|
OP ID: JL
<br />144r_,
<br />RO CERTIFICATE OF LIABILITY INSURANCE DAT
<br />DlYYYY)
<br />. 1
<br />0125
<br />10!25/12
<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 endorsements .
<br />PRODUCER 909-435-0230
<br />C
<br />S CONTACT
<br />NAME:
<br />awyer
<br />ook Insurance
<br />1200 California St., Ste 260 909-798-7971 P
<br />HONE FAX
<br />a/c No Ext : A/C No):
<br />Redlands, CA 92374 E-MAIL
<br />Small Business U
<br />it ADDRESS:
<br />n PRODUCER
<br /> CUSTOMER ID #: COMMU-5
<br /> INSURERS AFFORDING COVERAGE IC #
<br />INSURED Westbound Communications, Inc. INSURERA:Hartford Insurance Company 22367
<br />625 The City Dr., Ste 360
<br />O INSURER B: Atlantic Specialty Ins Co 27154
<br />range, CA 92868
<br /> INSURER C :
<br /> INSURER D :
<br /> INSURER E :
<br /> INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REV!-S!ON 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 />INTR TYPE OF INSURANCE INSR U R POLICY NUMBER MM DDY FF-F MM/DDfYYYY LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br />A X COMMERCIAL GENERAL LIABILITY X 72SBAAE3737 05/06/12 05/06113 PDAMAGE TO REN REMISES Ea occurrence $ 300,00
<br /> CLAIMS
<br />MADE X OCCUR
<br /> - MED EXP (Any one person) $ 10,00
<br /> PERSONAL & ADV INJURY $ 2,000,00
<br />
<br /> ;GENERALAGGREGATE $ 4,000,00
<br />
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 4,000,00
<br /> X POLICY PIECT -7 RO LOC $
<br /> AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2
<br />000
<br />00
<br /> ANY AUTO (Ea accident) ,
<br />,
<br />
<br />ALL OWNED AUTOS BODILY INJURY (Per person) $
<br />A SCHEDULED AUTOS 72SBAAE3737 05/06/12 05106/13 BODILY INJURY (Per accident)
<br />
<br />X
<br />
<br />HIRED AUTOS , PROPERTY DAMAGE
<br />$
<br /> (Per accident)
<br /> X NON-OWNEDAUTOS $
<br />
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> i
<br /> DEDUCTIBLE
<br />$
<br /> RETENTION $ $
<br /> WORKERS COMPENSATION WC STATU- OTH-
<br />X
<br /> AND EMPLOYERS' LIABILITY Y/ N TORY LIM TS ER
<br />A ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ?
<br />N/A 72WECLR3783 09/28/12 09/28/13 E.L. EACH ACCIDENT $ 1,000,00
<br /> (Mandatory in NH)
<br />If
<br />es
<br />describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,00
<br /> y
<br />,
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00
<br />B ( Professional Liab MEP1072912 09/25/12 09/25113 Aggregate 2,000,00
<br /> Occurrenc 1,000,00
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />City of Santa Ana, it's officers, employees, agents,volunteers and
<br />representative are named as additional insured with respects to general
<br />liability.
<br />APPROVED AL,? 1,4J j,?,Wtiev
<br />' - ?: i? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana Laura Stitt 7l lid' --TkIE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Assistant ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Civic Center Plaza City ,Af lornj-
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />U 1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
|