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SANO, CHIHIRO 1C - 2015
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SANO, CHIHIRO 1C - 2015
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Entry Properties
Last modified
2/14/2018 2:47:55 PM
Creation date
12/16/2014 9:16:58 AM
Metadata
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Template:
Contracts
Company Name
SANO, CHIHIRO
Contract #
N-2012-026-003
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
12/31/2016
Insurance Exp Date
12/8/2016
Destruction Year
2022
Notes
Amends N-2012-026, -001, -002
Document Relationships
SANO, CHIHIRO 1 - 2012
(Amends)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2022
SANO, CHIHIRO 1A - 2013
(Amends)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2021
SANO, CHIHIRO 1B - 2014
(Amends)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2022
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uATE (MM/Dury <br />A� CERTIFICATE OF LIABILITY INSURANCE 11/10/2014 <br />PRODUCER <br />Maguire Insurance Agency, Inc. <br />27101 Puerta Real Suite 200 <br />Mission VIA , CA 92691- <br />877.438.7459 <br />Chlhir. San. <br />106 Yorktown Ln <br />Costa Mesa, CA 92626 - <br />COVERAGES <br />THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADD'L <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LTR <br />(NEED <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE(MM/DD/YYYY) <br />DATE(MM/DD/YYYYI <br />LIMITS <br />A <br />% <br />GENERAL LIABILITY <br />PHPI(803569 003 <br />12/08/2014 <br />12/08/2015 <br />EACH OCCURENCE $1,000,000 <br />PREMISESEa�urrence $100,000 <br />MMERCIALGENERAL LIABILITY <br />TC"h <br />CLAIMS MADE 171OCCUR <br />MED E%P(Anyone person) $2,500 <br />PERSONAL& ADV INJURY $1,000,000 <br />FESSIONAL LIABILITY <br />GENERAL AGGREGATE $3,000,000 <br />PRODUCTS—COMP/OPAGG $3,000,000 <br />GEWL AGGREGATE LIMIT APPLIES PER, <br />% POLICY PROJECT LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANYAUTO <br />(EA accident) <br />BODILY TNI DRY <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per person) <br />BODILY INJURY <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY— EA ACCIDENT <br />OTHERTHAN EA ACC <br />ANY AUTO <br />AUTO ONLY: AGG <br />EXCESS/ UMBRELLA LIABILITY <br />f <br />^YT <br />EACH OCCU RENCE <br />OCCUR El CLAIMS MADE <br />•F`e,\Ned <br />V <br />AGGREGATE <br />DEDUCTIBLE <br />RETENTION <br />WORKER6 COMPEN/NAI I Cal AND <br />OTIi- <br />OFFICRR/NERM9RR%LUDED%EXECUTIVE EMPLOYERS' LIABILITY YN <br />ru.i'``�`G <br />u7�Gs! <br />TORYLIMITS ER <br />E.L. EACH ACCIDENT <br />EL. DISEASE — EA AMPLOYEE <br />(Mandatary in NH) <br />Ify describe under <br />SPECIAL PROVISIONS below <br />I <br />"� <br />P <br />I E.L. DISEASE— POLICY LIMIT <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Itis understood and agreed that the following entityls added es an edditiesur sured butonly with retreads) to the operations of the named Insured except that liability resulting from the additional Insured's sole <br />negligence. <br />CERTIFICATE HOLDER CANCELLATION <br />City Of Santa Are, Its officers, employee, agent, representatives & volunteers <br />20 Civic Center He <br />Santa Ana, CA 92701- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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