Laserfiche WebLink
J ,2rw1a, rv2.p <br />UNION-1 OP ID: TTL <br />CERTIFICATE OF LIABILITY INSURANCE °AT <br /> /13 <br />08/27 <br />08/27 <br />13 <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 poicy(los) 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 endorsement(s). <br />PRODUCER 916.784-9793 covTACT <br />B <br />ild <br />t NAME, <br />u <br />ers Advan <br />age Insurance <br />916 <br />7849799 PHONE FAX <br />- <br />107 Main Street I o aC No <br />Roseville, CA 95678 <br />Toni Luker E.rnAa <br />ADDRESS: <br /> <br /> INSURERS AFFORDING COVERAGE NAIC S <br /> INSURER A ; Security National Ins Co <br />INSURED Union Investments, Inc. <br />D <br />i INSURER E: <br />BA: S <br />oneshine - <br />2110 E. McFadden Ave., Suite G INSURERC : <br />Tustin, CA 92705 INSURER o ; <br /> INSURER E : <br /> INSURER : <br />COVERAGES CERTIFICATE NUMBER: RPVLCInN MIIMRPa- <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 S UCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />Im <br />Me <br />POLICYNUMBEft POLI F <br />MM11-%,.M POLICY E%P <br />MMIDOIYWY <br />UNITS <br /> GENERAL LIABILITY EACH OCCURRENCE <br />- $ 1,000,00 <br /> <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />NA102594501 <br />06117113 <br />06117114 1) AATni <br />PREMISES Eaoccurrence -- <br />$ 100.00 <br /> CLAIMS-MADE ® OCCUR MED EXP(my one person) $ 5,00 <br /> PERSONAL &ADV INJURY <br /> <br /> GENERAL AGGREGATE <br /> <br /> GEHL AGGREGATE LIMITAPPLIES PER; PRODUCTS -COMPIOP AD0 <br /> POLICY FED' LOG <br /> <br />AUT <br />OMOBILE LIABILITY <br />O el Ba <br />a O SINGLE OMIT <br />C M <br /> l <br />E <br /> ANY AUTO BODILY INJURY(Po, person) <br /> AUTOS ALLOINNED AUTOESULEO ROPILY INJURY (Pei accdenp <br /> HIREDAUT08 NON OWNED <br />AUTOS PROPERTY DA?EIAGE <br />Par acUZY <br /> $ <br /> UMBRELLA LIPS OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CIAINIS-MADE AGGREGATE $ <br /> <br /> DED RETENTION $ <br /> WORKERS COMPENSATION WC STAN- DTH- <br /> ANDEMFLOYERS'LIAeILITY Y <br />L'. I <br />'O Y <br />ER <br /> IN <br />AMY PROPRI ETORIPARTNERIEXEOUTIVE <br />OFPICER)MCMSER EXCLUDED4 <br />NIA <br />E.L. EACH ACCIDENT <br />$ <br /> INandatmy In NH) <br />If <br />d <br />db <br />d E.L.OISEASE.EAEMPLDYE $ <br /> re <br />aac <br />e un <br />er <br />DCRIPTION OF OPERATIONS below <br />E.L. DISEASE- POLICY UNIIT <br />$ <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atlacl, ACORD 101, Addltlonal Remora. echedula, If more apeoe a raqulrad) <br />The City of Santa Ana, it's officers, employees, agents and representatives <br />are named as additional Insured under the Commercial General Liability per <br />APPROVED AS TO I C'R:Ni <br />attached endorsement. <br /> <br />Re: Various locations throughout the City of Santa Ana, CA ?. <br /> LISFl F. sl-ORCK <br />? 1 <br /> 3 <br />Assistant City Attorney <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, <br />2D Civic Center Plaza M-16 <br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE <br /> I.JY.. Sohn Edinger <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />Exhibit C