|
COMMU5 OP ID: HE
<br />.d � ''
<br />I%A CERTIFICATE OF LIABILITY INSURANCE
<br />DAO 29113
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endoreament. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such andoreamentiII&L
<br />PROCVCM 909.435 -0230
<br />Sawyer Cook insurance 909.798.7971
<br />1200 California St., Ste 264
<br />Redlands CA 92374
<br />xAMe:
<br />PNONE
<br />L
<br />SoodWili{amson
<br />_.__._- -- - ---�^
<br />INSURER$ AFFORDING COVERAGE
<br />NAICN
<br />WsuRERA:Ssndnel Insurance Co. Ltd
<br />11000
<br />2,000,00
<br />INSURED Westbound Communications, Inc.
<br />Wsunaga 1Atlantic Specialty Inc Co
<br />27154
<br />Scott Smith
<br />625 The City Dr„ Ste 360
<br />Orange, CA92$8$
<br />WSURERC:
<br />05106/14 .,
<br />d „-
<br />-
<br />WSUH,FR E:
<br />� V q .y
<br />PERSONAL AAW INJURY
<br />£
<br />COVERAGES CERTIFICATE NUMBER: 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 SEEN REDUCED BY PAID CLAW,
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNEREO IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />IN RT
<br />ADD,
<br />TYPE OF WSUR4NCE
<br />P YNUMa
<br />Pajoy UP
<br />Umm;
<br />AUU,T.HHO,R/UED
<br />GENERAL LUUM ITY
<br />EACHOCCURRENCE
<br />S
<br />2,000,00
<br />pRE Er aaawrena l .
<br />M80ESP tAPg one PentMl
<br />s
<br />300,00
<br />A
<br />I X 72SSAAE3737 05108113
<br />CLAIM &MADE X7 OCCUR
<br />05106/14 .,
<br />d „-
<br />_10,00
<br />PERSONAL AAW INJURY
<br />£
<br />2,000,00
<br />i GENERALACGREGATB
<br />$
<br />4,000,00
<br />PRODUCTS. COMPttV+AGG
<br />f
<br />1,000,00
<br />LIMIT APPLIES P
<br />GEN'. AGGREGATE ER:
<br />POGCY I `�E PRO. M Loc
<br />S
<br />AUTOMONU LABILITY
<br />A ANY AUTO
<br />2SSAAE3737
<br />06/06/13
<br />06106/14
<br />aIN D I LIM ..—
<br />t
<br />2,000,00
<br />BODILY INJURY (Per persm)
<br />6
<br />RUTCS AUTSCHE�GUt €D
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />DOORYINJURY1Px.*.4}
<br />S
<br />OPERTY "AIA
<br />receide t
<br />S
<br />£
<br />'
<br />uMaREt3A WB OOCJA
<br />-
<br />EACH OCCURRENCE
<br />$
<br />EXCESS LAB OLAIAI6,MAOE�
<br />ADOREOATE
<br />$
<br />CEO, ParewmNS
<br />£
<br />_
<br />AND EMPSLOCYOEtRMS'B'NSALIT Y VfN B ANY NARTN Rx[GUnvE CLR3733 09128!12 9
<br />OFFICER MEMSER NA I
<br />(MMaaNn} I ,
<br />t0yyeeaa� i
<br />ESC,AUIP ONOFOTPERATIONSbel. i
<br />X TFl�CS A H.
<br />— ,L. EACH ACCIDENT —
<br />r
<br />'E.L. DISEASE_ -EA EMPLOYEES
<br />IEl. DISEASE POLICY LIMIT
<br />$
<br />1,tl60,00
<br />1,000,00
<br />S
<br />1,000,00
<br />A Professional Llab j 'MEP1072912 09126113 09125114
<br />Aggregate
<br />2,000,00
<br />-Dad
<br />10,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAluch ACORD M, AddMoRwI RemeeA Scheduk, R man,pear la eeuired)
<br />e10 day notice of Cancellation for non- payment of praminm> City of Santa Ana
<br />is named as additional insured with Primary and Non - Contributory wording
<br />with respects to general liability per attached SS00080405,
<br />M -'PROVED AS TO FORM
<br />CERTIFICATE HOLDER "y`°"'"'`-tr �''^a. -a--r� ,f a��`' CANCELLATION
<br />91988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD
<br />aul
<br />C NTANA
<br />AssiS 9Dt City Attorney
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 8EFORE
<br />CI of Santa Ana
<br />CY
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNEREO IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />AUU,T.HHO,R/UED
<br />91988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD
<br />
|