|
C
<br />ACII® CERTIFICATE OF LIABILITY INSURANCE
<br />��.
<br />DATE (MMIDOIYVW)
<br />6/14/2013
<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, OONBTITUTE A„ CONTFtACT 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(les) 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 endomement(s). -
<br />PRODUCER
<br />CONTACT
<br />NAME Vanessa Weidauer
<br />ONEFAX
<br />PHONE (415)898-1600 No:(415)898-3922
<br />Anixter 6 Oser, Inc.
<br />License OE28888
<br />pp :vanessa@properlyinsured.com
<br />INSURER(S) AFFORDING COVERAGE NAICN
<br />205 San Merin Drive
<br />INSURER A:Travelers Prop Cas Ins Co 36161
<br />Novato CA 94945-1227
<br />RENCE $ 1,000,000
<br />INSURER B:Travelers Ind Cc of CT 25682
<br />INSURER c Evans ton Insurance Com an
<br />SEi�S?tSuite
<br />INSURER D:
<br />120
<br />INSURER E
<br />INSURER F:
<br />San Francisco CA 94107
<br />COVERAGES CERTIFICATE NUMBER:CL131307280 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 />R
<br />TYPE OF INSURANCE
<br />City of
<br />Santa Ana
<br />POLICY NUMBER
<br />IMIDD Y Y EFF
<br />POLICY
<br />MI DIIYYYYr
<br />LIMITS
<br />AUTHORIZED REPRESENTATIVE
<br />GENERAL LIABILITY
<br />Santa Ana,
<br />CA 92701
<br />RENCE $ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DA A E RENTED
<br />occur Once $ 300,000
<br />A
<br />CLAIMS -MADE OCCUR
<br />X
<br />ZLP12N45052
<br />1/1/2013
<br />1/1/2014
<br />one perS 10,000
<br />ADV NJURY S 1,000,000
<br />REGATE $ 2,000,000
<br />GEN' L AGGREGATE LIMIT APPLIES PER:
<br />OMPIOPAGG $ 2,000,000
<br />X POLICY PRO LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />EOa COMBINED SINGLE LIMIT 1,000,000
<br />BODILY INJURY (Per perwn) $
<br />B
<br />ANY AUTO
<br />ALL OMED SCHEDULED
<br />AUTOS AUTOS
<br />A3402P458
<br />1/1/2013
<br />1/1/2014
<br />BODILY INJURY(Peraccident) $
<br />_
<br />PROPERTY DAMAGE $
<br />Peracoident
<br />NI
<br />X HIRED AUTOS X AUTOS
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE $ 4,000,000
<br />AGGREGATE $ 4,000,000
<br />A
<br />1X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO X I RETENTION$ C
<br />$
<br />ZUP12N45304
<br />1/1/2013
<br />1/1/2014
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS 'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE❑
<br />X WC STATLL IOTH-
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />OFFICERIMEMBER EXCLUDED'
<br />(Mandatory In NH)
<br />NIA
<br />8133P8T0
<br />1/1/2013
<br />1/1/2014
<br />E. L. DISEASE -EA EMPLOYE $ 1,000,000
<br />Ifyes tlesvibe under
<br />E.L. DISEASE -POLICY LIMIT $ 1f 0001000
<br />DESCRIPTION OF OPERATIONS below
<br />___
<br />C
<br />Errors S Omissions - Misc
<br />ITQ09201
<br />1/1/2D13
<br />1/1/2014
<br />IEd, Clam $2,000,000
<br />Professional Liability
<br />/Aggregael $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Adach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Certificate holder is named as additional insured per form CGD417 0112 attached.
<br />APPROVED AS T�OFO1 A
<br />LISA E. STORCK .
<br />CERTIFICATE HOLDER CANCELLATION Assistant
<br />ACORD 25 (2010105)
<br />INS025,,nmus, In
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />Th. ARrTRD nam. and Irmo or. r.ni.f.r.H m. r4. m aCrTRD
<br />clerk@ci.santa-ana.ca.us
<br />SHOU LD A NY OF T H E A BOVE DES C RI BED POLI C I ES BE CA NCEL LE D BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of
<br />Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Maria D.
<br />Huizar, Clerk of the Council
<br />AUTHORIZED REPRESENTATIVE
<br />P 0 BOX 1988, M-20
<br />Santa Ana,
<br />CA 92701
<br />V I Weidauer/NESSA
<br />ACORD 25 (2010105)
<br />INS025,,nmus, In
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />Th. ARrTRD nam. and Irmo or. r.ni.f.r.H m. r4. m aCrTRD
<br />
|