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OP ID: KA CERTIFICATE OF LIABILITY INSURANCE 1 OATD 1 00/01/101120014 14 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement (s). PRODUCER Phone: 858. 457 -5720 Rubin Insurance Agency Inc. 0363 Greenwich Dr, #120 Fax: 858. 457 -5729 CA #0645355 San Diego, CA 92122 Michael Rubin CONTACT NAME: PHONE - -- FAX AIC No Est), A /C, No EMAIL ADDRESS: PRODUCER CUSTOMERIO 4, B &DTO -1 INSURERS AFFORDING COVERAGE NAIC q INSURED B &D Towing, Inc INSURER A: Insurance Company of the West 27847 Balcaceras and Davalos Towing 1502 N Susan Street INSURERS: COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1 OCCUR INSURER C : Santa Ana, CA p /�' V IV•�OOJ -' /�/O ® INSURER D: INSURER E: $ VIED EXP(Anyone person) INSURER F: PERSONAL &ADV INJURY $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDDIVI'YY POLICY EX? MMIDOIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1 OCCUR - PREMISES Ea occurrence $ VIED EXP(Anyone person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER PRODUCTS- COMP/OPAGG $ POLICY PRO- LOO JED $ AUTOMOBILE LIABILITY ANY AUTO qq�� RY �g+ ADO tl IA F/qD� AS g / FORN COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ HIRED UTOAUTOS HIRED AUTOS p� �� A. Rossini PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS p A.ssisUnt City YA omey $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETCR /PARTNER /EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A X WSD502471101 10/0112014 10101/2015 X WC STATU OT H- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT 1 $ 1,000,06 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Proof of insurance. Waiver of subrogation endorsement WC990637(5 -02) applies. CERTIFICATE HOLDER CANCELLATION CITYSA City f Santa Ana y 60 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2009109) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD