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ECHAN, BARBARA A. 4 -2014
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ECHAN, BARBARA A. 4 -2014
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Last modified
7/6/2016 5:02:14 PM
Creation date
9/15/2014 2:45:23 PM
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Contracts
Company Name
ECHAN, BARBARA A.
Contract #
N-2014-123
Agency
PLANNING & BUILDING
Expiration Date
8/25/2017
Insurance Exp Date
6/1/2016
Destruction Year
2021
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AC61di' CERTIFICATE OF LIABILITY INSURANCE <br />8 /27/2014 ) <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 endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />COMPLETE EQUITY MARKETS INC <br />1190 Flex Court <br />Lake Zurich, IL 60047 dbacompift <br />IneevmeyR Mafit' <br />�1°''1np' <br />NAME: <br />__ <br />PHONE Ax- <br />ArC No Ed. (847)541-0900 PJC, No:(847) 541 -0444 <br />MAa - -- <br />ADDRESS: <br />INSURERIS) AFFORDING COVERAGE <br />NAICN <br />Underwriters at Lloyd's London <br />INSURER A: Y <br />INSURED Barbara Echan <br />INSURER B' <br />3056 Madeira Avenue <br />Costa Mesa CA 92626 /C/'o����/ 023 <br />INSURER C: <br />INSURER ___ _ <br />D: <br />INSURER E' <br />_ <br />INSURER F' <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />TI41S 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 />Man <br />TYPE OF INSURANCE <br />ADDL <br />INSO <br />su R <br />vivo <br />POLICY NUMBER <br />yy <br />VYYFF <br />I I MM /DD/YYYY) <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE C OCCUR <br />EACH OCCURRENCE <br />$ <br />_ <br />PREMISES Ea occurrence) <br />$ <br />_ <br />MED ESP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER <br />POLICY u PRO- �._I LOS <br />GENERAL AGGREGATE <br />$ <br />GEN'L <br />_ <br />y� p <br />A 11� V P AS <br />O DORM <br />PRODUCTS - COMP /OP AGO <br />$ <br />If <br />OTHER', <br />AUTOMOBILE <br />LIABILITY <br />Ea OINE nt SINGLE L <br />$ <br />BODILY INJURY (Per person) <br />— <br />$ <br />ANYAUTO <br />VftoMey <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS AUTOS <br />yr <br />City R• 0 <br />City <br />BODILY INJURY (Per accident) <br />$ <br />pe� accident E <br />s <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAR <br />CLAIMS MADE <br />AGGREGATE <br />$ <br />DED I RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRINTOR,PARTNERIE-XECUTIVE <br />GFFIGGRIMEMDER EXCLUDED? C <br />N/A <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />C-.L DISEASE -EA EMPLOYE <br />—. -. <br />. $ <br />(Ma'c"bam in NH) <br />1 /yyes, describe under <br />DE$CRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />- <br />$ <br />$1,000,000 Each Claim <br />A <br />Professional <br />853614 <br />06/01/1906/01/15 <br />$1,000,000 Aggregate <br />Liability <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) <br />This is a four page certificate. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Aria <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Civic Center Plaza (M -20) <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P O Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />©1988- 2013ACORD CORPORATION. All rights reserved. <br />ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD <br />
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