CARD METERING SYSTEMS, INC (2).- 2014

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M v3 A{CC&_ CERTIFICATE OF LIABILITY INSURANCE 5/1/2019 DATE YYY) THIS CERTIFICATE IS 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(les) 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 endarsernent(s). PRODUCER Ambassador Group Inc. 7010 E Chauncey Ln Ste 230 Phoenix AZ 85054 ONOMNT ffT Laurie SCOla PNDNE (4S0)776-6950 FAX No)' (46U)9966931 pppRIE S,lscola@ ambaa a ado riITa. com _ WSURER(S) AFFORDING COVERAGE a INSURER A National Fire Insurance Com Et _NAICk 0478 INSURED Card Meter Systems Inc. dba CMS 7056 Archibald Ave Ste 102-453 Corona CA 92880 INSURERS:Transp2rtation Insurance N� 20494 INSURERCi_Em_plo ers Comoernsation INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 MAster 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 ITR 'rypE OF INSURANCE ADD BR POLICY NUMBERD POLICY EFF POLICY EXP V LIMITS GENERAL LIABILITY EACH OCCURRENCE y�ff $ 1,000,000 $ 300,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS-MAOE lil OCCUR X 4025961553 5/1/2014 /1/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMTr APPLIES PER: _GENERAL PRODUC FS•COMP/OP AGO $ 2,000,000 POLICY 0 PRO X LOC $ AUTOMOBILE LIABILITY COMBINED SI GLE 0191T 1 000 000 BODILY INJURY(Per person) $ B Ix ANY AUTO ALL OWNED SCHEDULED AUTOS X NON OWNED HIRED AUTOS � ALTOS 4025961505 5/1/2014 5/l/2015 BODILY INJURY(Per aeUdeni $AUTOS __ PROPERTY DAMAGE a i n IL $ _ Uninsured moladsl rq prl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEB I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPMETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA IG2097823-00 5/1/2014 /1/2015 X WCSTA'I'U OTH. 0@Y1N117 E.L. EACH ACCIDENT $ l 000 000 E.L. DISEASE- EA EMPLOYE $ 11000,000 2es, dasoriUe under SCRIPTION OF OPERATIONS below El DISEASE -POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, Additional Rountree Schedule, Ignore space is required) Coverage subject to policy forma, terms and conditions.City of Santa Ana, its officers, agents and employees and xepreaentatives is Named as Additional Insured - Designated Person or Organization. insurance is primary & non-contributory. 'Fo�A APP'ROVE1� �8 � 4 A tsTORCK City of Santa Ana Parks, Recreation and C Services Agency Attn: Silvia Cuevas 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Scola/ARE G `_ ( �`,� _e ._ ACORD25 INS025,9ninneeni Thu Ar.npn namn and Innn .rn rnnl.fnrwd mark. of Ar.nPn rights reserved.