PERSONAL & ADV INJURY <br />$ 1000000 <br />GENERAL AGGREGATE <br />$ 2000000 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ 2000000 <br />POLICY PRO- LOG <br />$ <br />AUTOMOBILE <br />LIABILITY <br />OMBINEO SINGLE LIMIT <br />Ere a <br />BODILY INJURY(Perperson) <br />$ <br />ANYAUTO <br />_ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIREDAUTOS AUTOS <br />�% <br />"(> <br />r <br />;?,�- <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />-- <br />$ <br />$ <br />�,. <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />EXCESS LIAB <br />CLAIMS -MADE <br />- - <br />� �s;. <br />� <br />DED RETENTION <br />t' r- ,.. ,,I <br />$ <br />WORKERS COMPENSATION <br />-� <br />WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE = <br />OFFICERIMEMBEREXCLUDED? <br />N/A <br />"' <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />- <br />$ <br />(Mandatory in NH) <br />We describsunder <br />DES6RIPTION OF OPERATIONS below <br />— <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />CITY OF SANTAANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE LISTED AS ADDITIONAL INSURED ON GENERAL LIABILITY <br />BUT ONLY IF IT IS AGREED IN WRITING IN A CONTRACT OR AGREEMENT (SEE ATTACHED CG2010). ABOVE NAMED GL POLICY IS PRIMARY AND <br />NON-CONTRIBUTORY TO ANY INSURANCE THE CERTIFICATE HOLDER MAY HAVE. A30 DAY NOTICE OF CANCELLATION WILL APPLY EXCEPT FOR <br />NON-PAYMENT WHICH IS 10 DAYS. <br />CERTIFICATE HOLDER rANrF=1 I ATInN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTAANA <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PARKS, RECREATION AND COMMUNITY SERVICES <br />AGENCY <br />AUTHORIZED REPRESENTATIVE <br />20 CIVIC CENTER PLAZA <br />SANTAANA, CA 92701 <br />®1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD <br />