Laserfiche WebLink
00M <br />Client#: 567011 <br />CCDRCOMM <br />CERTIFICATE OF LIABILITY INSURANCE <br />BATE (MMIbb1YYYY) <br />n1 /91 9nId <br />THIS CERTIPICATE IS ISSUED AS A MATTER of INFORMATION ONLY AND CONP51RS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVE4Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the Certificate holder ie an ADDITIONAL INSURED, the poliey(les) must be endorsed, If SUBROGATION IS WAIVED, subject to <br />the tariffs a-nd Colfditlnnsof the policy, certain policies mayrequlre an endorsement. A statement on this certificate does not confer rights to tho <br />Certificate holder in lieu of such endorsements . <br />PRODUCER <br />NAME; <br />Mirayn Becarra <br />Hub International <br />H <br />- <br />E 562474-2541 nlc Ne, 562. 724.9900 <br />!i- <br />HUB Int'I Insurance Serv. Inc. <br />3/0112013 <br />- <br />mirB a.becarra @bubinternational,corn <br />- <br />10222 Lakewood Blvd. <br />°• <br />H <br />pl Effl %S ao curcence <br />Downey, CA 00241 <br />INSURER(S) APPCRDING COVERAGE <br />NA109 <br />INSURSRA; Hartford Casualty Insurance Com <br />29424 <br />INSUREq <br />CCDR Corn munlcetlone,InC,p Crystal -Clear <br />INSURER BI <br />0_2.,000,000 <br />_ <br />LIMIT APPLIES PER; <br />PRO LOG <br />130 E. Dyer Road Suite 8 <br />INSURER C! <br />$ <br />Santa Ana, CA 92707 <br />INSURER O: - <br />— <br />INSURER S: <br />COMB -LIMIT <br />Ea eccld <br />INSURdR R: <br />BODILY INJURY(Perperso0) <br />6UVIEKAUIZU CER(IFICATE NUMUER: REVISION NUMBER' <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEEN ISSUED TOTHE INSURED NAMEDABOVE FOR-ME POLICY PERIOD <br />NOICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 BY <br />R <br />TYPE OP INSURANCE <br />N5RL <br />WV� <br />POLICY NUMBER <br />ppROoE�L,tDtUCED <br />MMlo <br />IPI,,A�pIIyDy ®®C��LL�AIMS. <br />/00/YYYY <br />LIMIT$ <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS•MAtlE I OCCUR <br />x <br />72SBATU1039 <br />3/0112013 <br />03/0112014 <br />EACH OCCURRENCE <br />$1 0og000 <br />H <br />pl Effl %S ao curcence <br />$300 000 <br />MEO P-XP An one neraon <br />10 000 <br />PERSONAL &ADVINJURY <br />$1 000,00Q <br />GENERAL AGGREGATE <br />0_2.,000,000 <br />OEML AGGREGATE <br />POLICY <br />LIMIT APPLIES PER; <br />PRO LOG <br />PROOUOTa- COMPIOPAGG <br />$2000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED F7 SCHEDULED <br />AUTOS �. AUTOS <br />HIRED AUTOS NON-OWNED <br />AUTOS <br />COMB -LIMIT <br />Ea eccld <br />BODILY INJURY(Perperso0) <br />It <br />BODILY INJURY Par acnidenl <br />( ) <br />$ <br />PROPERTY DAMAGE <br />Per eccl dog t <br />$ <br />$ <br />UMBRELLA LIAR <br />OXCEae LIAR <br />OCCUR <br />CLAIM &MADE <br />EACH OCCURRENCE <br />$ <br />_ <br />AGGREGATE <br />$ <br />OED I I RETENTION $ <br />IS <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />ANV IoRGPRIETQWPARTNERIEXEGUTIVE Y! N <br />OFFICERIMEMBER EXCLUDED? ❑ <br />(Mandatory In NH) <br />If Ye0, 0I unticr <br />DESCRIPTION OF OPERATIONS helow <br />NIA <br />WG STATU- QTH• <br />E,I., EACH ACCIDENT <br />$ <br />EL, ONNAGE . EA EMPLOYEE <br />EL. DISEASE - POLICY LIMIT <br />$ <br />BaECRIPTIQN GF QPERATIQNP I LOCATIONS 1 VEHICLE$ (Attach AQORD 101, Addalonnl Ramama Schadula, X morn apaoa la required) <br />The City of Santa Ana, 20 Civic Canter Plaza, Santa Ana, California 92702; Its officers, employees, agents <br />and Volunteers are named as additional insureds. <br />Primary and Non Contributory wording included per attached farm 8800000406 <br />The City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ann, CA 02702 <br />ACORD 25 (2010105) 1 of 1 <br />#52660394/M2166529 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTION WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AUTHORIZED REPRgaBNTATIVE <br />© 1988.2010 ACORD CORPORATION. All rights reserved, <br />The ACORD nnme and logo are roglalorod marks of ACORD <br />MS43 <br />