|
Cliental 3506
<br />f7�'iF`tiY�iriF9
<br />ACORD,,, CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMIOor YYy)
<br />11/18/2013
<br />THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLOER. THIS
<br />CERTIPICATE DOSS. 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 INSURERS}, AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />I P N : If the certificate holder Is an ADDITIONAL INSURED, the poNoy(iae) 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 />oertlflcate holder in lieu of such endorssment(s ).
<br />PRODUCER
<br />The Simklss Agency, Inc.
<br />P. Q: Sox 17$7 �/� s��1i ]] (� �%'�
<br />2 PRIOR Office Park 1 v � l-i/ � .'� �-•° �,!
<br />Paoli, PA 19301
<br />POI,ICYNUM ER
<br />PO ICY EPp
<br />9I1NYY
<br />HO0N
<br />NC
<br />o 610 727.6300 LIB 610. 727.5414
<br />Ext; --
<br />E^
<br />All.
<br />Iorge
<br />NAIriN
<br />Insurance ce Cc
<br />INSURER .a: Valley Forge Insurance CO
<br />2060$
<br />INSURED
<br />Vi zantTo chnolgoes Systems, LLC LLC
<br />245 West Main Avenue, Suite 400
<br />Spokane, WA 99201
<br />INSURERS, Continental Casualty CO
<br />20443
<br />INSURER o; American Casualty Co of Reading
<br />20427
<br />INSURER o 1 '—"-
<br />INSURER al
<br />$10000
<br />INSURER F:
<br />PERSONAL A ADV INJ URY
<br />COVERAGES CERTIFICATE NUMBER; REVISION NUMBER:
<br />THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICYPERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY HE ISSUED OR MAY PERTAIN.. THE INSURANCE ArPORPSO 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 />NS
<br />7µ
<br />TYPa OR INSURANCE
<br />ADOLSURP
<br />,. y
<br />POI,ICYNUM ER
<br />PO ICY EPp
<br />9I1NYY
<br />RPLIpy EpP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />r09NERALVABILITY
<br />COMMERCIAL GENERAL LIABILITY
<br />OLAIMB.MAOE 7X OCCUR
<br />5085390222
<br />09/0112013
<br />00/01/2014
<br />EpApOMHprO;FC•CrURRENCE
<br />s1000000
<br />.PREMISES. 6a aNTEO ce
<br />31.000 -BBC
<br />MED EXP (Ary one p4map
<br />$10000
<br />PERSONAL A ADV INJ URY
<br />$1,000,000
<br />GENERALAGGRE0ATE
<br />$2000,000.
<br />OEN'L
<br />AGGREOATE:
<br />,POLICY
<br />UNIT APPLIES PER:
<br />P e LOO
<br />PRODUCTS. COMPIOP ADO
<br />$2,000000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />AUTRB NED AUTOS EO
<br />HIREDAUTOS X NOTN.OWNW
<br />.AUTOS
<br />6085390222
<br />09/011201$.09101
<br />/201
<br />(CEOMB"Ne0B1 GURUMIT
<br />ftll
<br />9,900,000
<br />BODILY INJURY (PO, person)
<br />$
<br />BODILY INJURY jNramldent)
<br />$
<br />K
<br />PROPERTY DAMAGE
<br />„(PIId nt
<br />$
<br />B
<br />X
<br />UMBRELLA LIM
<br />EXCESS WAS
<br />K
<br />I OCCUR
<br />CLA69S•MAOR
<br />50$6071494
<br />9/01/2013
<br />09/0112014
<br />EACH OCCURRENCE
<br />$10.000,000
<br />AGGREGATE
<br />$10000,000
<br />DEC I I RETENTION, _
<br />$
<br />C
<br />WORNER$ODMPENSATION _..
<br />AND EMPLOYERS'LIA YIN A4,YpRETORIPARTNEF&ECUPIVE
<br />UMBER EXCLUDE 07
<br />(M41 tl41eq In
<br />D ex IPTIbe eMep
<br />OS41RIPPIO OFDPERATIONhplaw
<br />NIA
<br />5065390351
<br />9101/2013
<br />0910112014
<br />X 0TH -.
<br />wIOC S AOrCu
<br />P I DENT
<br />$500000
<br />,ES
<br />E.L. DISEASC- EA: EMPLOYEE
<br />1600 000
<br />E.L, DISEASE - POLICY LIMIT
<br />$600000
<br />B
<br />„-
<br />Professional.
<br />LlabiOty
<br />429604889
<br />09/011201,
<br />O
<br />Limit- $5,000;000
<br />Ag g te._$5,000;000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Aasoh ACDRO 101, AAEItlonal Remarkp$4hedule,' q d)
<br />The City Of Santa Ana, its officers, employees., agents, voluntaers, andrepres n _ . all Q pa
<br />Insureds on a primary non contributory with respect to the above general I t if regbr �`r$3
<br />written contract,Ot
<br />L4t,�7 7 3i
<br />�tfdSy
<br />City of Santa Arta
<br />Clerk of the City Council
<br />20 Civic Canter Plaza (M•30)
<br />P ^O: Box 1988
<br />Santa Ana, CA 92702 -1988
<br />SHOULD.ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOP, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />All rldhtereeervad.
<br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S$8726/MS2855 AD
<br />
|