Laserfiche WebLink
'`� °® CERTIFICATE OF LIABILITY INSURANCE <br />D08 /05I °0Y3 <br />08/05/2013 <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 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 endorsement(s). <br />PRODUCER 1- 800 - 955 -8700 <br />Arthur J. Gallagher & Co. Insurance Brokers <br />of California, Inc. <br />18201 Von Karmen Ave, Suite 200 <br />AMME : CONTACT <br />N Arthur J. Gallagher & Co. <br />NAME <br />PHONE FA% <br />c No Ext: (949) 399 -9000 AIC No): (949) 399 -9967 <br />EMAIL <br />ADDRESS: <br />INSURER (S) AFFORDING COVERAGE <br />NAIC N <br />Irvine, CA 92612 <br />INSURERA: INSURANCE CO OF THE WEST <br />127847 <br />Jerry Niewiadomski <br />INSURED <br />INSURER B <br />MetroPro Road Services, Inc. <br />DAMAGE TO REED <br />NT <br />PREMISES lEa coourrencel <br />INSURER C: <br />MED EXP (Any one person <br />INSURER D: <br />PERSONAL &ADV INJURY <br />2550 South Garnsey Street <br />INSURER E: <br />Santa Ana, CA 92707 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 35085348 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 />ADDL <br />SUBR <br />POLICY NUMBER MMDDIYYVY <br />MMIDITYVY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F_ OCCUR <br />DAMAGE TO REED <br />NT <br />PREMISES lEa coourrencel <br />I $ <br />MED EXP (Any one person <br />- $ <br />PERSONAL &ADV INJURY <br />$ <br />_ <br />GENERAL AGGREGATE <br />$ <br />PROVED S T FORM <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />PRODUCTS- COMPIOP AGG <br />$ <br />$ <br />POLICY PRO LOG <br />JECT <br />� <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />En accidenp_ <br />La�r'd A. RoESSYnl <br />Laura <br />BODILY INJURY Per person) <br />(P_.._ ) <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS _._ AUTOS <br />Assistant rt ®rne <br />_____ <br />BODILY INJURY(Poraccidenl) <br />$ <br />PROPERTY DAMAGE <br />Per..Monl <br />_ <br />i$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />Ht <br />l..J ,r <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS ILIAD <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />Math <br />AND EMPLOYERS' LIABILITY Y N <br />X <br />WS ➢502374500 <br />04/01/1 <br />04/01/14 <br />WCSTATU- Ol'H- <br />X ' Y LIMITS <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />OFFICER /MEMBER EXCLUOEOP ❑ <br />NIA <br />EL DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />NORIPARTNER/EXECDTIVE <br />(Mandatory <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E. L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mere apace Is required) <br />Waiver of subrogation applies to certificate holder on workers compensation liability policy, per the attached form <br />WC990634800. <br />Re: Work performed by the named insured as required per written contract with respects to City of Santa Ana <br />Certificate holder continued: City of Santa Ana, its officers, officials, employees, agents, and volunteers <br />City of Santa Ana <br />Clerk of the Council <br />20 Civic Center Plaza (M -30) <br />P.O. Be. 1980 <br />Santa Ana, CA 92702 -1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE /�/ /y <br />USA ✓ Q� <br />reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />TS.ie123 <br />35085348 <br />